DURHAM, N.C. (WNCN) – Duke hospitals are at more than 90 percent capacity.

As COVID-19 cases continue to climb, health leaders are looking for ways to make room for a possible surge.

At Duke Raleigh Hospital in Raleigh, there are only 22 patients with COVID.

There are 71 COVID patients thorough the entire hospital system.

If there is a surge, CBS 17 is told that there is no place for non-COVID patients to go.

“Our COVID patients occupy a pretty small amount of our beds,” explained Dr. Lisa Pickett, the chief medical officer for Duke University Hospital.

Only 4.3 percent of the beds at her hospital are filled with COVID patients.

So, who’s taking up the rest of the 1,000 spots?

“People who are very sick and require a lot of care, plus the COVID patients, and then we have difficulty discharging patients to skilled nursing facilities and rehabilitation facilities,” said Pickett.

She told CBS 17 people are staying in the hospital longer.

“They can end up staying here for weeks or months waiting for an appropriate place,” added Pickett.

They’re in limbo because those facilities have lack of staff and space to care for more patients.

The North Carolina Health Care Facilities Association reports the average nursing home has more than 21-unfilled nursing jobs.

Around 12,000 nurses are needed in these facilities across the state.

“They have the same staffing difficulties that everyone else does,” explained Pickett. “There’s also a shortage in our state of facilities that meet the needs of the patients we have.”

The lengthy insurance process also plays a part.

“By the time you get the [insurance] approval, the beds are not available,” said Pickett.

Her team is worried about the next couple of months.

“[It’s going to be] a double whammy of a very contagious variant and everyone is going to be traveling and in big groups and with people they don’t live with,” she said. “So, we expect [COVID] to spread a great deal.”

Pickett’s staff is already working on backup plans in anticipation.

“The things we can do to decrease capacity, are the number of elective procedures,” she said. “But of course, we don’t want to do that.”

Pickett told CBS 17 people are coming into the hospital sicker than ever because they have not taken care of themselves during the pandemic.

She is encouraging everyone to get their flu shots, COVID shots, and take any preventative measures, to help.