With only 60 acute care hospitals, Massachusetts may not have enough beds to treat a big wave of COVID-19 cases.

Boston may be a global medical hub, but if you think our region and state will be spared from the worst of the coronavirus, dream on. 

Sure, we have some of world’s best medical researchers and specialists. 

Heck, Cambridge-based biotech Moderna may be the one to come up with a vaccine, having already shipped a batch for testing by federal regulators. 

But despite its position on the leading edge of medical research, Massachusetts is probably no better prepared to deal with a mass epidemic than many other places around the country. 

That’s because battling an epidemic like the coronavirus requires lots of relatively low– or mid-tech treatment, like hospital beds and ventilators, as well as enough nurses, primary care doctors and other front–line staff to care for potentially hundreds of thousands of cases. 

And the Bay State, in a pattern seen across the country, has sat by and watched as its network of smaller community hospitals has steadily shrunk over the decades. 

An Industry Transformed, and Smaller 

Many local hospitals have simply been unable to cut it amid an increasingly cutthroat, revenue–driven health care field dominated by a few elite teaching hospitals based in Boston. 

One stat says a lot here. Back in 1960, when John F. Kennedy was elected, Massachusetts had 140 acute care hospitals. 

By 1980, that number had dropped to 115. 

Today, that number is down to 60. 

Union Hospital in Lynn is set to close its doors later this year, joining a growing list of ghost hospitals across the state that includes Quincy Medical Center, Waltham Hospital and Symmes Hospital in Arlington. 

The number of hospital beds in Massachusetts has fallen by half, from 4.4 per thousand residents to 2.4, said Alan Sager, a longtime professor at Boston University’s School of Public Health. 

And even that figure may be higher than reality. Hospitals currently report “nominal” numbers when it comes to beds, based on the assumption they have enough medical staff on hand to cover them all, Sager said. 

“Hospitals in most parts of the state have done a good job in preparing for localized emergencies – a bad fire, a larger number of injuries from a car crash – but the magnitude of this potential public health disaster, this is a problem throughout the country,” Sager said. 

Not Enough Beds, By Far 

Simply put, there are nowhere near enough hospital beds in Massachusetts – or for that matter, the country as a whole – to deal with what is likely to be a massive wave of COVID-19 patients over the coming months, if not weeks.  

Estimates put the number of patients that may eventually need hospitalization in 6.9 million-person Massachusetts anywhere between 200,000 and 400,000, Dr. Ashish Jha, a Harvard Medical School professor, noted in a recent interview with WBUR.  

If hospitals are flooded with tens of thousands of cases all at once, the most severely ill patients will needlessly die of pneumonia for lack of respirators and other basics of modern medical care.

Public health officials on the state and federal level are now desperately playing for time, a precious commodity President Donald Trump recklessly squandered early on by bizarrely labeling the coronavirus a “hoax.” 

So far, the best we can do is cancel our conventions, postpone our meetings, put more and more school and college classes online, work from home and hope this will slow the spread of the virus so that it becomes more manageable for our already–overtaxed health care system. 

If hospitals are flooded with tens of thousands of cases all at once, the most severely ill patients will needlessly die of pneumonia for lack of respirators and other basics of modern medical care. 

Can Hospitals Cope? 

Whether hospitals across Massachusetts as a whole are prepared to deal with an epidemic on a scale not seen since in at least a century is an open question. 

The Bay State’s community hospitals, which currently handle about half all of patient admissions each year, will be manning the front lines across much of the state. 

And many of these smaller, local health care institutions are barely making it, as it is, with mega–hospitals like MGH and Beth Israel and their massive networks able to command much higher payments from insurers. 

Community hospitals in Massachusetts and a median operating margin of 0.9 percent, according to a 2018 report by the state’s Center or Health Care Information and Analysis. 

Nationally, half of all rural hospitals are losing money, with 100 having closed since 2010. 

Scott Van Voorhis

“One question is whether we have enough ventilators and ICU beds that can be adequately staffed that can care of patients with life-threatening lung infections,” Sager said. “It may be the costs of hospital care in Massachusetts are so high, that the cost of routine care is so high, it may be our hospitals don’t have enough to prepare for emergencies.” 

For years now, public health experts like Sager have been warning about the precarious state of our community hospitals. 

Now with the coronavirus on the loose and spreading fast, our hometown hospitals will face the ultimate stress test, with the health of hundreds of thousands of people across Massachusetts at stake. 

For all our sakes, let’s hope our beleaguered community hospitals get all the support they need to pass this life-or–death challenge. 

Scott Van Voorhis is Banker & Tradesman’s columnist; opinions expressed are his own. He may be reached at sbvanvoorhis@hotmail.com.