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Louisiana Governor John Bel Edwards, left, puts his mask back on after speaking during a press conference, before yielding the podium to Dr. Deborah Birx, following a round table discussion with Vice President Mike Pence, Tuesday, July 14, 2020, at LSU's Tiger Stadium in Baton Rouge, La.

State and federal officials are issuing familiar warnings to Louisiana residents as the coronavirus pandemic once again takes a firm grip on the state: Hospitals are on track to being overwhelmed, more restrictions may be needed and things will get worse before they get better.

Louisiana for weeks avoided the unprecedented surge in cases and hospitalizations happening around the country, though officials have worried about what they believed was the start of an increase. Now, Gov. John Bel Edwards and his top coronavirus leaders are seeing their fears realized.

“The luck has run out,” said Dr. Joe Kanter, the state’s top coronavirus response official. “This is our third surge. So people’s mindset needs to change.”

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Edwards and health leaders – including a doctor who has for months treated critically ill COVID-19 patients at the state’s largest hospital, Our Lady of the Lake Regional Medical Center in Baton Rouge – pleaded with people not to hold large Thanksgiving gatherings.

The U.S. Centers for Disease Control made a similar plea, advising people not to travel for the holiday and not to spend it with people from outside their household.

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The White House Coronavirus Task Force, in its weekly report to Louisiana, wrote “current mitigation efforts are inadequate and must be increased to flatten the curve to sustain the health system for both COVID and non-COVID emergencies.” State and federal officials have used the term “mitigation measures” interchangeably with restrictions that remain in place, like reduced capacity at bars and restaurants and a mask mandate.

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Louisiana has added more than 250 hospitalizations in the past week, a trajectory that officials say will overwhelm hospitals if it doesn’t change.

The governor delivered remarks that were eerily similar to those given as the state was experiencing similar surges twice before this year. He said hospitalizations were the “most concerning” trend.

While he didn’t announce new restrictions, Edwards said his administration is reviewing the data and contemplating ratcheting them back up. He said he doesn’t intend to go back to a “shelter-at-home” order like the one issued in March, when the pandemic was raging in the New Orleans area.

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“If we need to do additional restrictions, we are going to do that,” Edwards said. “My obligation to the people of Louisiana is to protect public health.”

Several states have already issued new restrictions. The country’s largest school system, in New York City, closed again as cases rise. Iowa’s Republican governor issued a limited mask mandate as hospitalizations soar in that state. GOP leaders in Utah, North Dakota and elsewhere similarly are changing course on restrictions and implementing measures to slow the spread of the virus.

The White House Coronavirus Task Force, led by Vice President Mike Pence, noted this week Louisiana is “experiencing a resurgence in COVID-19 with rising test positivity, cases and hospitalizations.”

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“There is now aggressive, unrelenting, expanding broad community spread across the country, reaching most parishes, without evidence of improvement but rather, further deterioration,” the report said, citing rising cases, test positivity and other worsening metrics.

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The task force includes Dr. Deborah Birx and Dr. Anthony Fauci, among other top health officials. Edwards participates in a regular call with the task force and other governors, and said the Monday call focused on the "bridge to the vaccine," which involves adhering to precautions between now and when the vaccine can immunize enough people to tamp down the spread, which is months away at best.

Louisiana is now in what the task force calls the “red zone” for cases, meaning more than 100 new cases per 100,000 population. The number in the state soared from under 100 new cases to 172 cases per 100,000.

The number of COVID-19 patients hospitalized has shot up at an alarming rate in recent days. In the past week, the number has risen by more than 200, to 929 people. That’s the highest number since late August, and an increase of 55 from the day before.

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Bars have been the most scrutinized settings by health professionals and the Edwards administration. In Phase 3, which the state is currently in, he laid out a system where parishes could reopen bars if they saw two consecutive weeks of 5% or less test positivity.

But parishes must close down bars again if they see 10% or more test positivity for two consecutive weeks. Ascension and West Baton Rouge parishes are among those that have gained the ability to reopen bars, only to have to shut them back down.

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State health officials Thursday said people need to make “sacrifices” this holiday season to avoid rampant spread of the virus between now and when a vaccine might immunize enough people to lift restrictions, which is likely months away.

Dr. Chris Thomas, a physician who has treated critically ill COVID-19 patients at Our Lady of the Lake for months, said the mounting stress of the pandemic has caused many of his colleagues to quit.

Thomas issued a stark plea to people to not hold Thanksgiving gatherings that will surely spread the virus, leading to needless hospitalizations and death.

Thomas said “every single” hospital in the state is at risk of seeing COVID-19 patients overwhelm their ability to deliver care.

OLOL was among the hospitals that received additional staff members to deal with a surge of patients in the summer, Thomas said. But officials worry that help won’t be available this time, as other parts of the country are tapping all available health care workers.

“At the current pace we will not have the capacity to do this again,” Thomas said. “We have the beds. What we don’t have is enough nurses in all of the beds in all of the hospitals in the state of Louisiana.”

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