NEW YORK (AP) — It has become a grim ritual outside New York City’s hospitals: workers in protective gear loading the bodies of coronavirus victims into refrigerated trailers.

A surge in deaths in the epicenter of the crisis in the U.S. has overwhelmed the city’s permanent morgues and filled storage spaces in many hospitals to capacity. The Federal Emergency Management Agency is sending 85 refrigerated trucks to serve as temporary morgues, the city said.

It’s been that way for days at Brooklyn Hospital Center, where a worker Tuesday wheeled out a gurney carrying a body covered in white plastic, a forklift operator carefully raised a body into the trailer and undertakers came to claim the remains of yet another of the city’s nearly 1,000 coronavirus dead.

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The hospital said in a statement that the “unprecedented crisis calls for extraordinary measures” and that extra storage is needed “to accommodate the tragic spike in deaths, placing a strain on the entire system of care — from hospitals to funeral homes.”

“Grieving families cannot quickly make arrangements, and their loved ones who have passed are remaining in hospitals longer, thus the need for this accommodation,” the hospital in Brooklyn’s Fort Greene neighborhood said.

The city’s medical examiner’s office has also started operating a makeshift morgue, as it did after the Sept. 11 attacks, to provide emergency capacity as the city’s permanent facilities fill up.

The city’s coronavirus death toll more than doubled in the past four days, surging from 450 on Friday to 932 as of Tuesday morning.

For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough. But for others, especially older adults and people with existing health problems, the virus can cause severe symptoms like pneumonia and can be fatal.

The city and FEMA have delivered refrigerated trucks to various hospitals, while the Office of Chief Medical Examiner has been guiding them on how to properly move and store bodies, officials said.

“To see the scenes of trailers out there and what they’re doing with those trailers — they’re freezers, and nobody can even believe it,” President Donald Trump said Tuesday.

At some hospitals, like Lenox Hill in Manhattan, the trailers are being parked on city streets, along sidewalks and in front of apartments. Cars and buses passed by as bodies were loaded Tuesday outside Brooklyn Hospital Center.

Cellphone videos posted on social media over the weekend drew attention to hospitals using trailers to store bodies. An image from one video of the activity outside Brooklyn Hospital Center appeared on the front page of Tuesday’s New York Post.

“It’s hard to believe this, but this is for real,” said the man shooting the video, his voice quaking. “Lord have mercy, help us Lord, this is for real.”