SEATTLE -- Rural hospitals across the Pacific Northwest that were already struggling financially have seen steep declines in business this month, shunned by patients who fear exposure to the coronavirus as it spreads from urban areas.
Emergency rooms have been eerily quiet. Many operating rooms went dark last week after the governors of Washington and Oregon halted most elective surgeries to conserve precious masks, gowns and other protective equipment.
But instead of enabling them to prepare for an expected surge in COVID-19 patients, the hospitals say, the lull threatens to bankrupt them.
In Washington, at least 13 rural hospitals have less than 45 days of cash on hand and five of them face imminent closure, according to Cassie Sauer, chief executive of the Washington State Hospital Association.
"The health care delivery system in Washington state is at a crisis point as result of the COVID-19 outbreak," association leaders wrote Friday in a letter to Gov. Jay Inslee requesting at least $40 million in grants for hospitals in "extreme financial distress."
"We expect certain hospitals to close if funding is not provided," the letter said.
Cash shortages have also prevented the hospitals from stocking up on the badly needed protective equipment, which is expensive and difficult to find even for better-financed urban hospitals.
The nonurgent procedures that the governors canceled pay the bills for many facilities, which often have fewer than two dozen beds. Some hospitals are now planning layoffs.
Rural hospitals across the United States were in trouble long before the coronavirus, partly because people in the countryside tend to be sicker, older and poorer than Americans as a whole -- hence more expensive to treat. Nearly 100 have closed since 2010, victims of rural flight, workforce shortages and government payments that reimburse less than private insurers.
Now many rural hospitals appear woefully unprepared to deal with a pandemic that few parts of the United States are expected to escape.