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Medical personnel carry an oxygen tank into Elmhurst Hospital Center's emergency room, in New York, on April 7, 2020.

Kathy Willens/The Associated Press

The number of coronavirus cases in New York State alone approached 150,000 on Wednesday, surpassing Spain for the most infections anywhere in the world, even as authorities warned the state’s official death tally may understate the true toll.

New York, the state considered the epicentre of the pandemic in the United States, and neighbouring New Jersey again reported new single-day highs for coronavirus deaths.

“Every number is a face,“ said New York Governor Andrew Cuomo, who ordered flags to be flown at half-staff across New York in recognition of the toll. “This virus attacked the vulnerable and attacked the weak and it’s our job as a society to protect the vulnerable.”

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New York State has 149,316 reported cases compared to Spain’s 146,690, according to a Reuters tally. The United States has recorded nearly 420,000 coronavirus cases and more than 14,300 deaths.

Sign up for the Coronavirus Update newsletter to read the day’s essential coronavirus news, features and explainers written by Globe reporters

New York officials said a recent surge in the number of people dying at home suggests the most populous U.S. city may be undercounting how many have died of COVID-19, the respiratory illness caused by the pathogen.

“I think that’s a very real possibility,” Mr. Cuomo told his daily news briefing.

Mr. Cuomo said 779 people died in the past day in his state. New Jersey Governor Phil Murphy said 275 had died there. Both totals exceeded one-day records reported just a day earlier.

Raychel Lewis, cell culture technician, sets up equipment to test COVID-19 samples from recovered patients at Mirimus lab on April 8, 2020 in Brooklyn, New York City. New York City is the epicentre of the coronavirus pandemic in the United States and over 122,000 New Yorkers have tested positive for COVID-19.

Misha Friedman/Getty Images

Despite the grim tally, Mr. Cuomo said overall trends still appeared positive. Mr. Cuomo cited a drop in new hospitalizations and other data points as evidence that New York was “bending the curve” and gaining some control over the infection rate.

Mr. Cuomo said the death count would continue at the current level or increase in the coming days as critically ill patients, who have been hospitalized for more than a week and on ventilator machines to assist in breathing, die.

Mr. Murphy tightened New Jersey’s social-distancing requirements, ordering retailers including grocery stores still allowed to operate to limit customers, ensure that customers and employees wear face coverings and regularly sanitize the premises.

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Louisiana announced 70 deaths in the past day, matching its single-day record announced a day earlier.

Residents and support staff are pictured outside a group home for people with special needs in Bayville, N.Y., on April 8, 2020. Of the home’s 46 residents, 37 have tested positive for the coronavirus.

JOHNNY MILANO/The New York Times News Service

U.S. President Donald Trump’s administration has called for 30 days of measures, including staying at least six feet away from other people, that have upended American life. Most people are staying isolated at home, schools and businesses have closed and millions are losing their jobs. About 94 per cent of the U.S. population has been ordered to stay at home.

“If people start going out again and socially interacting, we could see a really acute second wave” of infections, Deborah Birx, co-ordinator of the White House coronavirus task force, told NBC’s Today program.

DEATH TOLL PROJECTIONS

The University of Washington’s Institute for Health Metrics and Evaluation model lowered its projected U.S. death toll by 26 per cent, to 60,000 from 80,000 by August 4. The model is one of several that the White House Task Force has cited.

The task force previously projected 100,000 to 240,000 Americans could die.

The institute moved up its projected peak in U.S. deaths to this Sunday, when it predicted 2,212 people would die from COVID-19. The revision moves forward the projected peak by four days, suggesting the strain on the U.S. health-care system will lessen sooner than previously forecast.

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So far, New York’s announced death toll has reflected only laboratory-confirmed COVID-19 diagnoses. More than 200 people are dying at home in the city daily during the pandemic, up from 22 to 32 during the March 20 to April 5 period a year ago, authorities said.

The city will now try to quantify how many of those died from coronavirus-related causes and add that to its official toll.

Randall's Island has fifty refrigerated trucks and a crew of carpenters building shelves for the expected influx of deaths related to COVID-19 pandemic on April 8, 2020 in New York City. The trucks will be able to house an estimated 2,500 of the dead as city morgues reach capacity. New York state has nearly 150,000 of the nation's confirmed cases of COVID-19, including more than 6,000 dead.

David Dee Delgado/Getty Images

“People are dying outside the hospital, unfortunately. It happens every day,” Oren Barzilay, the president of a labour union representing city paramedics, said. “I think those numbers, those statistics in New York for deaths would significantly go up if they tested everyone that expired.”

New York Mayor Bill De Blasio said there were clear racial inequalities in how the coronavirus is affecting his city, although the disparities were less severe than in some other jurisdictions. Data showed Hispanic residents dying at more than twice the rate of non-Hispanic, white New Yorkers and slightly outpacing the death rate of African Americans.

Dr. Sonik Randev returned this week to her residency at Metropolitan Hospital Center in New York after missing nearly three weeks sick with COVID-19.

“As a doctor, just the idea that you know for sure a patient is going to die – it’s surreal,” Ms. Randev said.

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Dr. Craig Smith, surgeon-in-chief at Presbyterian Hospital’s Columbia University Medical Center in Manhattan, heralded encouraging numbers that suggested a turning tide in Wednesday’s edition of his daily newsletter to staff.

There were more discharges of patients than admissions for two days running, he said, adding: “Hosanna!”

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Your subscription helps The Globe and Mail provide readers with critical news at a critical time. Thank you for your continued support. We also hope you will share important coronavirus news articles with your friends and family. In the interest of public health and safety, all our coronavirus news articles are free for anyone to access.

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