MISSION, Kan. (AP) — Hospitals in Kansas and Missouri are delaying surgeries, turning away transfers, holding patients in emergency rooms while they wait for beds to open up and desperately trying to hire traveling nurses as COVID-19 cases double and triple before the holidays in an eerie reminder of last year.

Dr. Steve Stites, chief medical officer for the University of Kansas Health System in Kansas City, Kansas, said in a news conference Friday with hospitals throughout the region that he is particularly alarmed that the surge is coming even before the omicron variant hits the region in full force.

"Hospitals are full," he said. "There's no place to go. Our staff are tired. We're going to run out of travelers and Omicron is at our doorstep. This is a tornado warning to our community."

In Merriam, the number of COVID-19 patients with active infections at AdventHealth Shawnee Mission tripled from 12 in mid-November to 37 as of Thursday, said Dr. Lisa Hays, the hospital's chief medical officer. The hospital is also facing an increase in transfer requests from places like Minnesota and Oklahoma.

"A large part of the week for me has been spent helping manage how to juggle all those transfers," Hays said. "We're in a bed crunch."

Stites said his hospital normally accepts 65 to 70% of the transfer patients; it is now accepting less than 30% of them.

"We simply don't have the beds," he explained. "And even if you have a bed, sometimes it's very difficult to find staff. So these are difficult times."

At Children's Mercy, 14 patents are hospitalized with acute COVID-19 infections, three in the intensive care unit. The number of positive results from its walk-in and drive-through testing clinics has doubled to 400 from 200 over the past two weeks, said Dr. Jennifer Watts, the chief emergency management medical officer.

She said the lifting of mask mandates in several area school districts is "extremely" concerning, adding that it comes as nurses are in short supply and flu season is beginning. She's worried "that we're going to see schools shut down" because of illness.

The number of COVID-19 patients rose so sharply at the University of Kansas Health System's St. Francis campus in Topeka, that it delayed eight surgeries that were scheduled for this week, said Dr. Jackie Hyland, the hospital's chief medical officer.

"Those phone calls are incredibly difficult," she said. "Patients are upset. A lot of them are crying and don't understand."

University Health's campuses in Kansas City, Missouri and Lee's Summit, Missouri, have 62 COVID-19 patients who are filling up nearly 20% of the hospitals beds. That is double the number of patients the hospital had a week ago and six times higher than a month ago, said Dr. Mark Steele, executive chief clinical officer.

The percentage is even higher at Olathe Health in Kansas, where 41 COVID-19 patients are filling up 27% of its beds, said Dr. Elizabeth Long, the hospital's chief medical officer.

"We are struggling to with our staff. They are tired, they are overworked and we continue to ask them to do more and more with these volumes. And so we are anticipating issues with our travelers," she said, noting that their contracts are expiring. "So the next few weeks are going to be critical as far as the ability to take care of patients.

Dr. Kim Megow, chief medical officer for HCA Midwest Health, said staffing is worse than it was a year ago.

"Every hour, we are constantly monitoring how many nurses we need, how many can we get. When can they get here? How long can they stay? What do we need to pay them?"

Dr. Jennifer Schrimsher, an infectious diseases physician at Lawrence Memorial Hospital in Kansas and deputy public health officer for Douglas County, recommended people rethink holiday plans.

"I would look for smaller gatherings, trying to stay with your own household, not traveling across the U.S. You know, if it's nice, open the windows, wear your mask when you're not eating. All the things we've been saying since pretty much day one."

Meanwhile, the omicron variant has been detected for the first time in Missouri wastewater.

A lab at the University of Missouri went back through samples from as early as March. The variant appeared in low levels in one sample collected on Dec. 7 from a Jackson County treatment facility and another sample collected one day later at a St. Joseph facility, the Department of Health and Senior Services announced Friday in a news release.

The state also has confirmed a case in a St. Louis resident.

Donald Kauerauf, the department's director, urged residents to "be vigilant" and get vaccinated if they haven't yet done so.