KANSAS (AP) — Many overwhelmed hospitals, with no beds to offer, are putting critically ill COVID-19 patients on planes, helicopters and ambulances and sending them hundreds of miles to far-flung states for treatment.

The delta variant of the virus, combined with low vaccination rates in many states, is causing a surge that has hospitals scrambling to find bed space — even if it means sending patients far away from home.

The issue is that large hospitals in urban areas already were full and struggling with staffing problems when the outbreak started.

That means they have no free beds to offer to patients from small rural hospitals without ICUs. In some cases, the larger hospitals also are looking to transfer out some of their own patients to relieve the strain.