As of Sunday night, New York state had confirmed nearly 60,000 cases of Covid-19, with about 34,000 people sick in New York City. In the city there were 6,600 people hospitalized, about 1,500 of whom were in intensive care. Queens and Brooklyn had the highest number of cases, and 776 city residents had died from complications with the respiratory illness.

Cuomo has instructed hospitals that they must increase the number of beds in their facilities by at least 50%, with some hospitals tasked with doubling their capacity. The state anticipates needing 140,000 beds at the outbreak's peak.

Some of the city's largest gathering spaces are candidates to house patients. A 1,000-bed medical facility was built at the Javits Convention Center, and Cuomo said last week he is considering creating more facilities at Aqueduct Racetrack in Queens, the Brooklyn Cruise Terminal, CUNY's Staten Island campus and the NY Expo Center in the Bronx.

Hospitals have been setting up tents outside their doors to triage patients. Refrigerated trucks have been stationed outside the city medical examiner's office in Manhattan as a potential temporary morgue.

Efforts to close schools and businesses have all been aimed at delaying the apex of the outbreak, so the hospital system might have more time to ramp up its capabilities and acquire ventilators.

It is the ventilators that have truly vexed the Cuomo administration, which anticipates needing 40,000 when the largest number of patients are hospitalized. The state estimated it had 3,200 a few weeks ago. It now says it has about 12,000 and is exploring converting anesthesia machines and splitting the breathing machines using tubes to treat several patients at a time.

The problem was particularly pronounced at the city-run Elmhurst Hospital Center in Queens, where 13 patients died from Covid-19 during one 24-hour period, The New York Times reported.

"So many people are saying it's going to be OK, everything's fine, we have what we need," Dr. Colleen Smith, who works in Elmhurst's emergency department, said in a video shared with the Times. "And if this goes on for a month or two, or three or five like it did in China, and we're already this strained, we don't have what we need."

Dr. Eric Wei, an emergency medicine physician and chief quality officer at NYC Health and Hospitals, said the public hospital system has diverted more resources to Elmhurst Hospital as well as Lincoln Hospital in the Bronx and Bellevue Hospital in Manhattan, which have been treating the largest numbers of patients, he said.

Wei said the system hasn't determined the origin of the cluster of cases in Elmhurst. Certain factors, such as the density of the population there, might have been responsible, he said.

"I'm very proud of how we handled this as a system," Wei said. "We've never come close to running out of PPE or ventilators."

He said workers' concerns about inadequate supplies are understandable but said the system has procured 100 more ventilators. A city spokeswoman said Friday it was sending thousands of pieces of safety gear and dispatching 105 nurses to Elmhurst Hospital.

Dr. Amy Plasencia, chief medical resident in internal medicine at Brookdale University Hospital Medical Center in Brooklyn, said she is concerned not everyone has had consistent access to protective gear. Resident physicians in the emergency department get one N95 mask per shift, she said, but those in lower-risk specialties have been asked to reuse the masks.

Plasencia spent the first three weeks of March working in the medical ICU, where her shift ran 6:30 p.m. to 6:30 a.m.

"We do what we can with what we have. If that means that we have to reuse masks, we'll reuse masks," Plasencia said. "We protect ourselves in the ways that we can, but we're not going to stop treating our patients because of suboptimal conditions."

Plasencia has been alarmed by patients who are in their 30s and 40s who become critically ill with Covid-19. Those patients typically were obese but didn't have other underlying medical conditions, she said.

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Health care workers say they've never faced a medical emergency of this scale - Crain's New York Business