NEW YORK • In several hours last Tuesday, Dr Ashley Bray performed chest compressions at Elmhurst Hospital Centre on a woman in her 80s, a man in his 60s and a 38-year-old man. All had tested positive for the coronavirus and had gone into cardiac arrest.
All eventually died.
Elmhurst, a 545-bed public hospital in Queens, has begun transferring patients not suffering from the coronavirus to other hospitals, as it moves towards becoming dedicated entirely to the outbreak.
Doctors and nurses have struggled to make do with a few dozen ventilators. Calls over a loudspeaker of "Team 700", the code for when a patient is on the verge of death, come several times a shift.
A refrigerated truck has been stationed outside to hold the bodies of the dead.
"It's apocalyptic," said Dr Bray, 27, a general medicine resident at the hospital.
Across the city, which has become the epicentre of the coronavirus outbreak in the US, hospitals are beginning to confront the kind of harrowing surge in cases that has overwhelmed healthcare systems in China, Italy and other countries.
New York has more than 43,000 confirmed cases and 500 deaths so far, according to a New York Times tally. Last Wednesday, Governor Andrew Cuomo offered a glimmer of hope that social distancing measures were starting to slow the growth in hospitalisation. In the past week, the state's hospitalisation estimations were down markedly, from a doubling of cases every two days to every four days.
Still, hospitals are under siege. New York City's hospitals run the gamut from prestigious teaching institutions catering to the elite to public hospitals providing care for some of the poorest communities in the nation. Regardless of who they serve, few have been spared the impact of the pandemic: A flood of sick and fearful New Yorkers has besieged emergency rooms across the city.
Hospitals have repeatedly expanded the parts of their buildings equipped to handle patients who had stayed home until worsening fevers and breathing difficulties forced them into emergency rooms.
All of the more than 1,800 intensive care beds in the city were expected to be full by Friday, according to a Federal Emergency Management Agency (Fema) briefing obtained by The New York Times.
The federal government is sending a 1,000-bed hospital ship to New York, although it is not scheduled to arrive until the middle of next month.
Officials have begun erecting four 250-bed hospitals at the Jacob K. Javits Convention Centre in Midtown Manhattan, which could be ready in a week. Officials have also discussed converting hotels and arenas into temporary medical centres.
According to the Fema briefing, at least two city hospitals have filled up their morgues, and city officials anticipated the rest would reach capacity soon.
But a spokesman for the office of the chief medical examiner said the briefing was inaccurate, adding that they have significant morgue capacity and the ability to expand.
Doctors and nurses at hospitals across the city gave accounts of how they were being stretched.
Dr Rikki Lane, who has worked at Elmhurst for more than 20 years, compared the scene in the emergency department to an overcrowded parking garage where physicians must move patients in and out of spots to access other patients blocked by stretchers. Family members are not permitted inside, she said. She recalled treating a man in his 30s whose breathing deteriorated quickly. "He was in distress and panicked, I could see the terror in his eyes," she said. "He was alone."