On Thursday night at Holy Name Medical Center in Teaneck, five coronavirus patients died in just a few hours, a pulmonologist there said.

At The Valley Hospital in Ridgewood, cases are rising each day.

Doctors at both Bergen County hospitals describe staff as being tired, overwhelmed and afraid. Their hospitals are filling up. Many patients are alive simply because a ventilator is pushing air into their lungs. Some are in medically-induced comas.

For those on ventilators who are not improving or whose conditions are continuing to deteriorate, tough decisions may lie ahead, as more patients arrive in need of critical resources, said Dr. Theophanis Pavlou, a pulmonologist at Holy Name.

"I expect it will keep getting worse,” Pavlou said.

Holy Name is a small hospital, located in the middle of one of America’s first coronavirus hotspots.

If everyone follows the advice of the experts — and separates from one another by practicing social distancing and staying inside their homes as much as possible, Pavlou said, the hope is the caseload will peak and then begin to drop.

“We need a full lockdown of the entire country now,” Pavlou said. “Just stop.”

By Saturday afternoon, 11,124 people in New Jersey had tested positive for COVID-19, according to the state health department. In New York State, more than 52,000 people tested positive by Saturday, according to a statement by Gov. Andrew Cuomo.

Those numbers are likely low. Because the virus spreads so quickly, and because testing in the United States has been so slow, it's impossible to know how many Americans actually have contracted the virus, Ashish Jha, director of the Harvard Global Health Initiative, said in a statement.

There are 140 people in New Jersey that have died of the virus and 728 in New York State, according to officials.

There is a need for more and faster testing, Pavlou said.

"This is the biggest problem, that it takes five to seven days to get a test result. We just have to treat them because we can’t wait," Pavlou said. "People have died before their tests have come back."

“The number of cases is just rising exponentially,” said Dr. Jason Shatkin, a pulmonologist at The Valley Hospital.

Buildings pressed beyond limits

Of critical need in all hospitals is equipment, both to keep patients alive and protect caregivers.

Without enough ventilators, doctors are having to make decisions most never expected to confront.

“Yesterday I had a patient who I love. She’s been my patient for 16 years. She was on a ventilator, and she wasn’t improving,” Shatkin said. “I called the family and said, 'She is really not doing well. Can I ask your permission to remove the ventilator?' ”

Permission was granted. The ventilator was removed, sterilized, and connected to the lungs of a new patient. Shatkin’s patient received morphine until she died.

That experience, and others like it, have changed Shatkin.

“I have nine kids. I’m terrified,” said the doctor, who started to cry as he spoke by phone. “I’m going to do my job. I’m going to care for the sick. But I have a 4-year-old son. Will I see him grow up? Will I be barely a memory to him? Because what do you remember when you’re 4?”

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On Saturday afternoon, workers at Holy Name opened the hospital’s sixth intensive care unit, five of which are dedicated to virus patients, said Adam Jarrett, the chief medical officer. A seventh is under construction in a former storage space, and should open by the middle of the week, he said.

Hallways are sealed with plastic to create a makeshift quarantine around virus patients, according to videos and photos posted by Holy Name staffers to the hospital’s website. Many rooms likewise are sealed in plastic to create negative pressure inside, Jarrett said, a containment technique against airborne spread.

Machines built to deliver oxygen to patients during surgeries and to those with sleep apnea can be pressed into service after minor retrofits for use as ventilators, Jarrett said.

Doctors at Holy Name have not placed multiple patients on the same ventilator, as happened in parts of Italy hurt worst by the pandemic. Jarrett and his staff hope to avoid that decision, since it forces two or more patients to breathe the same air.

For the first time in the hospital’s history, however, such drastic steps are available if required, Jarrett said.

“That is our last contingency,” Jarrett said. “I hope we won’t get there.”

Six full floors are dedicated to virus patients at Holy Name, or about 80% of the hospital, Pavlou said. The hospital still has room for hundreds of more patients, Jarrett said.

More staff needed

The problem is finding enough staff to handle the load. Hospital leaders are tracking down retired nurses and others, Jarrett said. Soon he may need outside help, possibly from the federal government, to find additional doctors and nurses, he said.

Already the hospital is in “divert” mode. This means ambulance drivers are encouraged to take critical patients elsewhere, Jarrett said. New patients continue to arrive regardless, either on their own or driven by family members.

So far, the hospital is accepting them.

“Every few hours there are lulls, where I get the false hope that things are moving in the right direction," Jarrett said. "But that doesn’t last, and we get more patients.”

At Valley, the number of patients has reached an all-time high, Shatkin said. Intensive care units and post-surgery rooms have been converted to care for virus patients on ventilators, and the hospital is converting an outpatient surgery center into more space for intensive care.

“If it lasts more than two weeks, I don’t think anyone will be able to handle it,” Shatkin said. “I think in a week from now, if the number of cases is still going up exponentially, it’s going to be catastrophic.”

Pavlou, at Holy Name, had a similar take.

“This is worse than I thought it would be,” Pavlou said. “It’s going to run into the summer unless we take more drastic measures.”

This story has been updated to reflect changing conditions at the hospitals.

Christopher Maag is a columnist for NorthJersey.com. To get unlimited access to his unique perspective on New Jersey’s most interesting people and experiences, please subscribe or activate your digital account today.

Email: maag@northjersey.com Twitter: @Chris_Maag