O’FALLON, Mo. (AP) — Missouri’s health department is reporting the highest daily count of new COVID-19 cases since the dead of winter, and the association representing the state’s hospital has warned that the health care system is potentially on the brink of a crisis.

The Missouri Department of Health and Senior Services cited 2,302 newly confirmed cases of the virus on Thursday, the largest one-day count since mid-January, as the delta variant continues to spread in a state with one of the nation’s lowest vaccination rates.

The Missouri Hospital Association, in its weekly COVID-19 update, calls the situation in southwestern Missouri “dire” and says signals for the rest of Missouri are “foreboding.”