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(Reuters) – U.S. hospitals, bracing for a surge of coronavirus patients just as some staff are under quarantine after being exposed to the virus, are facing a shortage of temporary nurses who can fill in – and being asked to pay as much as double to make it worth it. So-called “travel nurses” total around 50,000 – or less than one percent of the nursing workforce – which represents an increase in recent years as the U.S. population ages, demand increases and workers seek more flexible employment options.

With the coronavirus outbreak escalating every day, the need for temporary nurses is growing exponentially throughout the United States.

But an “unprecedented number” are backing out of assignments because they do not want to travel in the midst of the crisis, said Alan Braynin, chief executive at staffing firm Aya Healthcare.

As staffing agencies have raised pay demands for temporary nurses still willing to accept assignments, some hospitals are leaning on their existing staff to help out – at least for now.

“A lot of hospitals have closed down other units, and scrambled staff to triage patients coming in for testing and for other purposes,” Braynin said.

Hospitals in New York and Connecticut are seeking to fill hundreds of temporary nursing positions, said Dan Weber, head of clinical innovation at staffing firm Trusted Health.

“Washington state has been in crisis for a while. We continue to see an uptick there in emergency room and now clinic jobs – they need people to staff things like phone trees and triage centers,” Weber said.

Some pay packages, which include a housing stipend, have more than doubled, with rates at the top of the market reaching $5,000 a week, although most are in the $3,000-$4,000 per week range, he said.

More than 18,000 people in the United States have tested positive for the coronavirus since early this year, upending daily life and prompting New York, Illinois and California to tell tens of millions of people to stay at home. The virus first appeared in China in December and has sickened more than 250,000 people around the globe.

InterActive Corp’s (IAC.O) temporary healthcare staffing unit NurseFly said it has seen an unprecedented surge in demand for positions related to the spread of COVID-19, the disease caused by the virus. It said emergency department specialists can now command compensation of upwards of $4,000 per week.

Some hospitals likened the pay increases to the kind of price-gouging that is illegal in some states during times of public emergency.

“The thing that is very distressing to us and to other hospitals is that these agencies are demanding exorbitant rates,” said Dr. Stephanie Hall, chief medical officer at Keck Medicine of the University of Southern California in Los Angeles.

Aya CEO Braynin conceded: “There are firms that are charging too much.”

The nurses are coming under unusual strains, however.

A travel nurse is typically contracted under 13-week agreements, and hospitals are now asking to extend many existing contracts, said Weber at Trusted Health. Nurses starting new contracts also need to take drug tests and undergo background checks.

Nurses wait for a patient in a car to pull forward to be tested for coronavirus disease (COVID-19) at a drive-through testing site in a parking lot at the University of Washington’s Northwest Outpatient Medical Center, during the coronavirus disease (COVID-19) outbreak, in Seattle, Washington, U.S. March 18, 2020. REUTERS/David Ryder – RC2NMF90LHMI

Trusted Health said it is starting to hear reports from clients that landlords, including at temporary Airbnb units, are refusing to rent to nurses and other medical professionals. “We have one nurse in Washington who was told by her landlord that she has to scrub the washing machine with Clorox after every load or she will be evicted,” Weber said.

USC has not had any patients test positive for the coronavirus, but staffing levels, especially at its intensive care unit, have been affected by the fact that some employees, and their contacts, are on quarantine for at least 14 days after being exposed to the virus outside of the hospital.

Training is now underway to make sure medical residents – doctors in training – can fill in for nurses. “We are training our surgical residents to be able to step in,” said Dr. Kenji Inaba, director of USC’s general surgery program. “If in a week or two from now we end up with a massive loss of critical care nursing staff, we won’t have the ability to teach others to handle the work.”

Reporting By Deena Beasley; Editing by Caroline Humer and Sonya Hepinstall

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