This is an “absurd situation where every state and every hospital is competing with each other to buy supplies from the private market and the government,” Kantor said. He compared the situation to “a crazy flea market,” and called it “no way to manage a natural disaster like this.”

Louisiana is leaning on its experience, trauma, and resilience from Hurricane Katrina. The state is currently building a massive health-care facility with 2,000 hospital beds for COVID-19 patients inside the New Orleans Convention Center. Across the street from the center, work is under way on a new 250-patient facility for people awaiting test results. “We are working at a breakneck pace to expand acute-care capacity,” Kantor said.

Governor John Bel Edwards has ordered 14,000 ventilators, including 5,000 from the federal stockpile. As of Tuesday, the state had received only 300.

Yani Turang, a nurse in New Orleans, is working on the COVID-19 response at the convention center. She complains that health-care professionals and experts knew that a pandemic was inevitable in the United States, but even though the “writing was on the wall,” it had never been a priority for the country. In 2018, the Trump administration disbanded the National Security Council’s directorate focused on pandemics , and it has urged budget cuts to the Centers for Disease Control and Prevention.

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In 2015, Turang worked in Sierra Leone during the Ebola outbreak, but says that experience was less stressful than what her colleagues are enduring now in the United States. In Africa, she said, “there wasn’t even a question that I would ever have to reuse any supplies.” Her colleagues are now forced to purchase their own protective eyewear and face masks. She blames privilege and arrogance for this chaotic mismanagement, a “consequence of living in a world where you think you’re kind of untouchable.”

And Turang worries about the future. “I see hospital beds being full,” she said. “I see our convention center being overrun by patients we can’t manage, because they are so sick. I see a lot of people dying.”

Louisiana is hardly alone. “Right now, we’re still in what I call a lull before the storm,” said Nauman Qureshi, a nephrologist and the chief of medicine at Athens-Limestone Hospital in Alabama. Being two to three weeks behind New York has given his facility time to learn and adapt.

Although his hospital has enough personal protective equipment, or PPE, for now, Qureshi says they are all “preparing for the worst.” His hospital has been accumulating masks and gowns, and has increased its stock of ventilators by 80 percent. Local physicians are discharging nonessential patients and postponing elective surgeries. Teams of physicians have already been organized to rotate when patients become sick with COVID-19.