One nurse says she places her N-95 mask in a brown paper bag with her name on it until she has to use it for her next patient. 

Another doctor keeps protective personal equipment known as “PPE” under lock and key to try to conserve the limited supply. 

And another prays he won’t have to re-use a batch of masks they’ve disinfected with UV light.

“It is running out, we are in need,” Dr. Mark Einstein, interim chief medical officer at University Hospital said of his hospital’s PPE stock. “At our current burn rate, we're going to be out relatively soon.”

Protective gear for health care workers at the frontlines of New Jersey’s growing COVID-19 pandemic is dwindling across hospitals as the number of cases reaches nearly 9,000. But nurses and doctors tell WNYC/Gothamist they’re also concerned about shortages in critical care beds—and having enough medical staff to care for the expected surge in patients that could come as early as mid-April.

“It's the numbers that are going to kill us,” Sue Scaglione, a per diem nurse at Bayshore Medical in Holmdel said. “We're going to have too many people in need of high-level nursing care and medical care and not enough people to fill those roles.”

There was a nurse shortage even before the pandemic struck. Hospitals say they desperately need more critical care nurses that can care for patients needing to be hooked up to a ventilator and watched continuously. But hospitals are challenged by staff shortages when they have to self-quarantine if they’re exposed or test positive. 

“It's a bit of a mini crisis,” Dr. Adam Jarrett, the Chief Medical Officer at Holy Name Medical Center in Teaneck said. “I'm still comfortable that we have not compromised care at all. But I'm worried about the future.”

Holy Name in Bergen County is at the center of the state’s crisis. Bergen County has the highest confirmed coronavirus cases in the state with more than 1,500.

State officials said they did not have the total number of medical health care workers diagnosed with coronavirus or who are under quarantine. They said the state’s first health care worker to die from the illness passed away on Thursday when the death toll reached 81 (the death toll was 108 on Friday). 

Hackensack Meridian Health, the state’s largest hospital network, said last week about 150 health care professionals were in quarantined situations. Officials did not provide an updated number. 

Hospitals say things have changed dramatically since the state’s first patient was identified on March 4. This week more and more people are coming in needing immediate hospitalization—particularly in the state’s hardest hit counties of Bergen, Essex and Hudson, right across from New York City, which is now the epicenter of cases in the U.S. 

Hospitals look drastically different. No visitors are allowed inside, plastic sheets separate areas of the hospitals holding COVID-19 patients and nurses and doctors have to refrain from providing some of the human comfort they’re used to doing.

“You have a 95-year-old patient that has no family because they can't come in. They have COVID and they're ill. But usually the nurses and doctors want to give you compassion, you know,” Dr. Chris Freer, the Clinical Chairperson of Emergency Medicine at Saint Barnabas Medical Center said. “And that means touching the patient and sitting next to the patient. You can't do those things.”

State Health Commissioner Judy Persichilli says the state’s hardest hit counties along the more northern end of the state can expect to see a peak of patients needing hospitalization shortly after New York City sees its surge. Persichilli said Friday she thinks the state will be “fine” and ready to handle it. (On Friday, New York Governor Andrew Cuomo said he expected the “apex” of cases to be in 21 days.)

But the crunch for hospital beds is already being felt. 

“Within two or three days of the start of this, it became one big giant tidal wave that has not not let up,” Dr. Jarrett said. “We have the sickest patients because it hit here first … everyone else is going to catch up.”

He says Holy Name had 97 known or suspected COVID-19 patients on Wednesday, with 25 on ventilators. The hospital has created two additional intensive care units to absorb the influx. He has enough ventilators for now but says things change every few hours.

Other hospitals echoed a similar sentiment. They’ll run terrifyingly short on N-95 masks or other gear and put out a call for help—sometimes on social media. They’ll secure a few donations or procure a couple hundred more masks to last another few days. 

“It's literally a day-to-day kind of thing,” Dr. Jarrett said. 

New Jersey has asked the federal government for 2,300 ventilators and Persichilli says they will need another 2,000 ICU beds. Four pop-up field hospitals will be built across the state with the help of the U.S. Army Corps of Engineers. The state is also trying to re-open recently shuttered hospitals or closed wings of hospitals in its aggressive push to build out bed capacity before the surge. 

But without more ventilators, beds, or staffing, doctors worry about the tough choices they might be forced to make. 

“We have a lot of plans in place for how we're going to be ethically deciding some decisions between bad and worse if we have more patients than we have the capabilities of being able to manage,” Dr. Einstein from University Hospital in Newark said. “And these are decisions that we're making in small rooms that I think give many leaders goose bumps to have, that we actually have to have this conversation.”