The doctor’s voice was filled with distress.

Dr. Suraj Saggar didn’t have much time to talk. At times, he even sounded almost out of breath. Holy Name Medical Center in Teaneck is under siege from the coronavirus, and he needed to get back to his patients.

But first, he had a desperate message he needed to send.

They need help.

“It looks likes a war zone,” said Saggar, Holy Name’s chief of infectious disease.

The hospital is in such dire need, it took the unprecedented step of pleading to the public for donations to buy critical supplies.

Holy Name is filling with COVID-19 patients. Supplies are running low. Doctors and nurses — already at risk of exposure — could be put in further danger if they run out of protective equipment, while some already have gotten sick, medical workers said.

The Bergen County hospital — located at the epicenter of New Jersey’s coronavirus outbreak — is on the brink, nearing its capacity and supply stock. And it’s not alone in this deepening crisis as hospitals throughout the state face diminishing supplies and equipment.

Holy Name is running out of ventilators. The facility is down to only a four-day supply of respirators. Its stock of protective gloves and eye shields are dwindling. And disposable gowns are already gone.

"Everything is running low,” Saggar said, speaking rapidly as a clamor of background noise carried over the phone line — the cacophony of doctors and nurses rushing around him, tending to patients.

Dr. Suraj Saggar inside the ICU of Holy Name Medical Center in Teaneck.Photo by Jeff Rhode

The shortage of supplies puts health care workers at risk. The protective equipment is the only line of defense for them. Each infection means one less medical professional is available to care for the soaring number of COVID-19 patients, threatening the state’s already overburdened health care system.

New Jersey recorded 935 new cases of COVID-19 Monday, giving it 2,844 confirmed infections. There were also seven more deaths, raising the total to 27.

The escalating number of cases only taxes medical facilities, their supplies and their staff.

The biggest fear among many might be over the shortage of ventilators, the life-saving breathing machines that have become vital with the coronavirus attacking patients’ lungs.

Holy Name has only 10 ventilators — out of a total of 34 — remaining with 85 patients in the hospital, according to a spokeswoman for Holy Name.

Christoudias, who chairs the New Jersey Doctor-Patient Alliance, said Holy Name is “in the worst shape” of the hospitals he’s seen, but The Valley Hospital in Ridgewood “is very close behind them.”

“We are almost at capacity like that scene from Italy where people are making choices whether people live or die,” Christoudias said of available ventilators. “We are almost there. We’re not even out of the first inning on this thing, and we are almost there.”

Despite the crisis, the way Holy Name has handled the challenges “is impressive and should be a role model for other hospitals,” Christoudias said. It is persevering despite the rush of patients.

The Valley Hospital issued its own public appeal over the weekend for donations of personal protective equipment (PPE) to be dropped off at its front door. The plea on Facebook and Twitter asked for unused N95 respirators, surgical masks, face shields, goggles, isolation gowns and latex-free gloves.

The Valley Hospital did not return a request for comment.

The anguish at Holy Name only intensifies with each passing day as more patients arrive.

“Patients who are coming in are high acuity — very sick,” Saggar said. “And they are progressing to respiratory failure.”

Names are written on protective masks so they may be used again if safely possible, due to a nationwide shortage of personal protective equipment, in Holy Name Medical Center in Teaneck.Photo by Jeff Rhode

‘Horrendous’ situation

The toll is starting to wear on hospital staff.

Doctors in Bergen County are stressed, and nurses are suffering under the strain as supplies shrink and patients struggle, Christoudias said.

“It’s pretty horrendous,” he said. “What really pains me the most is to see the nurses’ anguish. They feel like they have nowhere to turn.”

Hospitals are using thousands of masks and other supplies each day. They protect medical workers from respiratory droplets that spray out from coughs or sneezes and spread the contagious coronavirus.

Competition for equipment has ramped up as every state is vying to purchase them.

So hospitals have been forced to get creative, making do with what little they have remaining.

Health care workers are reusing gear and coming up with ad hoc ways to stretch supplies as far as they can.

“Right now we’re using the same mask throughout the day,” Saggar said. “Everyone is using one mask and pair of goggles.”

Saggar said workers are using safety pins to secure a plastic bag on the inside of their scrubs, where they store N-95 respirators before reusing them again. They apply bleach to clean them. If entering a room with a patient, they’ll place a surgical mask over the respirator to provide some extra protection.

Some hospitals have resorted to disinfecting masks with ultraviolet light for reuse, according to news reports.

Christoudias said he is supplying masks he had previously purchased to health care workers.

“I bought three cases of 3M N95 masks from an industrial warehouse in January," he said of the masks that filter out 95% of particles. The first reports of the coronavirus’ emergence in China were published in January in the United States. “They got here last week. And it’s all gone. I’m giving away the last two boxes now.”

He has been handing them out at North Jersey hospitals. But some on the front lines have already been infected.

“They literally cry…" Christoudias said of giving away the masks. "This one doctor who is at Valley Hospital just texted me today. I gave her three boxes on Friday. She said, ‘One box is gone. So is four of our doctors.’

"I’m like, ‘What do you mean?’ She said, ‘Four of our doctors are sick. They’re dealing with COVID symptoms.’”

A medical worker at Holy Name Medical Center in Teaneck during the first few days of the COVID-19 pandemic.Photo by Jeff Rhode

It’s unclear how many health care workers in the state may have contracted COVID-19. The New Jersey Department of Health was unable to provide figures.

“If we don’t keep our health care workers protected, we have nobody,” said Debbie White, president of Health Professionals & Allied Employees.

Holy Name has received so many patients, Saggar has lost count.

“I have to be honest, there are so many at this point,” he said, his voice dropping.

From the beginning, health care officials’ greatest fear has been a surge of patients flooding emergency rooms at once, overrunning facilities and leaving a shortage of critical care beds, equipment and supplies. These fears, raised more than a month ago by some experts, seem to be coming true.

And officials expect the outbreak in New Jersey to get much worse in the coming days and weeks.

“We have to make sure we are protecting our first-line responders — the ones who are taking care of these very sick patients," Saggar said.

‘Human cost’

The resources they need are rapidly dwindling.

The issue is so pressing, Gov. Phil Murphy spoke with President Donald Trump on Monday about the state’s need for protective equipment, he said during his daily coronavirus media briefing.

Equipment remains more vital than hospital space, Dr. Daniel Varga, chief physician at Hackensack Meridian Health, said Monday.

“We’re trying to get them the stuff that they need to really manage what they’re seeing every day,” he said. “But the big issue is going to be materiel … We’ll find space. It’s really more the supply chain and the human cost.”

Holy Name is in a precarious position with only three ventilators remaining but several COVID-19 patients, Christoudias said.

“Any one of them could crash and need one of them immediately,” he said. “So if today, if three of them crash, anyone else who crashes could end up dying short of breath in the hallway.”

The state has nearly 2,000 critical care beds in hospitals, but only 1,700 ventilators, New Jersey Health Commissioner Judith Persichilli said Monday during the governor’s briefing.

“Not all of them are in use at this time,” she said. “We do believe for every critical care bed there should be a one to one ratio — ventilator to critical care bed. So, looking at our inventory and full number of beds, we have a deficit of about 300."

The state has requested 400 more, she said.

But ventilators are only as good as the caregivers who use them. If they don’t have protective gear to keep them healthy, a medical staffing shortage could be next.

"We can have all the ventilators in the world and then no caregiver,” White said.

Holy Name Medical Center in Teaneck during the first few days of the COVID-19 pandemic.Photo by Jeff Rhode

Cracking ice

Hospitals have been transformed as if it’s wartime.

Tents have been set up in parking lots. Unused rooms and wings are being utilized. Retired nurses, school nurses and even nursing school students have been called on to help.

Saggar said Holy Name is holding the line — barely. It’s as if everyone is beginning to hear the cracking of the ice beneath their feet.

He said the hospital is in “crisis mode."

A month ago, no one thought hospitals would be issuing pleas to the public, begging for donations and supplies.

“We hope that they will see what’s happening here,” Saggar said. “We know it’s going to keep spreading.”

What happens if doctors and nurses run out of respirators? Other gear?

“It would be devastating ... They are going to be at risk,” he said.

And amid the supply crisis, workers are pressing on like soldiers in battle. They are under unimaginable stress, Saggar said.

“Everyone is exhausted,” he said. “There’s anxiety in everyone. There’s sorrow.”

And the worst may be yet to come.

It’s unclear whether Holy Name and other facilities that are already overwhelmed can handle a surge of patients.

“We can’t let it get to that point," Saggar said, angst in his voice. “We’re not at that point — we’re ahead — but it’s literally a race. We have to stay ahead.”

But medical workers are paying a steep price to fight this battle.

Their emotions fluctuate daily, according to Saggar.

“Everyone feels like they have a calling. But it would be false to say there isn’t a level of anxiety and concern for everyone’s well being,” he said. “If we had enough PPE, we can take care (of patients). But when you combine (that) … it adds a level of anxiety and dread and depression, and it makes an already difficult situation that much worse.”

Saggar added: “And it’s not just PPE. It’s critical care staff, ICU beds, hospital beds, ventilators … We literally built extra ICUs in the hospitals. It’s unprecedented.”

Anyone seeking to donate to Holy Name should visit HelpHolyName.org.

For more information on how to donate to The Valley Hospital, visit ValleyHospitalFoundation.org.

Spencer Kent may be reached at skent@njadvancemedia.com. Follow him on Twitter @SpencerMKent. Find NJ.com on Facebook.

Keith Sargeant may be reached at ksargeant@njadvancemedia.com. Follow him on Twitter @KSargeantNJ.

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