With thousands of workers still thought to be holding out, hospital administrators prepared contingency plans that included cutting back on noncritical services and limiting admissions at nursing homes.

Gov. Kathy Hochul said this weekend she was prepared to call in medically trained National Guard members and retirees, or vaccinated workers from outside the state, to fill any gaps. The governor has held firm on the mandate in the face of pleas to delay it and multiple lawsuits challenging its constitutionality.

All health care workers in New York state at hospitals and nursing homes are required to be vaccinated with at least one dose of the COVID-19 vaccine by Monday. Employees who refuse the shots face suspensions and termination.

The rules apply not just to people like doctors and nurses, but also to others who work in health care institutions, like food service workers, administrators and cleaners.

The mandate comes as hospitals are already reeling from staff shortages fueled in part by workers retiring and employees seeking other jobs after 18 months of the pandemic.

Health care workers can apply for a religious exemption, at least for now. A federal judge on Oct. 12 will consider a legal challenge arguing that such exemptions are constitutionally required.

More health care and Big Pharma coverage from Fortune:

• Nearly 1 million U.S. children have contracted COVID in the past 4 weeks
• A doctor’s journey to recognize her own mental health
• New models show COVID cases could drop tremendously through March
• 43.7% of the world’s population has received a COVID vaccine. See the rate in your country
• When to expect COVID vaccine booster shots