Several Nebraska communities recently joined Omaha and Lincoln in requiring the use of masks – although Gov. Pete Ricketts has resisted calls, including one made by the Douglas County Board of Commissioners, to bring uniformity via a statewide mandate.

Eight of the state’s 10 largest cities have adopted mandates, although the state’s third-largest city, Bellevue, doesn’t have one.

Ralston, La Vista and Gretna adopted mask requirements last week. Other cities recently adopting mandates include Norfolk, Beatrice, Hastings and Fremont.

Papillion has been considering adopting a mask mandate, with special council meetings scheduled Wednesday and Thursday.

Bellevue’s mayor has said he lacks the authority to issue a mandate.

“Fortunately, individual businesses and organizations have the right to enact their own policies and many have put their own masking policies in place in our area,” Mayor Rusty Hike said in a Nov. 16 statement.

The recently established mandates mean more than half of the state’s 1.95 million people live in a community that requires masks to be worn in indoor public settings. Most cities with mandates are located in eastern and central Nebraska.

Officials in the more conservative western Nebraska have said they were encouraging people to wear masks but not requiring it.

In Grand Island, Dr. Rebecca Steinke, who serves on the local board of health, told the city council that she’s worried that hospitals will be overwhelmed if the recent surge in COVID-19 cases doesn’t slow down.

“The numbers of COVID tests that came back positive in the last week confirm we’re already on that trajectory,” Steinke said. “It will be almost impossible to safely contain and properly care for that surge of patients, even with plans to double up rooms or use beds that are not meant for sick people. If things do not change soon, rationing of care will become a reality.”

Ricketts has relied on educating people about the benefits of wearing masks, which he regularly urges people to do. Ricketts said he believes – based on his own observations – that more people are wearing masks and following other social distancing rules on their own. And the state does require masks in businesses where employees have close contact with customers for more than 15 minutes, such as salons.

The number of people in Nebraska hospitalized with the coronavirus dipped below 900 for the first time in more than two weeks Sunday, but hospital capacity remained strained across the state. The possibility of new cases following the Thanksgiving holiday also adds to the uncertainty about future hospitalizations.

The state said that 896 people were hospitalized with COVID-19 statewide on Sunday, nearly 100 patients below the record of 987 set on Nov. 20. Hospitalizations had nearly quadrupled since the start of October when 227 people were being treated in hospitals.

As of Sunday, coronavirus patients occupied 22% of the state’s hospital beds. Ricketts has said that he will impose additional restrictions if coronavirus patients start to take up 25% of the hospital beds.

“We’re going to really manage this around hospitalizations, so we can provide that hospital bed, that ICU bed or that ventilator to anybody who needs it when they need it,” Ricketts said.

In board action last week, the Douglas County Commissioners called on Ricketts to reconsider his position, noting that Omaha’s mask mandate doesn’t extend to the rest of the county and the Douglas County Board of Health lacks the legal authority to implement such a requirement.

Nebraska had the sixth-highest rate of infection in the nation on Sunday, according to data from Johns Hopkins University. In the past week, one out of every 156 people in the state was diagnosed with COVID-19.

The Associated Press contributed to this report.