Nurses across Texas are alarmed at the recent spike in COVID-19 cases, and hospitals in several major cities were at capacity in November, according to the Texas Nurses Association.

Texas had close to a million COVID-19 cases as of Nov. 10, 2020, meaning one in 10 American cases and one in every 50 cases worldwide was Texas. The Texas Nurses Association, a statewide organization of registered nurses, called on local and state officials to encourage Texans to wear masks as a public health measure.

“We urge every resident of Texas to wear masks and practice physical distancing to reduce the spread of COVID-19,” the organization said in the news release. “Just like wearing a seat belt or helmet, masks are uncomfortable but lifesaving.”