With hospital beds quickly filling up, workers being forced to ration critical supplies like N95 masks and Gov. John Bel Edwards warning federal officials that a rising tide of coronavirus patients will likely overwhelm the New Orleans area’s hospital systems by April 4, Louisiana’s health care workers are bracing for chaos.

Newly released Louisiana Department of Health figures from Tuesday evening show that ICU bed capacity is lacking across the state. But it is particularly concerning in Orleans, Jefferson, St. Bernard and Plaquemines parishes, where coronavirus cases have been clustered and where just 15% of adult ICU beds are still available. In those parishes, there are 429 adult ICU beds total, while 65 are free.

Statewide, just 29% of adult ICU beds are now available, but no region has more than 50% of adult ICU beds free. The state is in better shape when it comes to total bed counts, with nearly half of total beds free across the state.

Louisiana’s COVID-19 death toll climbed to 46 on Tuesday, and the number of known coronavirus cases reached 1,338. Of those patients, 20% were hospitalized and 94 required ventilators. The state’s ventilator capacity is still OK, with every region still having more than half of its ventilators available, according to the state’s data.

More than a dozen health care workers on the front lines of the crisis say they are scrambling to treat a steady influx of patients while already short on supplies and feeling the crunch on ICU space. Of the hospitals in New Orleans, Ochsner seems to be adding patients most rapidly, according to people who work there, health care workers at other hospitals and political officials.

The workers spoke with The Times-Picayune | The Advocate on the condition that their names not be published since the hospitals they work in all have policies requiring that media inquiries be handled by communications specialists.

One ICU nurse at Ochsner told a reporter that her years of critical care experience didn’t prepare her for the waves of coronavirus patients who have filled her unit in less than a week.

“The first night I worked where the entire unit was COVID patients, I got into my car and started bawling,” said the nurse. “When I tell you it's like a war zone up there, that's kind of putting it easy.”

There are so many patients that the recommended ratio of one nurse for every patient on a drug that blocks their movements has already fallen by the wayside, the nurse said.

Ochsner said it has quickly opened or will soon open 96 beds at its Jefferson Highway location and 12 in Kenner, and it is putting the staff needed to care for those patients on a coronavirus crash course.

Warner Thomas, Ochsner’s president and CEO, didn’t dispute the governor’s dire prediction about hospital capacity, but he said that better outcomes are still possible.

“A lot of that is going to depend on whether the social distancing works, and whether we see a change in the trajectory of the spread of the virus over the next several days,” he said.

Staffers at other hospitals across the state have also shared similar stories with the newspaper, saying they are desperate for supplies and dreading the days to come. Actions that could have gotten them in trouble in the past — like re-using disposable gear — have become directives to save supplies, even though contaminated equipment is a hazard to both workers and other patients.

Dr. Robert Hart, chief medical officer at Ochsner, said it was a “running battle” to keep his network supplied.

“We have asked people to do things that, in a perfect world, we wouldn’t necessarily do. When supplies are plenty, we’re not always having to manage very conservatively,” Hart said.

Hart emphasized that protective gear isn’t being used across distinct wards of coronavirus patients, who are “cohorted,” and the general patient population.

One emergency room doctor at a major New Orleans hospital said her hospital’s personal protective equipment is now being held under lock and key because of concerns about staffers and patients stealing it.

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And it’s been over a week since a patient care technician at Touro Infirmary in New Orleans has changed her N95 face mask or her gown, she said — even though she said she should be changing them each time she works with a new patient in the hospital’s quarantine units.

Health care workers at Touro can only receive new N95 masks if the ones they’ve been wearing are broken, wet or visibly dirty. The masks are not meant to be used for more than eight hours, she said, and she works 12-hour shifts. That means her mask was potentially ineffective by the end of her first day wearing it; she’s now worn it for five.

She said the hospital is also short on gowns, with workers being told to preserve them unless they rip, get wet or soiled.

“They’re short of everything,” she said. ”Everybody is scared to be in the (COVID patient) rooms for a long period of time. It seems like we’re not caring for the patient, and that adds stress.”

The CEO of LCMC Health, the hospital group that runs Touro and several other hospitals across New Orleans, acknowledged in an email to staff Tuesday that protective gear is at “low levels,” the Lens reported.

In a statement, CEO Greg Feirn said LCMC was trying to add 75 ICU beds across its hospitals, and that LCMC was providing additional counseling and resources to help employees manage stress.

“There is no question there is a shortage of PPE — masks, gowns, eye protection,” said Dr. David Mushatt, an associate professor of medicine and section chief of infectious diseases at Tulane University. “How much of a shortage is hard to get a handle on. It’s fluid, it changes by the hour and varies from hospital to hospital. It’s difficult for leadership to even keep track of it.”

Edwards’ projection for when New Orleans-area hospitals could become overwhelmed has changed — for the better — since last week. On March 19, the governor said New Orleans-area hospitals could exceed their capacity within seven days. Five days later, he pushed that forecast back by more than a week, to April 4. He said in a Tuesday news conference that his office is revising its projections daily, and that their latest data went into the new estimate.

“We cannot say with certainty what the next few weeks will hold,” said Sarah Balyeat, a spokeswoman for HCA HealthCare, which runs Tulane’s hospital system. “We are doing everything in our power to ensure our capacity, staffing, supplies and equipment are as prepared as they can be to care for our communities.”

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At his news conference, the governor said he hopes members of the public will focus less on hospital surge capacity, and more what they can do to help prevent the spread of coronavirus, including staying at home as much as possible. The governor’s office has also started identifying hotels and public buildings that could be used to provide beds for patients, and opened isolation sites at three state parks with the capacity to house more than 300 patients, including homeless people.

Health care workers are echoing those requests, asking citizens to take care of themselves and to preserve hospital resources to the greatest extent possible.

A physician assistant at a major Baton Rouge hospital said he is increasingly worried about the number of people showing up in the emergency room, without dire symptoms, just to get “checked out.” Spending time with such patients takes time and resources away from others who are far sicker, the staffer griped.

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And another New Orleans-area ICU nurse, who was diagnosed with coronavirus that she believes she acquired outside of the hospital, said she’s trying to rebuild her strength before she returns back to work. But news of supply shortages has been discouraging.

“I cannot express how severe the headache and bone and joint pain was. Severe and terrible,” she said. “Now I am dreading going back to work. If we’re down to re-using masks today, in a week are we going to have any left at all?”

Staff writer Blake Paterson contributed to this report.

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