The sweeping order would affect health care providers in the state’s largest counties, including Harris, Dallas, Travis, and Bexar counties. “These four counties have experienced significant increases in people being hospitalized due to COVID-19, and today’s action is a precautionary step to help ensure that the hospitals in these counties continue to have ample supply of available beds to treat COVID-19 patients,” wrote Abbott.

The state’s health department said there were nearly 4,400 hospitalized COVID-19 patients in Texas as of June 24. One month ago, that number stood at 1,600. And the number of available hospital beds and intensive care unit beds have plummeted over the past few weeks with an influx of patients, especially in these major metropolitan areas, according to state data.

There have been more than 2,200 new daily cases since the beginning of the month, leading to extraordinary measures such as admitting adult patients to Texas Children’s Hospital to make up for a lack of resources.

That helps explain Abbott’s Thursday decision to once again halt elective surgeries in certain regions, as well as a pause on any further reopening of the Lone Star State. Abbott’s announcement does not, however, reverse other reopenings already underway, including many bars, restaurants, and other commercial venues.

Hospitals in the affected locales may face a cash crunch given how much money elective procedures bring in to health systems. And these procedures are by no means cosmetic. They can encompass everything from hip replacements to cancer biopsies.