NEW ORLEANS -- It just keeps getting uglier by the week for the New Orleans Saints and their depleted offense.

With running backs Alvin Kamara and Mark Ingram II and right tackle Ryan Ramczyk out of the lineup on Thanksgiving night, their leftovers didn't come anywhere close to getting the job done in a 31-6 loss to the Buffalo Bills (7-4), leading to some audible boos from the home crowd in the Caesars Superdome.

Eventually, the defense caved, too. And the Saints (5-6) are now 0-4 since Trevor Siemian replaced the injured Jameis Winston at quarterback.

“Let’s start with the obvious – obviously we weren’t very good tonight,” Saints coach Sean Payton said. “Obviously it was difficult – and I’m sure difficult for the television viewing audience.”

The Saints’ six points matched their lowest total in the Payton era (2015 at the Houston Texans) – and it was their lowest in the Superdome since 2001.

Curiously, New Orleans also decided to leave backup Taysom Hill on the sideline for the second straight week -- just days after he signed a four-year contract extension worth at least $40 million.

Payton explained that Hill was still limited by the foot injury he suffered in Week 10 – even though he practiced fully during the short week – so they only wanted to use him in case of emergency. Payton said if the Saints were forced to use Hill on Thursday night, “obviously his role would be limited.”

But when asked if the Saints will look at expanding Hill’s role when he gets healthier, Payton said, “We’ll see. We’ll look at everything right now. Obviously we have to.”

Perhaps that could mean a possible quarterback change as early as next Thursday night, when the Saints host the Dallas Cowboys (7-4). And Kamara, Ingram and Ramczyk are all expected back soon.

But the Saints are getting dangerously close to the "too little, too late" stage.

QB breakdown: Siemian has been less effective by the week after a promising start in the role. He continued a disturbing trend of slow starts, but this time he was only able to salvage one touchdown in the fourth quarter before throwing his lone interception, finishing 17-of-29 for 163 yards. He threw for just 68 yards in the first half while the Saints went 0-for-6 on third downs (their worst output since they rested their starters in Week 17 of the 2009 season, according to ESPN Stats & Information).

Pivotal plays: It's hard to choose any individual plays that could have made a difference. But the ugliest moments came on two failed fourth-down attempts in the second quarter. First the Saints tried to convert a fourth-and-2 from Buffalo's 41-yard line, but running back Tony Jones Jr. lost five yards when multiple players didn't appear ready for the snap. Center Erik McCoy said it was “all on me” for hearing the snap count incorrectly and snapping too early. Later, the Saints tried a desperation fake punt from Buffalo's 49 on fourth-and-8, but it didn't come close as punter Blake Gillikin airmailed receiver Lil'Jordan Humphrey.

Silver lining: The Saints intercepted two passes in the first half -- one by cornerback Bradley Roby and one fantastic diving catch by linebacker Kwon Alexander -- while holding Buffalo to 10 points. But the wheels eventually came off on a night when the Saints had their worst tackling of the season.

“We gotta put it on our defense right now,” said defensive end Cameron Jordan, who pointed out that the defense is much healthier than the offense. “We’ve gotta be who we think we are. … We have to be the strength. We have to be more than we were this game.”

Eye-popping stat: The Saints have now failed to convert a two-point conversion in four straight games. And they have missed on a staggering 10 consecutive two-point conversion attempts, dating back to 2018 -- by far the longest drought in the league.

“I’ll be honest with you,” Payton said. “If you’re a pretty good offensive team, it’s probably not a problem. And if you’re not a good offensive team – which I would say that’s where we’re at right now – it probably is a problem. Two yards on a handful of downs tonight was a struggle.”