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With Alabama’s mask mandate set to expire next week even as COVID-19 cases explode statewide, filling hospitals and killing people daily, health leaders urged the state Friday to again extend the requirement, perhaps into 2021.

Dr. Sarah Nafziger, who teaches emergency medicine at the University of Alabama at Birmingham, told an online news briefing it was “critically important” for Gov. Kay Ivey to extend the mask requirement, which is opposed by some who consider it an infringement on personal rights or discount the threat of the coronavirus.

“A lot of people like to argue that masking is not helpful, that it’s a bunch of voodoo,” Nafziger said. “I’m here to tell you that the science shows that it works.”

Alabama added 3,840 new cases on Friday as the 7-day average for new cases rose past 3,000 for the first time, according to the Alabama Department of Public Health.

Pike County added 14 new cases and one confirmed death, bringing the 14-day positive rate to 34.93 percent.

The president of the Alabama Hospital Association, Dr. Don Williamson, said the organization “absolutely” supports continuing the order as coronavirus trends worsen.

“We would support one probably through January. The situation is slipping rapidly in the wrong direction,” Williamson said.

The order, which expires Dec. 11, requires anyone older than 6 to wear a mask in public spaces indoors and outside if they can’t socially distance. First imposed in July, health officials credit the mandate with a sharp decline in cases until a recent spike began nationwide.

Dr. Scott Harris, head of the state health department, said the decision of whether to extend the order ultimately rests on the Republican governor, who publicly encouraged mask wearing in recent days while saying she would not shut down the state’s economy again.

“I would say unequivocally in public health we believe masks work,” Harris said at a news briefing. “I don’t have any indication the mask order is going to go away, particularly given the kind of numbers we are seeking right now.”

The state health department has reported more than 264,000 confirmed and probable cases and at least 3,831 confirmed and probable deaths, and Alabama is setting coronavirus records almost daily. More than 4,000 new cases were reported Thursday, an increase of more than one-third within just a week and before an expected spike in cases related to Thanksgiving gatherings.

“Unfortunately, we have very difficult times ahead this month and as we get into winter. We are seeing numbers like we haven’t seen before,” Harris said.

Officials say vaccines could be shipped to Alabama as early as next week if they are federally approved, but initial doses will be reserved for health care workers who are most at risk for contracting the virus. Widespread distribution among the general public isn’t expected before spring.

Dr. David Hicks, deputy health officer in populous Jefferson County, which has reported more than 35,000 cases and more than 500 deaths, said public health officials are trying to “buy time” until the vaccines are distributed by encouraging mask wearing, hand washing and social distancing.

With state hospitals filling up with COVID-19 patients, officials have discussed plans for setting up field hospitals to accommodate patients who can’t get into regular beds. Such contingencies are typically difficult and less desirable than regular treatment wards, Hicks said.

“I hope it doesn’t come to that,” he said.

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AP writer Kim Chandler contributed from Montgomery.

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Find AP’s full coverage of the coronavirus pandemic at https://apnews.com/hub/coronavirus-pandemic.