Orleans Parish has the sixth-highest rate of known coronavirus cases of any county in the U.S., and it’s the only county among the nation’s top 10 that is not in the New York metro area, an analysis by The Times-Picayune and The Advocate shows.

Yet New Orleans has gotten scarce mention in national discussion of the pandemic. Over the weekend, for instance, President Donald Trump said he was approving major disaster declarations and National Guard deployments for New York, California and Washington state because of the pandemic's impact on those places. Gov. John Bel Edwards on Monday requested a similar designation for Louisiana, a prerequisite for the declaration.

But on a per-capita basis, the pathogen's known spread around New Orleans -- and even neighboring Jefferson Parish -- dwarfs that of any California county. With 567 confirmed cases as of Monday, New Orleans actually has more cases than Los Angeles County, which has a population 26 times as large.

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The Crescent City has just under half the 1,172 cases in Louisiana, while neighboring Jefferson Parish, which according to the newspaper’s analysis is ranked 15th in the rate of known infections, has 252 cases, nearly a quarter of the state’s total.

City Councilwoman Helena Moreno said she kept waiting to hear the words “New Orleans” or “Louisiana” during the president’s comments Sunday night, and was shocked when neither warranted a mention.

Dr. Rebekah Gee, the state’s former health director and now head of LSU’s health care services division, thinks the city is being dangerously overlooked.

“Louisiana is set to become the epicenter” of the coronavirus outbreak in the U.S., Gee warned in an interview Sunday with KLFY-TV. “Louisiana needs to be a priority. Louisiana needs help. We need more people; we need more creative solutions; and we need more assets to be deployed here so we can solve this problem.”

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In a dire news conference Sunday, Gov. John Bel Edwards warned that if Louisiana is not able to “flatten the curve” of infections, the state could quickly run out of hospital beds and intensive care units.

A Harvard University analysis published recently had similar findings, though it found that Louisiana was actually better off than many states in terms of the adequacy of its hospitals. However, the study assumed the coronavirus would spread evenly across communities, whereas it is in fact spreading much more quickly in some than in others.

“My concern is our health care capacity,” said Susanne Straif-Bourgeois, an associate professor at the LSU Health Sciences School of Public Health and an expert in pandemics. “In some models, looking at the growth rate, we estimate that in three to five days, we are over capacity.”

Gee, Straif-Bourgeois and others now believe the massive spread in New Orleans is attributable to Mardi Gras, which this year arrived on Feb. 25, after the coronavirus had arrived in America but before it had caused widespread concern.

Around 1.4 million people from all over the country and the world visited for the celebration, Gee said, crowding onto the streets, catching beads, sharing drinks and God knows what else. “This was really the perfect storm, perfect conditions for this virus to spread,” she said.

Straif-Bourgeois agrees that Carnival was almost certainly the vector for early spread and explains New Orleans’ outlier status on the list of most-infected cities.

“My best assumption is that one or more infected people were here around Mardi Gras and they spread it to the broader population,” Straif-Bourgeois said.

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Both Gee and Straif-Bourgeois said they are troubled by the numbers that continue to come out every day. Mass testing has been slow to take hold in Louisiana, with only very sick people been screened in the virus’ early spread.

As the testing effort ramps up, they are concerned that the rate of people testing positive remains high compared to other jurisdictions, with about 20% of the 5,948 Louisianans screened so far testing positive. In places where testing is more widespread, like Washington state, that rate has been as low as 6% or 7%.

“Our test-positive-to-test ratio is way too high, and what it indicates is we’re not testing enough,” Gee said.

“Our metaphor we throw around every day is, this truck is moving faster and faster; it’s moving at different distances and different speeds in different places,” said Shawn Moses Anglim, pastor of First Grace United Methodist Church, a leader of the interfaith group Together Louisiana. “But in New Orleans, the truck is a block away, and it’s coming at 120 mph.”

The feeling of being overlooked is not an unfamiliar sensation for New Orleanians, many of whom felt a strong sense of abandonment after Hurricane Katrina’s floodwaters laid waste to the city in 2005.

But this time is different in that the rest of the country is going through the same struggle -- it’s just hard to be noticed when places with far more people and wealth have also been hit hard.

City Councilman Joe Giarrusso said it was “disconcerting” that the crisis in New Orleans has not been a greater part of the national discussion.

“The story, in my view, is that for a small city that typically punches above its weight, we have a disproportionately high number of cases,” said Giarrusso, noting that cities with larger media markets seem to be getting all the attention.

“We were left behind by the federal government when Katrina happened,” Moreno said. “We’re not going to let that happen again.”

Editor's note: This story was updated March 24 to clarify that Louisiana could not be included in a major disaster declaration until Gov. John Bel Edwards requested it, which he did March 23.