When Dr. Darien Sutton saw what was happening in Italy, he braced himself.
Sutton, an emergency medicine physician in Queens, New York, anticipated that the reality in Italy during the novel coronavirus pandemic -- not enough hospital beds, a lack of protective gear -- would soon become the reality in the U.S.
In New York City, he was right.
"Right now, looking at a large hospital in Queens, the medical intensive care unit is already at capacity," Sutton told ABC News on Friday.
He hopes it will serve as a wake-up call for other communities throughout the country on how to respond.
"We should use this as an igniting event," Sutton said, encouraging other communities to test early and actively push for social distancing even if they aren't in a dire situation right now.
Currently, there are more than 100,000 confirmed cases of COVID-19 in the U.S. and at least 46,000 in New York. More than 26,000 of the state's cases are in New York City and at least 450 city residents have died. A breakdown of where the cases are shows that the areas with the most patients testing positive are in six neighborhoods in Queens and nine neighborhoods in Brooklyn.
The city's density has helped aid the spread of the virus, according to health experts. There are 27,000 people per square mile, the densest metropolitan area in the U.S.
"As soon as a virus that is this transmissible gets into a population density that's this urban, you're gonna see exponential growth," Dr. Eric Cioe-Peña, director of global health at Northwell Health, told ABC News.
In Queens, Sutton said there has been a higher rate of cases than in the other boroughs because it's home to two major airports -- John F. Kennedy International Airport and LaGuardia Airport -- and because many residents there don't have access to health care.
"What we've seen is that when you don't have instructions, medical care or help, you increase the likelihood of transferring it to other people in your community," he said. "If you're looking at New York City, you really have to get into the grid."
Health experts also noted that the numbers in New York are just a snapshot of the virus' spread.
The rate of testing has to be accounted for, as well. Gov. Andrew Cuomo has said that New York is completing more testing than other states, leading to a rise in the numbers.
And with all eyes on the city, more people are aware of the situation and residents may seek out testing at higher rates than in other areas, according to Dr. Jon Zelner, an associate professor of epidemiology at the University of Michigan.
Heightened anxiety around coronavirus in the city is certainly on the rise. On Thursday, the New York City Fire Department handled more than 6,000 911 calls, on what was the busiest day ever for FDNY paramedics in terms of individual medical incidents, according to the department.
The record-high call volume was largely driven by calls from people who are scared or concerned they have coronavirus.
The high number of cases has also put a significant strain on the city's hospital beds and protective gear.
There are more than half a million health care workers in the city, according to a report released by New York City Comptroller Scott Stringer. He feared that many didn't have the proper equipment, noting that he heard stories from nurses who have only one mask because there aren't enough to go around.
Stringer also noted that these workers are ones who "are too often ignored, underpaid, and overworked."
Though they are the ones protecting the city, 18% are living below twice the poverty line, according to city data. The New York City poverty threshold was $33,562 in 2017.
As for hospital beds, there were 53,000 hospital beds, but Cuomo said the city would need 143,000. ICU beds were also lacking. The 3,000 currently in place don't match up to the predicted 40,000 needed, according to Cuomo. The USNS Comfort and a military hospital established at the Javits Center are both expected to take non-COVID-19 patients soon in order to free up beds in the city for those who are sick.
Sutton said the notion that there is equal need across all five boroughs is a misconception.
In Queens, there are just 1.5 beds for every 1,000 people. But in Manhattan, there are 5.4 beds for every 1,000 people, according to Sutton.
"This is a humongous difference," he said.
Those differences need to be taken into account when looking at the city as an example, Sutton said.
And as the city continues its uphill battle in facing the pandemic, Sutton pointed out that other communities could soon experience the same suffering.
"It's a mess. It's really a mess," he said. "You may walk around being naive. I just want you to know that we are already at a point of critical mass."
What to know about coronavirus:
- How it started and how to protect yourself: Coronavirus explained
- What to do if you have symptoms: Coronavirus symptoms
- Tracking the spread in the US and Worldwide: Coronavirus map
ABC News' Aaron Katersky contributed to this report.
This report was featured in the Monday, March 30, 2020, episode of “Start Here,” ABC News’ daily news podcast.
"Start Here" offers a straightforward look at the day's top stories in 20 minutes. Listen for free every weekday on Apple Podcasts, Google Podcasts, Spotify, the ABC News app or wherever you get your podcasts.