NEW YORK/LOS ANGELES • In excruciating pain with lesions on her face and scalp, Ms Tracey Fine lay for 13 hours on a gurney in a hospital's emergency room hallway. All around her, Covid-19 patients filled the beds of the hospital in Madison, Wisconsin.

Her nurse was so harried that she could not remember Ms Fine's condition, and the staff was slow to bring her pain medicine or food.

In a rural hospital in Missouri, Mr Shain Zundel's severe headache turned out to be a brain abscess. His condition would typically require an operation within a few hours, but he was forced to wait a day while doctors struggled to find a neurosurgeon and a bed - finally, at a hospital 600km away in Iowa.

From New Mexico to Minnesota to Florida, hospitals across the US are teeming with record numbers of Covid-19 patients.

Staff members at smaller hospitals have had to beg larger medical centres repeatedly to take one more, just one more patient, but many of the bigger hospitals have sharply limited the transfers they will accept, their own halls and wards overflowing.

Earlier this year, the pandemic was concentrated mainly in hard-hit regions like New York, which offered lessons to hospitals in other states anticipating the spread of the virus. But despite months of planning, many hospitals in the United States are now hit with a staggering swell of patients, no available beds and widening shortages of nurses and doctors. Some hospitals have had to turn away transfer requests for patients.

And rising infection rates among nurses and other front-line workers have doubled the patient load on those left standing.

There is no end in sight for the nation's hospitals as the pandemic continues to hammer cities and rural areas, with cases totalling 13 million so far this year. Public health experts warn that the holidays may speed the already fast-moving pace of infection, driving the demand for hospital beds and medical care ever higher.

Some 90,000 Americans are now hospitalised with Covid-19, and new cases have been climbing to nearly 200,000 daily.

Nationwide, state and local authorities have instituted or re-imposed a wide range of Covid-19 limitations in hopes of blunting the wave of coronavirus infections. For example, come tomorrow, Los Angeles will ban all social gatherings of individuals from more than a single household for at least three weeks, according to local health officials.

And even if hospitals in some cities appear to have enough physical space staff shortages still pose challenges.

"Beds don't take care of people; people take care of people," said Dr Marc Harrison, chief executive of Intermountain Healthcare.

NYTIMES, REUTERS