A doctor at a major public hospital in New York City described having worn a single N95 mask, a critical tool in protection from the coronavirus, for an entire week. Normally, the Brooklyn doctor would change it after every visit with a patient. Colleague after colleague, including nurses and residents, have been falling sick with the virus. Patients were coming in for unrelated health issues and suddenly testing positive for coronavirus after coming to the hospital.
"The situation is quite horrible and they're saying we haven't hit the peak yet and we're doing all sorts of crazy things to keep up," the doctor, who spoke on the condition of anonymity, said. "We're having so many patients dying."
The doctor said medical staff have been fighting over rationed personal protective equipment, pediatric doctors have been asked to care for patients in their 70s and 80s, orthopedic doctors and cardiologists have been asked to help treat coronavirus patients and urologists have been working as senior intensive care unit staff.
"They're pulling in doctors from everywhere to deal with the patient load,'' the doctor said. "It's changed the way the whole hospital culture operates."
The doctor said the pandemic was ravaging a public hospital that was "already underresourced and underfunded," showing a critical weakness in the health care system as coronavirus cases continue to overwhelm medical facilities that often serve vulnerable populations.
"We don't have enough access to supplies on a regular basis, let alone when there is a crisis," the doctor said.
"We are overwhelmed, extremely tired, working extremely long hours and it's becoming in some cases dangerous because it's not enough," the doctor said. "Mistakes can be made and certain things can be missed."
New York Gov. Andrew Cuomo on Monday said he believed public hospitals would face "the greatest stress" in the fight against the coronavirus and urged other medical facilities to share resources, staff and supplies to help them. He also called on hospitals to take on patients from overwhelmed facilities.
"No one hospital has the resources to handle this," he said during a news conference Monday afternoon at the Jacob K. Javits Convention Center in Manhattan, which has been converted into a field hospital.
Cuomo called on the state's hospitals to work together as one system and said the state was centralizing the buying and distribution of supplies and creating a stockpile in anticipation of the apex of cases.
He said that as one hospital starts to overload, patients should be moved to facilities that have available space and that this should be done on a daily basis. Eventually, as more and more hospitals hit capacity, Cuomo said that the public and private hospital systems "should work together to share the load."
"The public system I think is going to face the greatest stress," Cuomo said.
As of Monday morning, there were more than 36,000 known cases of COVID-19 in New York City and 790 deaths. Queens and Brooklyn remain the hardest hit boroughs, with nearly 12,000 cases and nearly 6,000 cases respectively.
The doctor in Brooklyn said what was especially concerning was how quickly vulnerable coronavirus patients could take a sharp turn for the worse.
"They're talking to you, they're fine, next you know they're gone," the doctor said.
Public hospitals were already more likely to treat vulnerable populations, such as people without health insurance and those with complicating factors, the doctor said
The source described treating a patient in their 40s with minimal complicating factors needing to be sent to the intensive care unit and "numerous" patients in their 60s, 70s and 80s needing to be intubated.
Last week, two nurses in New York died of the coronavirus. One of them was an assistant nursing manager with the Mount Sinai Health System, a nonprofit hospital system.
An emergency room doctor with the Mount Sinai Health System said, "I think we have not been as hard hit yet" as colleagues in Brooklyn and Queens, but still, "pretty much every single patient we see is a COVID patient."
"I feel like I live, breathe and feel COVID on me all the time," the doctor said.
The doctor added, "Even at Mount Sinai hospitals, you just don't have the infrastructure to support, to take care of these patients."
"There's just not enough staff to watch them," the doctor said.
Staff at the hospital have been increasingly concerned about bringing the disease home to their loved ones, the doctor said. The doctor said staff were now being told they could have one N95 mask per day, but the week before the source felt there was not enough personal protective equipment.
The doctor said the fear was that as cases continued to escalate, the hospital would have to make incredibly tough decisions about treatment and who would have access to precious medical equipment.
"How do I tell someone that their family members are going to die and their family member is not going to get a ventilator if they want it?," the doctor said.
One of the hardest hit hospitals has been the Elmhurst Hospital Center, a public hospital in Queens. Inside Elmhurst, doctors have described overfilled waiting rooms, patients waiting six hours to be seen, others packed closely together on stretchers waiting 50 to 60 hours for a bed and doctors desperately trying to get more ventilators.
The doctor at the Brooklyn public hospital feared it was a sign of what was to come.
"I think our hospital will be the next Elmhurst," the doctor said.
NYC Health + Hospitals, the city's public hospital system, did not immediately respond to a request for comment about the issues public hospitals have been facing.
The hospital system said in a statement to NBC News last week it was "working day and night to ensure that all our patients receive the care they need."
The hospital system said it had "adequate supplies at the moment but were fully cognizant of the nationwide scarcity of resources" and that "reports of lack of personal protective equipment and ventilators in our system are false."
"The public health system is working with all local, state and federal agencies to ensure that resources are strategically allocated throughout to accommodate the surge caused by COVID-19," the hospital system said. "We are committed to our mission to care for all New Yorkers regardless of immigration status and ability to pay, and are focused on keeping all our patients and staff safe."