Texas officials and funeral home directors are ordering extra body bags and refrigerated trucks as they prepare for an increase in deaths from Covid-19, which has already killed 3,657 in the state.

The Federal Emergency Management Agency is sending 14 refrigerated trucks to the state next week — on top of the eight already sent — to serve as temporary mortuaries, while some funeral homes are reserving their own trucks from private companies.

“The directors I’ve talked to in the last week are at capacity or over capacity, thus the reason they had to bring in the trailers,” said Gene Allen, president of the Texas Funeral Directors Association.

Travis County, where Austin is located, is in the process of procuring three extra mortuary trucks “out of an abundance of caution,” public information officer Hector Nieto said in an interview.

The state doesn’t yet need the additional mortuary trucks, said Seth Christensen, a spokesman for the Texas Division of Emergency Management. They are on standby in case local municipalities get overrun with Covid-19 deaths. 

“We want to be on top of this and prepared in case we have the need,” Christensen said. 

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FEMA sent eight mortuary trucks to Texas in early April when the state was reporting fewer than 1,000 new cases a day, according to the Texas Department of State Health Services. The case count has climbed dramatically since then to a record 10,791 new cases on Wednesday, according to the state. On Thursday, 10,291 new infections were confirmed.

Deaths and hospitalizations haven’t risen as quickly in recent weeks, but epidemiologists say that’s because it can take a while after someone is diagnosed before they are hospitalized and die. Some patients wage particularly lengthy battles before succumbing to Covid-19, like Broadway actor Nick Cordero who died earlier this month after spending more than three months in the hospital.

With cases surging in Texas, the rise in hospitalizations isn’t far behind. Covid-19 hospitalizations stood at 10,457 on Thursday, up more than fourfold from 2,518 a month ago, according to data compiled by the Covid Tracking Project, a volunteer project started by journalists at The Atlantic. 

And deaths in Texas have already started to climb, averaging 93 per day on Thursday, based on a seven-day average, up from around 20 deaths per day a month ago, according to Hopkins. 

The outbreak has local officials scrambling to set up testing facilities and ramp up their hospital capacity. Houston, the nation’s fourth-largest city, is “facing a situation where our numbers have surged. More people are testing positive, showing up in our hospitals and our ICUs,”  Mayor Sylvester Turner said on a conference call with New York Gov. Andrew Cuomo on Thursday.

Cuomo said New York has sent teams to Houston to help set up testing sites and partner with churches, delivering hand sanitizer, personal protective equipment and testing kits.

The coronavirus is hitting particularly hard in the southern part of the state, which has a higher Hispanic population and lower incomes on average compared with the rest of Texas. That has local officials concerned. Epidemiologists have found that Black and Hispanic people have been dying at a disproportionately higher rate from Covid-19 than White people.

Officials in Hidalgo and Starr counties, near the Mexican border, have previously warned that their hospitals were already at full capacity and urged residents to shelter in place and avoid large gatherings. Hidalgo County reported 150 Covid-19 deaths on Tuesday, more than triple the number since July 1, according to the Texas Department of State Health Services.  

The U.S. Department of Defense is deploying the Army Urban Augmentation Medical Task Force to the Rio Grande Valley, which composes of the southernmost tip of Texas, to provide extra doctors, nurses and other health workers to local hospitals, Gov. Greg Abbott said Wednesday.

The economic numbers are stacked against Hidalgo County as well. The median household income is about $38,398, more than 32% of its residents under 65 don’t have health insurance and 30% of all residents live in poverty, according to U.S. Census data collected from 2014 through 2018. Across the U.S., the median income was $60,293, roughly 10% of all Americans didn’t have health insurance and 11.8% lived in poverty by comparison. 

The Texas heat might not help things either, experts have warned. People over the age of 65 are most at risk of heat-related illness and the coronavirus. While roughly 90% of U.S. households have air conditioning, according to federal census figures, a disproportionate number of low-income and minority families don’t.

The Texas Funeral Directors group has sent three of its four refrigerated trucks, typically used during hurricane season, to South Texas, Allen said. 

“I quit trying to guess this thing,” he said when asked how the Covid-19 crisis outbreak could compare to other natural disasters. “South Texas has just been hit hard.” 

Timothy Brown, manager of Ric Brown Family Funeral Home in McAllen, Texas, which sits in Hidalgo County, said up to 85% of the inquiries he’s received in the last 15 days have been for Covid-19 fatalities. The funeral home is scheduling services about seven to eight days out when usually the wait time is a few days, he said. 

“I’ve spoken to about five funeral homes all in the same situation,” Brown said. “The deaths here in Hidalgo county are very bad. Most funeral homes are at full capacity.” 

Funeral homes just north of Hidalgo are starting to prepare as well. John Winstead, a funeral home manager at Seaside Funeral Home and Memorial Park in Corpus Christi, said his funeral home reserved an additional truck through a private company in case space is crunched, although they aren’t at capacity yet. 

Corpus Christi, in Nueces County, sits about two hours north of Hidalgo along the Gulf of Mexico. Nueces County Judge Barbara Canales told local NBC affiliate KRIS-TV last week that she received a letter from the county’s medical examiner requesting an additional FEMA mortuary truck. Nueces County has reported 50 additional deaths since July 1, according to Texas’ DSHS. A spokesperson for Canales wasn’t available for comment. 

“I am now having to order additional body bags and morgue trailers,” Canales said. “People have to understand how real it is.”