New York, New Orleans and other hot spots faced a surge in hospitalizations and looming shortages in supplies, staff and sick beds. Medical facilities were running low on ventilators and protective masks and were hampered by limited diagnostic testing capacity, as the number of U.S. cases of coronavirus reached over 81,378, overtaking China and Italy.

At least 1,178 people in the United States have died from COVID-19, which has proven especially dangerous to the elderly and people with underlying chronic health conditions, according to reports from state and local public health authorities.

"Any scenario that is realistic will overwhelm the capacity of the healthcare system," New York Governor Andrew Cuomo told a news conference. "The number of ventilators we need is so astronomical – it's not like they have them sitting in the warehouse," Cuomo added. "There is no stockpile available."

At least one New York hospital has begun a trial of sharing single ventilators between two patients. Dr. Craig Smith, surgeon in chief at New York-Presbyterian/Columbia University Medical Center in Manhattan, wrote to staff that teams had worked "day and night" to get the split-ventilation experiment going.

In New York state, the goal is to make as many as 140,000 hospital beds available, up from the current capacity of 53,000, and authorities are scouting new sites, Cuomo said.

Asked about media reports of some New York City healthcare workers resorting to using plastic trash bags to try to protect themselves, Cuomo acknowledged issues with the distribution of protective equipment and said there was enough in stock for the "immediate need" but not for the longer term.

New York hospitals were scrambling to comply with Cuomo's directive that they increase capacity by at least 50 percent.

While New York was the coronavirus epicenter in the United States this week, Louisiana could be the next. In New Orleans, the state's biggest city, Mardi Gras celebrations last month were believed to have fueled the outbreak.

Demand for ventilators has doubled in Louisiana, with some 80 percent of intensive care unit patients now on the breathing machines, said Warner Thomas, chief executive of Ochsner Health System, the state's healthcare group.

Louisiana Governor John Bel Edwards warned that his state, reporting about 1,800 infections, including at least 83 deaths is rapidly running out of beds and ventilators.

"If we don't flatten the infection curve soon, we will be out of ventilators in New Orleans by April 2, and we would potentially be out of bed space for individuals by April 7," he said at a press conference.

"It's not conjecture, it's not some flimsy theory, it's not some scare tactic. This is what is going to happen."

The projected ventilator shortfall and surge in hospitalizations has already raised the prospect of rationing healthcare.

Asked about guidelines being drafted on how to allocate ventilators to patients in case of a shortage, New Jersey Governor Phil Murphy said such bioethical discussions "haunted him" but were unavoidable in the current situation.

Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, told WNYC public radio that the changing weather could help fight the virus because generally warm and moist conditions are better than a cold, dry winter. Fauci said the virus could return for the Northern Hemisphere's next winter.

"We hope we get a respite as we get into April, May and June. It is likely to come around next season because it's a very vigorous virus," Fauci said.

Outside New York and New Orleans, other hot spots appeared to be emerging around the country, including Houston and Detroit.

Brandon Allen, 48, bought groceries in Detroit for his 72-year-old mother who has tested positive for the coronavirus and was self-quarantining at home.

"It's surreal," Allen said. "People around me I know are dying. I know of a couple people who have died. I know a couple of people who are fighting for their lives. Everyday you hear of another person who has it."

(With input from Reuters)