Window Rock, Ariz. • Navajo Nation health officials on Tuesday reported 159 new COVID-19 cases and six more deaths.

In all, the tribe has now reported 18,324 cases and 688 know deaths since the pandemic began.

Navajo Department of Health officials said over 175,000 people on the vast reservation that includes parts of Arizona, New Mexico and Utah have been tested for COVID-19 and more than 10,000 have recovered.

But officials have identified 77 Navajo Nation communities with uncontrolled spread of the coronavirus since late last month.

Tribal officials said nearly all intensive care unit beds on the reservation are being used as coronavirus cases surge.

They warn that the tribe is nearing a point where health care workers will have to make difficult decisions about providing care with limited hospital resources.

“Our health care system is still in a state of crisis,” Navajo Nation President Jonathan Nez said in a statement Tuesday. “We have to do everything we can to bring down the number of new COVID-19 cases.

The tribe has extended its stay-at-home order though Dec. 28 in an attempt to stop the spread of the virus.