NEW YORK (BLOOMBERG) – A 1,000-bed navy hospital ship. The 167,225 square-metre Javits Convention Centre. Madison Square Garden, home of the New York Knicks.

As New York braces for a surge in coronavirus cases requiring hospitalisation, state and local officials as well as hospital executives are thinking about requisitioning massive spaces to make room for a flood of patients.

The efforts are part of a tremendous push to cobble together additional space for a surge in patients before hospitals are overwhelmed.

In the near term, hundreds of beds are being added this week, with far more ambitious solutions under discussion. Hospital systems in and around the most populous US city have already moved to free up existing beds and add more.

Since the weekend, New York City has spelled out how it will add some 1,500 hospital beds to its current stock of about 20,000. In neighbouring New Jersey, which entered the year with about 26,000 beds, state officials are adding 500 beds over the next few weeks and may add 300 more by reopening a hospital it closed in December.

The grand plans will take more time. The Navy ship, the USNS Comfort, is being reassigned to add 1,000 beds to the city’s capacity, Governor Andrew Cuomo said on Wednesday (March 18).

The Defence Department, in separate comments, said the ship is undergoing maintenance in Norfolk, Virginia, and would be ready to move up the coast in weeks, not days.

Once it docks on Manhattan’s west side, it would take trauma and other non-virus patients, the Pentagon said. That would effectively free up hospital spaces elsewhere for treating severe Covid-19 cases, which Mr Cuomo says could peak in 45 days.

Officials in New York and New Jersey have raised alarms that their medical facilities could be swamped if capacity isn’t added. In New York, Mr Cuomo has issued an executive order to boost bed-counts statewide by 9,000, with 5,000 in the city.

He plans to meet later on Wednesday with the Army Corps of Engineers about adding more space.

It’s a race against time. Mr Cuomo has estimated that the virus could reach its peak in six weeks, and could necessitate as many as 110,000 hospital beds, nearly double the state’s count when the crisis began.

On Monday, New York City Mayor Bill de Blasio touted early efforts that identified 1,300 additional beds, including 600 being set up at a former nursing home in Brooklyn, and 270 at hospitals in the Bronx. Coler Specialty Hospital on Roosevelt Island could add 350 beds within a week.

More potential space in the city materialised on Tuesday. By converting space in five hotels, the city will add another 250 rooms, according to the city’s hospitals website. The city also bought 11 tents to use for temporary facilities and has placed orders to buy as many as 20 more.

The city could tap recently vacated college dormitory rooms as well. On Tuesday, New York University informed students that they should clear out their rooms in case the city asked to deploy them for the coronavirus medical response, the student newspaper reported. There was no indication the request was made.

City officials are seeking state approval for use of the Javits Centre, a facility on Manhattan’s west side that’s hosted giant car, boat and other trade shows.

City Council Speaker Corey Johnson, in a Tuesday radio interview, weighed using Madison Square Garden, better known for hosting Billy Joel and the New York Rangers. A spokeswoman for MSG didn’t immediately return a request for comment.

The USNS Comfort is capable of carrying 12 fully equipped operating rooms, medical laboratory and pharmacy, and can provide digital radiological services, CAT scans and oxygen production, according to the Navy. It has provided extra capacity in crises before, including after the Haiti earthquake and New Orleans hurricane.

Hospital executives are looking for ways to boost capacity in more modest ways as well. Mr Cuomo has appointed Greater New York Hospital Association President Ken Raske and Northwell Health President Michael Dowling to lead that effort, and area hospital CEOs held a planning call on Tuesday.

Dr David Batinelli, chief medical officer of Northwell Health, the largest healthcare provider in New York state, said that his system had a base capacity of 5,500 beds, and could add 1,000 more in its existing facilities by doubling up beds in rooms that are currently single occupancy and by retooling other spaces.

Northwell is also in the process of identifying places for staff to stay, primarily hotels, if they don’t want to return home between shifts, Mr Batinelli said. Non-clinical support staff are already working remotely.

New Jersey on Wednesday expected to make 260 acute-care beds available beyond usual capacity, Ms Judy Persichilli, the state health commissioner, said at a Trenton news conference.

A further 227 beds are expected to open in the next few weeks, she said. Additionally, authorities are examining whether to reopen Underwood-Memorial Hospital in Woodbury, which closed in December. That would add 300 beds, Ms Persichilli said.

Hackensack Meridian Health, New Jersey’s largest health network, has taken several steps to increase its 4,700-bed capacity.

It has opened units at its hospitals that had previously been closed, suspended elective surgeries and discharged patients more aggressively, said Dr Daniel Varga, the chief physician executive there.

“We think we’ve bumped our potential capacity by about 20 per cent in the last week or so,” Dr Varga said.

Mr Batinelli of Northwell Health described Mr Cuomo’s numbers as a worst-case scenario, and though it’s difficult to see clearly how well mitigation efforts are working, he estimated that “we’re doing relatively well”.

The primary problem continues to be access to ventilators.

“The people who make these are scrambling,” he said. “If you don’t have the ventilators, you’re going to be making some extremely difficult decisions.”

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