As  of Friday, Louisiana was reporting 479 confirmed cases of COVID-19, one  of the highest numbers in the country. Ten people had died. The  majority of cases are in New Orleans, which now has one confirmed case  for every 1,000 residents. New Orleans had held Mardi Gras celebrations  just two weeks before its first patient, with more than a million  revelers on its streets.
      
I  spoke to a respiratory therapist there, whose job is to ensure that  patients are breathing well. He works in a medium-sized city hospital’s  intensive care unit. (We are withholding his name and employer, as he  fears retaliation.) Before the virus came to New Orleans, his days were  pretty relaxed, nebulizing patients with asthma, adjusting oxygen tubes  that run through the nose or, in the most severe cases, setting up and  managing ventilators. His patients were usually older, with chronic  health conditions and bad lungs.
      
Since  last week, he’s been running ventilators for the sickest COVID-19  patients. Many are relatively young, in their 40s and 50s, and have  minimal, if any, preexisting conditions in their charts. He is  overwhelmed, stunned by the manifestation of the infection, both its  speed and intensity. The ICU where he works has essentially become a  coronavirus unit. He estimates that his hospital has admitted dozens of  confirmed or presumptive coronavirus patients. About a third have ended  up on ventilators.
His  hospital had not prepared for this volume before the virus first  appeared. One physician had tried to raise alarms, asking about negative  pressure rooms and ventilators. Most staff concluded that he was  overreacting. “They thought the media was overhyping it,” the  respiratory therapist told me. “In retrospect, he was right to be  concerned.”       
He  spoke to me by phone on Thursday about why, exactly, he has been so  alarmed. His account has been condensed and edited for clarity.