U.S. doctors, nurses under strain as coronavirus rages on

By Gabriella Borter

NEW YORK, March 27 (Reuters) - U.S. doctors and nurses on the front lines of the coronavirus outbreak came under increasing stress on Friday as the number of cases skyrocketed and doctors and nurses were forced to ration care for an overwhelming number of patients.

The United States surpassed two grim milestones on Thursday. The death toll soared past 1,000, reaching 1,261 by the end of the day, and the total number of infections topped 85,000, surpassing the national totals of China and Italy to make the United States the world leader in confirmed cases.

"This is past a movie plot. Nobody could ever think of this, or be totally prepared for this. You're going to have to wing it on the fly," said Eric Neibart, infectious disease specialist and clinical assistant professor at Mount Sinai Hospital in New York. "The scale is unbelievable."

Meanwhile, with much of the country on lockdown in an attempt to contain the virus, a record 3.3 million Americans filed jobless claims last week, nearly five times the previous record set during the recession of 1982.

Even so, the stock market extended a three-day rally on Thursday after the U.S. Congress neared passage of a $2.2 trillion relief package, a step that reinforced an extraordinary array of economic measures that the U.S. Federal Reserve rolled out on Monday.

Stock futures were down before the start of trade on Friday after the Dow and S&P 500 scored their biggest three-day percentage gains since the 1930s.

After the Senate voted 96-0 to pass the relief package on Wednesday, leaders of the U.S. House of Representatives said they hoped to follow suit on Friday or Saturday at the latest, sending the bill to President Donald Trump, who has promised to sign it.

The federal largesse will aid hospitals, unemployed workers and businesses, welcome relief for hot spots such as New York and New Orleans.

The surge of critically ill coronavirus patients has placed unprecedented strain on hospitals, which do not have enough ventilators needed by sufferers of COVID-19, the respiratory disease caused by the virus, to help them breathe.

New York Governor Andrew Cuomo has said any realistic scenario about the unfolding outbreak would overwhelm the healthcare system. His state, which has become the epicenter of the U.S. outbreak with more than 37,000 cases and 385 deaths, is scrambling to create more sick beds. It is looking to convert hotel rooms, office space and other venues into healthcare centers, while setting up a convention center as a temporary hospital.

As of Thursday, Mount Sinai hospital had 215 inpatients with COVID-19, the respiratory ailment caused by the coronavirus.

"The fear is next week we'll have 400," Neibart said, expecting a shortage of doctors and nurses.

He has seen preparations under way for additional bed capacity in the hospital's cafeteria and the atrium. Tape marks off where each makeshift hospital "room" will be in the wide open areas.

Neibart said he and his coworkers at the hospital are subsisting on fast food like pizza and doughnuts in the frenzy of their long hours.

In lighter moments, he and his colleagues morbidly joke about using thick-tipped markers to write their names on the tape to claim their spots, for when they inevitably fall ill with the virus, although he said they routinely check on one another's well being.

The Department of Veterans Affairs may be asked to help in New York, even as it struggles to provide enough staffing and equipment for armed forces veterans hospitalized with the coronavirus illness.

Maria Lobifaro, a New York intensive care unit (ICU) nurse treating veterans with COVID-19, said they normally change masks after every patient interaction. Now, they are getting one surgical mask to use for an entire 12-hour shift.

The ratio of patients to nurses in the ICU is usually two-to-one. As of Monday it was already four-to-one, she said.

"Right now we can barely handle the veterans that we have," Lobifaro added.

Cuomo wants to expand the number of available hospital beds in the state from 53,000 to 140,000.

Many hospitals are running low on crucial protective supplies, such as masks, gloves and gowns, to guard staff from the disease.

New York City Mayor Bill de Blasio projected that over half of the city of more than 8 million people will become infected with coronavirus and appealed to the federal government to provide New York with more ventilators to face a public health crisis he estimated would last into May.

"The overall projection, we believe that over half the people in this city will ultimately be infected," de Blasio told ABC's Good Morning America, although he added that for the vast majority of those the illness would have little impact.

(Reporting by Gabriella Borter and Maria Caspani in New York; Writing by Daniel Trotta)