The hospitals in New York are overrun with coronavirus infections and emergency rooms are trying to minimize the number of difficult arrivals.
"It almost seems like it's never stopping, people keep coming and coming and coming and there's just no space to put them," said ER Dr. Darien Sutton.
City officials have released stark new guidance to equally overworked ambulance crews, effective immediately, if they can't resuscitate a patient in the field, they must withhold CPR and declare the person dead.
They can no longer continue to the hospital.
"These orders are binding and the FDNY will devise a plan for implementation," said Deputy Fire Commissioner Frank Dwyer.
The new approach shows how stretched thin EMS and hospitals are.
"When you're doing the CPR, you're pushing really hard on the patient's chest and they're expelling some air in the process as well, so if they are COVID patients, they'll be spreading it all around," said Dr. Vinayak Kumar with the Mayo Clinic. "This is the risk-benefit math you have to take into account."
The orders to stop CPR in the field is shocking to veteran doctors who are used to doing whatever it takes to save a life.
"As a doctor in New York and as a New Yorker, I have family that live here, and when I hear things like that I obviously get afraid, fearful for the livelihood of my family," Sutton said. "It is terrifying, it is really terrifying."
The new guidance only applies to cardiac arrest patients 18 years or older.
MORE CORONAVIRUS COVID-19 COVERAGE
Where are the testing centers
See how our communities are making a difference
Free educational resources for parents and children
How you can help victims of coronavirus
Coronavirus news and live updates in New York
Coronavirus news and live updates in New Jersey
Coronavirus news and live updates in Connecticut
New York City updates
Long Island updates
How coronavirus is leaving ghost towns in its path
Coronavirus prevention: how clean are your hands?
Social distancing: What is it and how does it stop the spread of coronavirus?
Coronavirus closures and cancelations
Coronavirus tips: What Americans need to know
Centers for Disease Control and Prevention on coronavirus
Total count of COVID-19 cases based on patient address