HOUMA, La. — The wind ripped chunks off the hospital’s roof and the entire building rumbled. One nurse said the cement pounding into the walls sounded like the loudest bowling alley she could imagine. Another felt like she was inside a meteor shower.

One of the most powerful hurricanes in the nation’s history was barreling into southern Louisiana. Fifty miles southwest of New Orleans, the staff at Leonard J. Chabert Medical Center in Houma was already weary from a year and a half of caring for patients with COVID-19.

Now water was pouring from the ceiling tiles. A giant metal beam tore off the building and thumped into a glass door, over and over, like a battering ram.

Hurricane Ida was colliding with the country's out-of-control pandemic. Hospitals facing a Category 4 storm typically either evacuate or discharge as many patients as possible. But this time, amid the community’s fourth, brutal surge of COVID, many of Chabert Medical Center’s patients were too sick to be sent home. And hospitals that lay outside the hurricane’s most destructive path were too full of COVID patients to absorb any more. So here they stayed — nurses, doctors, paramedics — exhausted from battling one catastrophe, watching through the windows as a second one tore into town with 150 mph winds.

“The mental stress on our employees is much worse now than it’s ever been,” said Richard Zuschlag, the owner of Acadian Ambulance Service, the state’s largest emergency medical outfit. “COVID set us up for that. And the hurricane is the icing on the cake.”

By the time the sun came up, both hospitals in Houma had endured so much damage, they had to coordinate a massive evacuation.

The hospitals were stretched to their limits by COVID-19 long before Ida brought her screaming winds and pelting rain.

Intensive care units filled to capacity, with some hospitals creating overflow units to accommodate patients so sick they couldn’t survive without extraordinary medical intervention. To keep up, nurses and doctors pulled extra hours, filling in for colleagues who’d caught the virus or simply had enough.

“You couldn’t even have a patient pass away before the room needed to be used,” said Phyllis Peoples, president and chief executive officer of Terrebonne General. “And some of our docs in there said, ‘Are there happy moments here at all?’”

Health care workers are now seeing whole families fall critically ill due to the highly communicable nature of the delta variant and the region’s low vaccination rate.

“It’s a difficult time for the nurses,” said Chabert’s house supervisor, Jeanie Songe, a longtime nurse who is in charge of logistics such as shift changes and hospital transfers. Nurses are now so busy, so stressed, so emotionally drained that some feel they have little left to give, she said.

“And then this freaking storm,” she said. “It was a nightmare here.”

They had just over 40 patients, 17 with COVID and five on ventilators in the ICU. After losing power and water, Chabert decided they needed to evacuate.

“I had COVID patients with no air conditioning. And it’s already hard for them to breathe. Imagine how that must have felt,” said head nurse, Jana Semere.

Meanwhile, at Terrebonne General Health System, the county’s other hospital, huge sections of the roof ripped off. Rain flooded the fifth floor. It then gushed down to the floors below.

The hospital lost water. The staff had discharged as many patients as they could before the storm but still had 120.

Peoples realized that without water, if something caught fire, they couldn’t extinguish the flames. They made an excruciating decision to evacuate for the first time in the hospital’s 65-year history.

Dr. Chuck Burnell, the chief medical officer of Acadian Ambulance, coordinated the evacuation from the hospital’s basement. They had no radio communication and no cell reception. To tell each other anything, they had to run across floors slippery from the rain and the sweat. They worked off printed papers to choreograph who would go where and when, to make sure patients positive for COVID didn’t cross with those who weren’t.

Ambulances darted around the region’s shredded buildings and overturned utility poles to deliver patients to other hospitals that were also overwhelmed by COVID and rushing to make room.

Burnell has been an emergency physician for almost 30 years, and he said this is among the worst storms he’s been through, arriving as it did just as the state’s COVID deaths soared.

“We have the perfect twin-demic going on,” Burnell said. “This could not have happened at a worse time. Mother Nature was not kind to us.”

Terrebonne General was so badly damaged it remains closed, save a makeshift emergency room set up in tents across the street. The ER at Chabert has reopened, but the generator still trips every so often, briefly leaving the hospital in darkness. Medical staff are trying to patch the holes, sweep up the debris, wipe down the floors and begin the process of recovery. But what awaits them on the other side is grim.

Several days after the storm, patients came in seeking help for issues unrelated to the coronavirus. Some were diabetic and hadn’t been able to take insulin for days. Four tested positive for COVID.

Nurses are frustrated that people in their own community, whom they’ve known for years, are refusing to get vaccinated. The state’s vaccination rate is only around 43%. And the relentlessness of the virus won’t end when the power comes back on.

“It’s daunting, it’s very daunting,” said Semere. “When we get this hospital up and running again, we’re still going to be in a crisis.”