New York City health officials issued an urgent alert to healthcare providers Friday, asking them to stop testing patients who did not require hospital care for COVID-19, citing a “critical shortage” of personal protective gear like N95 and surgical masks, gowns and gloves for doctors and nurses and other hospital staff.

Following the health department guidance, Health and Hospitals canceled all appointments at testing sites it had just set up a day earlier, Christopher Miller, a spokesman for the city’s hospitals, confirmed. Tents set up for testing outside some city hospitals would be used for overflow from the emergency room, officials said at a Sunday press conference.

“To preserve [personal protective equipment] for [healthcare workers] providing medically necessary care for hospitalized patients, the NYC Health Department is directing healthcare facilities to IMMEDIATELY STOP TESTING NON-HOSPITALIZED PATIENTS FOR COVID-19 unless test results will impact the clinical management of the patient,” the all caps memo signed by Dr. Demetre Daskalasis, Deputy Health Department Commissioner reads. “Do not test asymptomatic people, including [healthcare workers] or first responders. COVID-19 testing is only indicated for HOSPITALIZED PATIENTS.”

The alert went out one day after Mayor Bill de Blasio announced expanded testing capacity at 17 city hospitals and community health centers across the five boroughs. Though the centers were briefly allowing testing by appointment only, long-lines of New Yorkers anxious to be tested queued up outside of Elmhurst Hospital in Queens.

This was the line of people looking to get tested outside Elmhurst Hospital in Queens yesterday. It was one of the most sobering things to witness in person. So ummm think twice before trying to play some ball please! #CoronavirusPandemic pic.twitter.com/Dbg4Y6J5V6 — Christopher Mendoza (@CMendoz_a) March 21, 2020

Testing a person suspected to have the virus requires fresh personal protective gear that’s in increasingly short supply across the city and nation. Surgical masks, gowns and gloves can’t be reused for different patients to prevent the potential spread of the virus between people suspected but not confirmed to have the virus. And for most patients, even with positive COVID-19 test results, guidance will be to self-isolate, stay hydrated, and recuperate at home, and only seek medical help if symptoms worsen after three or four days.

“If you have a high fever and a dry cough...a test result doesn’t change that,” said Councilman Mark Levine, the chair of the council’s Health Committee, who called the memo “long overdue.”

“Look at every level of protective gear that...could have and should have been for a hospital worker [and] the staff themselves, should have been at a hospital,” he said. He also feared testing sites may have contributed to the further spread of the virus.

“You’re bringing mildly symptomatic people who should be resting at home into a crowded place...and people who don’t carry the virus but are worried [into places] where they might actually get [it].”

A surge of severely ill patients have flooded New York hospitals and is expected to keep climbing in the coming weeks, as the city and state scramble to increase the number of hospital beds and secure more personal protective gear for workers. The state is asking all hospitals to double their capacity, and is working with the Army Corps of Engineers to create pop-up hospitals at other locations, like the Jacob Javits Convention Center in Manhattan which would also have four 250-bed FEMA hospitals.

As of Sunday, nearly 2,000 people were hospitalized across New York, according to Governor Andrew Cuomo. Approximately 15,000 people were confirmed to have the virus statewide, 9,654 of whom live in New York City’s five boroughs, an increase of 2,000 people in a day, according to city and state figures announced Sunday. The death toll in NYC reached 65 on Sunday, de Blasio told reporters.

Meanwhile, healthcare workers across the country have taken to social media to plead for donations of protective gear with the hashtag #GetmePPE and described having to ration limited supplies. In an interview with the Atlantic, one doctor said she was spending her limited time off driving around the city collecting mask donations. Several New York City hospitals are now accepting donations of all kinds of protective gear.

De Blasio estimated the city would run out of supplies in two weeks time without reinforcements, though Governor Cuomo said he would send New York City one million N95 masks from the state’s stockpile.

“That’s crucial, that’s wonderful,” Mayor de Blasio said at a press conference Sunday, “But I have no announcement from the President of the United States... so far we have no specifics on what supplies we will get when and we need them now.”

“Now we’re at a point where we have to treat testing on a priority basis...Everything is changing by the day in our calculations... It all comes down to the supply situation,” he said.

In a letter to staff at New York-Presbyterian/Columbia University Medical Center Craig R. Smith, the Surgeon-in-Chief explained why staffers would only get one N95 mask and have to reuse it indefinitely.

“[Personal protective equipment] is an increasingly limited resource, most dramatically illustrated by masks,” he wrote. “Employees will be responsible for keeping their one mask clean and available.” (Some other hospitals around the country are experimenting with ways to make masks last longer.)

The hospital usually goes through 4,000 N95 masks a day but is currently up to 40,000 and will need about 70,000 a day in an estimated 23 days as the outbreak grows, the letter reads. Spokespeople for New York Presbyerian/Columbia University Medical Center didn’t return a request for comment right away.

“Remember that our families, friends and neighbors are scared, idle out of work and feel impotent,” Dr. Smith wrote to conclude his letter. “Anyone working in healthcare still enjoys the rapture of action. It’s a privilege! We mush on.”