Texas recorded an all-time daily high of 5,489 new Covid-19 cases on Tuesday as hospitals neared capacity in Houston. The dramatic increase in cases prompted the governor, Greg Abbott, to tighten public health restrictions after resisting calls to slow the state’s reopening process. Cases have steadily increased in Texas since March, but a surge in the past two weeks has activated concerns about the state’s ability to respond. To cope with the surge, some adult ICU patients are being treated at Texas Children’s hospital in Houston, the country’s fourth-largest city. “Just like that – in Houston we, the pediatricians at Texas Children’s Hospital, will now start seeing adult patients,” tweeted pediatrician Shubhada Hooli. “I’m up for the challenge, but please help us out. #WearAMask and stay home. I guess its time to retire my giraffe reflex hammer…” Adult patients at the children’s hospital will be treated for serious health issues including Covid-19. Those who test positive for the illness are being treated in a special isolation unit. “Texas Children’s is committed to providing additional capacity through ICU and acute care beds across our hospital campuses to take on both pediatric and adult patients,” the hospital said in a statement. In response to the hospital admitting adults, its endowed chair in tropical pediatrics, Dr Peter Hotez, tweeted: “We knew this day would come, I thought perhaps later this summer or fall, but the exponential rise came a bit early.” Houston’s Texas medical center, often referred to as the largest medical center in the world, showed its ICU beds were at 97% of normal capacity. The hospital has maximum capacity for nearly 1,000 more ICU beds if it activates its plans for public health emergencies. The surge in cases in Texas and increase in hospitalizations has been accompanied by a higher rate of positive tests. These are indicators cases are not increasing just because more people are being tested. The head of the Houston Methodist hospital system, Dr Marc Boom, wrote in an email to employees on Friday: “We appear to be nearing the tipping point.” In the email, seen by the Texas Tribune, Boom continued: “Should the number of new cases grow too rapidly, it will eventually challenge our ability to treat both Covid-19 and non-Covid-19 patients.” Texas was one of the first states to reopen, prompting Donald Trump to praise Abbott’s leadership of the state during the pandemic. At a meeting in the White House in May, the president said of Abbott: “I rely on his judgement.” In the face of criticism that Texas was reopening too quickly, Abbott had insisted the state could contain any new outbreaks. But the skyrocketing number of cases have prompted him to reverse course. Abbott tightened lockdown restrictions on Tuesday – one day after declaring that Texas would remain “wide open for business”. “We want to make sure that everyone reinforces the best safe practices of wearing a mask, hand sanitization, maintaining safe distance, but importantly, because the spread is so rampant right now, there’s never a reason for you to have to leave your home,” Abbott told local news station KBTX-TV on Tuesday. “Unless you do need to go out, the safest place for you is at your home.”