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In the US, the focus of the coronavirus outbreak last week shifted from the West Coast to New York City. As of 30 March, the city of 8.6 million people had 38,087 confirmed cases, which account for more than a quarter of cases in the US, and 914 people had died of covid-19.

In one 24-hour period last week, 2000 people were hospitalised in the city. Most of the positive covid-19 test results have been clustered in the boroughs of Queens and Brooklyn.

At a press conference on 25 March, New York City mayor Bill de Blasio said these are “numbers I can barely even comprehend… number[s] that would have been unimaginable just a couple of weeks ago”.

In Queens, hospitals and emergency rooms have been flooded with critically ill covid-19 patients struggling to breathe. “It’s inconceivable. Everything we know about medicine is out the window,” says Lisa Epstein, a nurse at New York-Presbyterian Queens, who is working in the hospital’s emergency room.

Waiting areas have been repurposed to treat people with covid-19. Beds, chairs, wheelchairs and stretchers fill every available space. “It’s like a war zone, only there’s no blood,” says Epstein, who has been a nurse for 40 years.

New York governor Andrew Cuomo said at a press conference on 24 March that the city has 53,000 hospital beds and may need as many as 140,000. The Javits Center, a convention hall in Manhattan, has been converted into a temporary field hospital with nearly 3000 beds.

The disaster unfolding in New York City is the culmination of errors made in the US response to the outbreak. Mistakes with the initial test kits designed and distributed by the US Centers for Disease Control and Prevention sparked a weak testing effort that has yet to be fully remedied.

Social distancing, which is key to delaying the spread of the virus, was slow to be adopted: schools closed on 16 March and non-essential businesses shut a week later. Officials reported the city’s first case on 1 March, and declared a state of emergency 11 days later.

The city has now entered its second week of lockdown, and once bustling streets are deserted. Even Times Square is empty. It still isn’t clear whether the lockdown will stem the viral tide, but even if it is effective, estimates suggest that hospitalisations won’t peak for three weeks yet, due to the virus’s long incubation period.

Epstein’s hospital is turning away people that would normally be admitted so physicians can focus on the most seriously ill. “Covid, covid… everywhere you look, it’s all covid,” she says.

New York City is experiencing shortages of ventilators to help the most seriously ill breathe when infection overwhelms their lungs. Protective gear is also in short supply. Epstein has to reuse her N95 mask day after day and is only issued one gown per day.

Cuomo said the city will need 30,000 ventilators at the peak of the outbreak. De Blasio has asked President Donald Trump to divert medical equipment to the city.

In a Fox News interview on 26 March, Trump responded: “I don’t believe you need 40,000 or 30,000 ventilators. You go into major hospitals sometimes, and they’ll have two ventilators. And now, all of a sudden, they’re saying, ‘Can we order 30,000 ventilators?’”

Epstein calls this a disregard for human life in the city, adding: “I very much think things are just going to get worse.”