This week the state health department reported record-breaking daily COVID-19 cases, topping out at 981 on Wednesday. 

The facility, which was set up in about three weeks at a cost of about $8-million, is a cavernous space reminiscent of a big-box store off Pontiac Ave in Cranston. Inside, hundreds of hospital beds sit empty and unmade, blocked off in rows, divided by nurses’ stations and corridors named for Rhode Island beaches.

The decision to use the field hospital will rest with state leaders and be based on a variety of metrics, according to Department of Administration head Brett Smiley. That includes availability of beds and resources at hospitals, current case numbers, and estimates of where the positivity rate might go.

“But that is a fluid number,” said Shannon Sullivan, the chief operating officer at Women and Infants Hospital, who also oversaw the construction of the field hospital. On calls with the Governor’s office and the state health department, Sullivan said, the group had not come up with a firm number for “when we open.”

During a press conference earlier this week, Raimondo said that local hospitals are currently at about 84 percent capacity. If the virus continues to spread at its current rate in Rhode Island, she estimated the hospitals will reach their limit in three weeks. 

“Staff are exhausted, we’ve spent eight months taking care of people with COVID,” said Dr. Laura Forman, head of emergency medicine at Kent Hospital and medical director of the Cranston field site. “It’s really hard to maintain resilience.”

Forman said the COVID-19 wing of Kent Hospital is “nearly full,” and that hospitals generally are struggling to maintain adequate staffing levels, in part because of their own exposure to the virus. 

“Staff have to quarantine, staff are caring for family members at home,” Forman said. “Staff are sick.”

Though the number of staff for the field hospital will be dependent on the number of patients ultimately admitted, the staffing requirements will be less than a typical hospital Forman said. The current plan is about one doctor per fifty patients, and one nurse per every 25. But comparison, Forman said, nurses are typically responsible for less than 10 patients. 

“This is a tremendous amount of work,” Forman said.

The southwest corner of the state is not seeing the same surge in COVID-19 cases as other parts of Rhode Island according to Oliver Mayorga, chief medical officer at Westerly Hospital, "but we are seeing a gradual uptick.” 

Mayorga said Friday, the hospital had only six COVID-19 patients and none were in the ICU. However, he added that the hospital has seen the return of patients admitted for other reasons, including non-urgent care that may have been postponed during the initial wave of the virus.

“Now the challenge is managing a continued COVID population that is rising, in addition to non-COVID populations that were not here in the spring because we actually stopped things like elective surgery and many surgeries that even were urgent,” Mayorga said.

On Aquidneck Island, Newport Hospital has been running around 80 percent capacity, but that includes a number of non-COVID beds in other units, including the labor and delivery wing.

Jeffrey Gaines, the chief medical officer at Newport Hospital, said Friday afternoon the facility was in "a good place," but noted it is difficult to predict how long that will last. With 129 beds, a community hospital of its size would only take a few dozen new patients to reach capacity.

“All it takes is one bad weekend in Newport and you can have an outbreak. And it could overwhelm the system within a few days,” Gaines said. “It’s all pivoting on how well people can really protect themselves and protect the people around them.” 

During her press conference Thursday, Raimondo warned that another shutdown may be necessary to contain the spread of the virus, though she previously ruled out the mass closure of restaurants and issuing another stay-at-home order. She has already restricted restaurant hours and lowered the social gathering limit.

“If everybody stayed home, this would be over in a month,” Forman said Friday. “This does not have to be, this is completely avoidable.”

If another field hospital facility is necessary, the convention center will be used as a “second line of defense” said Smiley. 

With reports from Lynn Arditi.