(AP) — The number of people being treated for the coronavirus in Iowa hospitals continued to soar Monday, prompting doctors and hospital officials to warn their facilities and staff could be overwhelmed without serious efforts to curtail the virus spread.

Data from the Iowa Department of Public Health indicated 1,469 new confirmed cases and 17 additional deaths in the past 24 hours. That follows a weekend in which more than 2,800 new cases were reported each day.

The seven-day rolling average of the positivity rate in Iowa has risen over the past two weeks from 25.5% on Oct. 18 to 36.4% on Sunday, according to researchers at Johns Hopkins University. Iowa’s rate is now third in the nation behind South Dakota and Wyoming.

All 99 Iowa counties have a positivity rate above 7.5% and 46 are above 15%, an indication that the virus is aggressively spreading statewide.

Health care professionals said increased hospitalizations typically follow higher positive case rates, leading to concerns that Iowa hospitals could soon be overwhelmed with COVID-19 patients.

University of Iowa Hospitals and Clinics CEO Suresh Gunasekaran said Iowa is entering it’s third peak, one that is higher than previous ones in May and July. His biggest concern is that this peak is at the beginning of the cold weather season during which the flu and other respiratory conditions typically increase illness and hospitalizations.

“The infection rate is definitely a leading indicator for hospitalizations and the hospitalization rate is a leading indicator of mortality,” he said.

If all Iowans start wearing masks, not gathering in crowds and staying distant from one another there would be a lag of a couple of weeks before we would see impact of the actions, he said.

“At this present infection rate we fully expect the hospitalization rate to increase at least another week to 10 days. What it does after that is really in the hands of Iowans,” he said.

Iowa reported 718 people infected with the coronavirus in hospitals Monday, the highest number since the beginning of the pandemic. There were 80 long-term care centers with outbreaks.

Gov. Kim Reynolds, who has been campaigning for Republican candidates in the past few weeks and has held no statewide press conference for much of October to update Iowans about the situation. She hasn’t announced any new initiatives or mitigation efforts. More than 370 Iowans died during October.

Reynolds spokesman Pat Garrett said the governor and her team have been monitoring the numbers, talking with hospital officials about resources and capacity and briefing local radio and television stations as she traveled the state campaigning ahead of Tuesday’s election.

“She plans to hold a news conference later this week to update Iowans on the state’s response,” Garrett said.