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Jersey Shore hospitals have kept up with the initial round of coronavirus cases, officials say, but they have been frustrated by the slow pace of test results and dwindling supply of protective gear.

Left unaddressed, they warn, the obstacles threaten to slow down care, not only for infected patients, but also for others needing health care.

"With a hospital that's more and more backed up, you start to create a situation more and more where other things a community needs to take care of get squeezed out," said Dr. Daniel Varga, chief physician executive for Hackensack Meridian Health.

Interviews Tuesday with officials with Hackensack Meridian and other hospital networks in Monmouth and Ocean counties provided a snapshot of where their hospitals stand in the early stages of the crisis. Among the takeaways:

Hospitals are in a holding pattern while they wait for private laboratories to ramp up testing services.

They are working to streamline a far-flung health care system so they can efficiently funnel patients to the proper place.

Front-line workers described an increasingly stressful environment, never sure of who has the disease.

And hospitals are turning to mobile emergency rooms and tents to overcome a potential shortage of beds.

As of Wednesday, New Jersey reported 427 coronavirus cases, including 32 in Monmouth County and nine in Ocean County. The disease has resulted in five deaths statewide.

But more than a week after the first cases were diagnosed in New Jersey, they sounded increasingly frustrated about the wait for lab results.

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Freehold Township-based CentraState Healthcare System as of 4 p.m. Tuesday had at least two dozen 24 patients who were under investigation for the virus. Two of them had been awaiting results from a test taken nearly a week ago, officials said.

"The turnaround time on testing is still longer than we need to see," said John T. Gribbin, president and chief executive officer of CentraState.

The state has said its laboratory can only handle 40 cases a day. The American Clinical Laboratory Association, which represents private testing laboratories, said it expects to increase its capacity to 20,000 tests a day nationwide by the end of the week and 280,000 tests a week by April 1.

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At the Jersey Shore, hospitals, doctor's offices and public health officials are trying to coordinate care and brace for a potential surge in patients with COVID-19, a disease whose symptoms of a fever and shortness of breath can be mistaken for the flu.

The logistics sound daunting. Providers and health officials need to quickly figure out who should stay home, who should visit a doctor's office, who should go to the emergency room, and who should be admitted, all while being careful to avoid exposure themselves.

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Debbie White, president of the Health Professionals and Allied Employees, a union representing 14,000 workers, said there is no standard protocol on how to prepare for a pandemic.

And best practices seem to change hourly, she said.

It has put a heavy burden on doctors and nurses. They don and doff massive amounts of protective gear, while they watch their supply of respirators dwindle, they said.

"We're really working in the dark," said Rose Knapp, a nurse practitioner at Family First Primary Care, an urgent care center in Ocean Township. "We don't know if they have it or don't have it."

For now, Shore-area hospital and public health officials said they are staying on top of the disease, hoping to get the word out for patients to at least call ahead before visiting the emergency room.

There is good reason. Hospitals have been reducing the number of beds over the past decades.

If the coronavirus follows the infection pattern of flu cases, New Jersey can expect to have 6.3 patients for each hospital bed, according to data compiled by USA TODAY.

With approximately 64% of beds occupied on average, the state could have 17 patients for each available bed, according to the data.

New Jersey Health Commissioner Judith Persichilli said Tuesday the state could reopen two or three unused hospitals to handle non-coronavirus patients.

"Generally, the medical system does not have a lot of excess built into it in the U.S.," said Belinda Anderson, director of the Institute for Health and Wellness at Monmouth University in West Long Branch.

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Hospital officials said they are taking steps to shore up their capacity.

RWJ Barnabas Health, which owns Monmouth Medical Center in Long Branch, Monmouth Medical Center Southern Campus in Lakewood and Community Medical Center in Toms River, said it should have enough beds, but its hospitals also have tents they can construct on their campuses to treat coronavirus patients.

Hackensack Meridian has taken other steps. Its hospitals include Jersey Shore University Medical Center in Neptune, Riverview Medical Center in Red Bank, Bayshore Medical Center in Holmdel, Ocean Medical Center in Brick and Southern Ocean Medical Center in Stafford.

The company postponed all of its elective surgeries for at least two weeks, and it has tried to free up beds by discharging patients who can recover either in other facilities or at home, Varga said.

It also has set up emergency mobile units both at Jersey Shore and Hackensack University Medical Center, which have seven beds and equipment that can be found in intensive care units, he said.

And it, too, is setting up tents equipped with heating, cooling, water and oxygen to treat patients suspected with coronavirus, so that other patients can go to the emergency department, he said.

It leaves the hospital network with two obstacles, he said. It has been taking its own coronavirus tests, but only has the capacity to do 50 a day. And it needs protective gear for front-line employees.

"Those are our two shortcomings right now," he said.

Contributing: James M. O'Neill and Lindy Washburn

Michael L. Diamond is a business reporter who has been writing about the New Jersey economy for 20 years. He can be reached at 732-643-4038; mdiamond@gannettnj.com; and @mdiamondapp