By The Associated Press

INDIANAPOLIS — Indiana has nearly recorded its most COVID-19 deaths for a single month with a week remaining as health officials on Tuesday added 103 more deaths to the state’s pandemic toll.

The Indiana State Department of Health’s daily update included the new deaths mostly occurring over the past several days through Monday, and which push November’s total to at least 991.

Indiana’s monthly high for COVID-19 deaths was 1,041 in April, when at most the state’s moving seven-day average was 42 fatalities a day. That daily average has now reached 51 as Indiana’s hospitals are treating nearly double the number of coronavirus patients as at any point since seeing their first infections in March.

Coronavirus hospitalizations have reached a level where health care leaders say the system is becoming overwhelmed and some hospitals have started rationing care to treat those most severely ill.

Indiana hospitals were treating 3,279 COVID-19 patients as of Monday — a more than 300% increase since late September when Gov. Eric Holcomb lifted nearly all business and crowd size restrictions before reinstating some limits this month.

Indiana has now recorded 5,435 coronavirus deaths, including both those with confirmed and presumed infections.