ROME - Facing intense surges in the need for hospital ICU beds, European nations are on a building and hiring spree, throwing together makeshift hospitals and shipping coronavirus patients out of overwhelmed cities via high-speed trains and military jets. The key question is whether they will be able to find enough healthy medical staff to make it all work.
Even as the virus slowed its growth in overwhelmed Italy and in China, where it first emerged, hospitals in Spain and France reached their breaking points and the U.S. and Britain braced for incoming waves of desperately ill people.
"It feels like we are in a third world country. We don't have enough masks, enough protective equipment, and by the end of the week we might be in need of more medication too," said Paris emergency worker Christophe Prudhomme.
In a remarkable turnaround, rich economies where virus cases have exploded are welcoming help from the less wealthy. Russia sent medical equipment and masks to the U.S. on Wednesday. Cuba sent doctors to France. Turkey sent a planeload of masks, hazmat suits, goggles and disinfectants to Italy and Spain.
London is just days from unveiling a 4,000-bed temporary hospital built in a massive convention center to take non-critical patients so British hospitals can free up space and keep ahead of expected virus demand. Still, there are concerns about finding thousands of medical workers to run it.
Spain has already boosted its hospital beds by 20%. Dozens of hotels across Spain have been turned into recovery rooms, and authorities are building field hospitals in sports centers, libraries and exhibition halls.
Europe's greatest need at the moment, however, is intensive care units, which are essential in a pandemic in which tens of thousands of patients quickly descend into acute respiratory distress. Those ICU units are much harder to cobble together quickly than standard hospital beds.
Milan opened an intensive care field hospital Tuesday at the city fairgrounds for 200 patients, complete with a pharmacy and radiology wards. It expects to eventually employ some 900 staff. The move came after the health situation turned extreme in Italy's Lombardy region, where bodies overflowed in morgues, caskets piled up in churches and doctors were forced to decide in some cases which desperately ill patient would get a breathing machine.
"We aren't happy to have done this," fairgrounds foundation head Enrico Pazzali said. "It something I never would have wanted to do."
The pressure is easing on hard-hit Italian cities like Bergamo and Brescia as the rate of new infections in Italy has slowed and hospitals have boosted ICU capacity. Still, many people are dying at home or in nursing homes because hospitals are saturated and they could not get access to ICU breathing machines.
With over 12,400 dead so far, Italy has the most coronavirus deaths of any nation in the world.
Italy, Britain and France are among countries that have called in medical students, retired doctors and even airplane attendants with first aid training to help, although all need re-training.
The medical staffing shortage has been exacerbated by the high number of infected medical personnel. In Italy alone, nearly 10,000 medical workers have been infected and more than 60 doctors have died.
Dr. Silvio Brusaferro, the head of Italy's institutes of health, said three weeks into a nationwide lockdown, the country is seeing the rate of new infections level off.
"(But) arriving at the plateau doesn't mean we have conquered the peak and we're done," he warned. "It means now we should start to see the decline if we continue to place maximum attention on what we do every day."
In neighboring France, nearly 500 people died Tuesday and Paris hospitals are overflowing.
"We had an extremely difficult night, we are at the end of our hospitalization capacity," Aurelien Rousseau, director of the Paris regional health agency, said Wednesday on France-Info radio.
The Paris region more than doubled its ICU capacity over the past week - but the beds are already full. So Paris was sending some critically ill patients to less-saturated regions on specially fitted high-speed trains Wednesday and Thursday. Others have been moved by military plane, helicopter or warship.
One reason Germany is in better shape than all other European countries is its high proportion of ICU beds, at 33.9 per 100,000 people, compared to 8.6 in Italy.
For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough. But for others, especially older adults and people with existing health problems, it can cause severe symptoms like pneumonia and can lead to death.
As U.S. health authorities warned the number of dead could reach up to 240,000 even with social distancing measures in place, the New York region also rushed to set up extra hospital capacity.
A 1,000-bed emergency hospital set up at the mammoth Javits Convention Center began taking non-coronavirus patients Tuesday to help relieve the city's overwhelmed health system. A Navy hospital ship with 1,000 beds was expected to accept patients soon, and the indoor tennis center that hosts the U.S. Open tournament is being turned into a hospital.
"I want every American to be prepared for the hard days that lie ahead," President Donald Trump said at a Tuesday briefing, as he extended social distancing guidelines until April 30. "We're going to go through a very tough two weeks."
The U.S. recorded a big daily jump of 26,000 new cases, bringing its total infections to more than 189,000, the highest in the world. The U.S. death toll leapt to over 4,000, and refrigerated morgue trucks were parked on New York streets to collect the dead.
Worldwide, more than 860,000 people have been infected and over 42,000 have died, according to a tally kept by Johns Hopkins University. Italy and Spain accounted for half of all the deaths. China, where it began late latest year, on Wednesday reported just 36 new COVID-19 cases.
Some have chosen to ignore social distancing guidelines. In Louisiana, buses and cars filled a church parking lot Tuesday evening as worshippers flocked to hear a pastor who is facing charges for holding services despite a ban on gatherings.
A few protesters also showed up at the Life Tabernacle Church, including one with a sign that read: "God don't like stupid."
Two ships carrying passengers and crew from an ill-fated South American cruise are urging Florida officials to let them dock. Two people aboard with the virus have died, and nine have tested positive. Trump said, for humanitarian reasons, Florida should do so.