A 73-year-old man is the latest Covid-19 fatality in Guam, bringing the territory’s death toll to 197, as the territory’s health system struggles with cases.

The fully vaccinated man had underlying health conditions and was one of two deaths on Wednesday at Guam Memorial Hospital. An unvaccinated 59-year-old male died earlier that day.

Guam’s health system has struggled to keep up with the increased hospitalizations due to a shortage in nursing staff, so U.S. Army Reserve nurses have been brought in to help in the emergency room and intensive care unit of Guam Memorial Hospital.

“Once again a family is faced with devastating loss,” said Gov. Lou Leon Guerrero in a Joint Information Center update. “We mourn with them as a community and for each person affected by this virus.”

But almost 88% — 119,436 people — of Guam’s eligible population had completed their vaccination series. The problem is a shortage in nursing staff, according to Guam Army National Guard state surgeon Dr. Mike Cruz.

Cruz said the struggles to date were due to a high demand for nurses worldwide, who were being offered more than $100 an hour. Guam was not only unable to afford to bring nurses in, but it was also losing nurses.

“When you come to a surge, the most important thing is to … protect the health care system. So all resources need to go toward making sure that’s not getting overwhelmed,” Cruz said Wednesday.

The reservist nurses would continue to help at Guam Memorial Hospital through the end of October, and continue to help with Covid and non-Covid patients.

Fifty-eight people had been hospitalized with the virus as of Wednesday and 35 were unvaccinated, while 144 new cases had been identified.

Among the positive cases were three education workers from Daniel L. Perez Elementary School, Finegayan Elementary School and Tiyan High School, and contact tracing was underway, according to the Joint Information Center.

Booster shots have been made available to those aged 65 and above, and to those 18 and over with underlying health conditions.