NEW ORLEANS – Earlier this month, Yanti Turang, a New Orleans hospital emergency room nurse, stepped out into the parking lot in full protective gear to meet a woman with flu-like symptoms who had just returned home after a stopover in South Korea. The woman was immediately taken to an isolation room.
At about the same time, a man who had never left the country and had been to New Orleans during the recently concluded Mardi Gras season, presented to the emergency room with a high fever and dry cough. He was placed in a neighboring room and attended by hospital workers without any special equipment.
To everyone's relief, the woman who had traveled through Asia tested positive for the standard flu. The man, however, did not, Turang said. Her symptoms improved but her diagnosis was unclear, she was told to take Tylenol and get some rest. And he was sent back to the city.
Turang doesn't know what became of that man, but it was on his mind two days later when the first confirmed case of the new coronavirus was announced in Louisiana: someone else, in another hospital. The coronavirus had been in town the entire time. Since then, the outbreak here has become one of the most explosive in the country.
According to a study, Louisiana, with more than 2,300 cases as of Thursday afternoon, is experiencing the fastest growth in new cases in the world. Gov. John Bel Edwards said Tuesday that the current trajectory of case growth in Louisiana was similar to that of Spain and Italy. This week, President Donald Trump approved the governor's request for a major disaster declaration, which unlocks additional federal funds to combat the outbreak.
The situation in and around New Orleans is particularly dire, as the city reported 997 confirmed cases as of Thursday afternoon, more than the total number of cases in all but 13 states. Hospitals are overwhelmed and critical safety equipment is running low.
The parish of Orleans, which shares its borders with the city of New Orleans, has suffered the highest number of deaths per capita of any county in the nation. Of the parish's 46 deaths, more than twice the death toll for Los Angeles County, 11 are from a single retirement home, where dozens more residents are infected.
In a sad irony, there is growing suspicion among medical experts that the crisis may have been hastened by Mardi Gras, the city-wide celebration unfolding in living rooms, ballrooms, and city streets, culminating in this year on February 25.
It is the expression of joy characteristic of the city, and the nightmare of an epidemiologist.
"I think it all comes down to Mardi Gras," said Dr. F. Brobson Lutz Jr., a former New Orleans director of health and infectious disease specialist. "The best free party in the world was a perfect incubator at the perfect time."
The feel is both familiar and distinct for a city whose history is peppered with epic disasters, including the deadly yellow fever outbreaks of 1853 and 1905, and Hurricane Katrina in 2005. Once again, new Orleans residents fear leaders nationals may neglect them. Only this time because the coronavirus is a worldwide calamity.
"This hurricane is coming for everyone," said Broderick Bagert, organizer of the community organizing group Together Louisiana.
Edwards, who, like most other Louisiana governors, has extensive experience in hurricane management, said the state was struggling to cope with this new type of disaster.
"We really don't have a playbook on this one," he said.
"If you have a flood or a hurricane, only a small part of the country is affected, so you can get the full attention of the federal government and you can get a lot of help from sister states," he said. "That is not possible at the moment because this is in all the states of our country."
As a kind of ghost settles over an enclosed nation, the effect of social estrangement is particularly jarring in New Orleans, a city that is based on intimacy, from the deep networks of kinship and geography that connect families and neighborhoods with the fleeting threads that unite strangers and regulars in historic restaurants and crowded and sweaty clubs.
Now great restaurants offer takeout, if they are open. The clubs are silent. Bourbon Street is just another lonely street, its only crowds being the hordes of rats that have become increasingly cheeky in their search for food.
Dr. Catherine S. O & # 39; Neal, infectious disease specialist and chief medical officer at Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana, compared this year's Mardi Gras to the infamous "Loan of Liberty "of 1918 in Philadelphia. That meeting took place amid an influenza pandemic, brought 200,000 people to the streets of the city, and likely contributed to Philadelphia's horrifying death toll, with more than 12,000 people dying in a six-week period.
But O & # 39; Neal did not blame anyone for not taking steps to limit the Mardi Gras festivities. At the time, no cases of the virus had been identified in Louisiana, and there were fewer than 50 known cases in the United States.
"We were still talking about washing hands," he said.
Dr. Susan Hassig, an epidemiologist and associate professor at Tulane University School of Public Health and Tropical Medicine, said there were other probable reasons, beyond Mardi Gras, that could explain why New Orleans has been hit so hard. : the dense and compact nature of the city; its tourism industry; its port, which connects it to the world; and the way people connect culturally.
"Everyone talks to everyone, which means you stop and have a conversation and then go ahead and have a conversation with someone else," said Hassig, who participated in a Mardi Gras parade with the Krewe of Muses this year. .
Turang, the emergency room nurse, who worked in Sierra Leone during the 2015 Ebola epidemic, said doctors and nurses are now talking about patients who had come to hospitals between Mardi Gras and the announcement of that first case on March 9, people with moderate flu-like symptoms tested negative for the flu
"We were surprised," he said, "by the fact that he was actually here in New Orleans already."
The first confirmed case in Louisiana was announced less than two weeks after Fat Tuesday. Around the same time, reports began popping up across the South – Tennessee, Arkansas, Texas – of people who tested positive after recently returning from New Orleans.
The first people to test positive in New Orleans, according to Dr. Jennifer Avegno, the city's director of health, had not recently returned from anywhere. But its variety of unusual symptoms had worried doctors.
"They just had a feeling that something was wrong," Avegno said. "It became apparent fairly quickly that there was a spread of the community, that the cases were not directly related to each other."
Within days, state schools were closed and large public gatherings in New Orleans, including the annual grand St. Patrick's Day parade, were banned, though enough people came out that Saturday to attract police. A week after the first case was announced, the governor issued an order to close restaurants, bars, and restaurants, some of which had to call carpenters to install door locks that had not been secured for years.
Edwards also limited the meetings to less than 50 people. But some have remained defiant, including Tony Spell, pastor of the Life Tabernacle Church outside of Baton Rouge, where hundreds of people have reportedly gathered to pray without observing the rules of social estrangement. Spell has called the virus "spiritually motivated,quot; and said it would heal infected members of its herd by laying hands on them and praying.
As the evidence increased, the number of cases in Louisiana increased. A medical worker at the city jail tested positive, as did a founder of the Grammy-winning Rebirth Brass Band. Sean Payton, the New Orleans Saints coach, announced he had tested positive. The Archbishop of New Orleans also did so.
The rate of growth of new infections in Louisiana was the fastest in the world when comparing areas during the two weeks following their first confirmed diagnosis, according to a recent study by Gary A. Wagner, professor of economics at the University of Louisiana at Lafayette . In a small, nearby city like New Orleans, that means almost everyone knows someone who has been infected.
"One of my members, Sister Monica, is on a respirator," said Tyrone Jefferson, 46, pastor of a church in the city's St. Roch neighborhood. "Another ran to a hospital yesterday. Two are at home with it.
Doctors and nurses at city hospitals, like hospital workers across the country, describe a severe shortage of critical protective equipment. The Cajun Navy, one of Louisiana's informal volunteer brigades, famous for rescuing people from floods, and the Cajun Army have delivered several boxes of masks and gallons of hand sanitizer to medical workers.
But the flood of patients continues to come.
Edwards, a moderate Democrat in his second term, has always been careful to criticize the Trump administration for political and practical reasons: after a hurricane, it is of little use to choose a fight with a federal government that holds the key to the relief of disasters.
However, on Tuesday, Edwards said he would like to see the Trump administration become more involved in the coronavirus response in a way that prioritizes the most affected areas.
Fans and personal protective equipment should be assigned, he said, "based on demonstrated need, as opposed to the current situation, in which each state, each health care provider, is working to the best of its ability but independently of the other,quot;.
As the disease spreads and sickens its sufferers, the increased shortage of medical workers, particularly nurses and respiratory therapists, is for many the greatest concern. For now, many exposed health workers, a description that represents more than half of the city's emergency medical technicians, wear masks and monitor their temperatures, but, while showing no symptoms, they remain on the job.
The concomitant tragedy of the pandemic, the economic devastation in a city that lives on tourism and the good times, has been very close. Most of the tens of thousands of city hotel and restaurant jobs don't pay enough for workers to have saved enough for weeks in closing, but they pay better than nothing.
"Our food banks say they will run out of food next week," said New Orleans Mayor LaToya Cantrell, adding that the city was estimating a budget deficit of at least $ 100 million next year, given the tax revenue. that fade away.
"And," the mayor continued, "we have hurricane season in June."
In his request for a federal emergency declaration, Edwards said the projected hospitalizations would exceed the state's capacity by April 4, and that the state had begun contracting to "build hotels,quot; to provide additional hospital beds. Three state parks have also been equipped with trailers to house more than 300 patients.
If hospitals reach capacity, state officials are considering housing non-critical patients at the Ernest N. Morial Convention Center in New Orleans, which housed thousands of residents who were forced to flee their homes due to the Katrina floods, and it became a symbol of the chaotic response to that disaster.
For now, the death toll continues its steady rise. A well-known 44-year-old DJ who defended the city's bouncing music scene. A 53-year-old man who drove for Uber and Lyft in Mardi Gras. On Thursday, health department officials reported the death of the state's youngest known victim, a 17-year-old boy in Orleans parish.
Ellis Joseph was friends with Oliver Stokes, the DJ, and also with Ronald Lewis, a New Orleans cultural icon who died of the coronavirus on Friday, as evidence would posthumously confirm. At another time, Joseph would have walked with his bass drum behind the coffin in Lewis' funeral procession, leading a marching band in the traditional chant "Just a Closer Walk With Thee." Hundreds, if not thousands, of people would have followed or lined the streets.
"I'm going to say a silent prayer for Mr. Ronald now and I'll roll for him later," said Joseph, who is now trying to avoid even going to the store.
The funeral was on Monday. Under current regulations, it was limited to one pastor and nine others.
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