The 38-year-old registered nurse at a Manhattan hospital was nearing the end of his shift Sunday morning when he stepped toward the building’s ambulance bay.

There, a giant refrigerator truck was sitting, ready to carry away those who had died from complications of COVID-19. He walked up to the truck, opened the latch, and snapped a picture.

“I took it to show to people,” said the emergency room nurse. “It is the ghastly reality of what we deal with and where some of us have ended up already.” He asked that neither he nor his hospital be identified for fear of repercussions. BuzzFeed News altered the image to blur the names of the deceased.

Earlier Saturday night, he had sat with a patient and held her hand as she took her last breath. Now, her body lay inside the truck.

“I never had the patience to sit with somebody I’d just met until they took their last breath. But I really liked this lady’s cardigan and pajamas so I decided to stay and get to know her a little,” he said over text message. “Her hair was elegantly done with a sharp, meticulous clip and casually pulled up with a bandana that matched her house clothes. Perhaps if she’d covered her face with it instead, she wouldn’t have ended up here in the first place. But she didn’t die alone.”

One of the many unique horrors of the coronavirus is that its victims are frequently forced to die alone, isolated from relatives and friends, because of its high infection rate.

The nurse’s patient was 71 and otherwise healthy. He described how she gasped for air as she died. He said she had tested positive about a week ago and was sent home, only to return on Saturday with shortness of breath. She asked not to be intubated, and died overnight.

As of Saturday night in New York City, 672 people are known to have died from COVID-19 since the coronavirus outbreak began, with well over 30,000 known to be infected. Hospitals around the city are stretched to the limit, handling a constant influx of patients while running dangerously low on personal protective equipment like masks and gowns for doctors and nurses.

The nurse described a horrific Catch-22. “If we are covid positive, we are expected to work for as long as we are asymptomatic. However we cannot get tested unless we are symptomatic,” he said. “They don’t want to test us because, at the rates we are exposed, we are likely all sick and we don’t know it.”

“We are rationed personal protective equipment to absurdity,” the nurse said. He said they were given “one disposable mask and one disposable gown that we must sign out for, that is expected to be used for five 12-hour shifts before they will be replaced.”

Governor Andrew Cuomo has pledged to deliver more supplies for doctors and nurses, and said his office was “actively looking into” whether CDC guidelines on their use were sufficient. The nurse described a chaotic situation at his hospital, with ever changing rules. “Everything changes from day to day at work,” he said. “They are scrambling to figure out what to do as we go.”

“A week ago we were instructed to take off our masks at work. Now we are being instructed to wear them at all times because so many of us are testing positive.”

Texting on Sunday morning, he said he had to go to sleep, because another long shift awaited him. He couldn’t get the images of the truck out of his head.

“Maybe as a Jew i relate it to all of the Holocaust footage because that’s my only point of reference for such an image of humans,” he said. “[N]ever seen something quite like it.”