I decided to take an objective look at Cape Cod’s hospital capacity and the two primary metro areas people are coming from and the percentage of the adult population 65 years old or older.
Comparing Boston, MA HRR, Manhattan, NY HRR & Cape Cod (Barnstable County, MA)
Comparing Boston, MA HRR, Manhattan, NY HRR & Cape Cod (Barnstable County, MA)
Cape Cod Hospital has 283 beds, and Falmouth Hospital has 95 beds for a total of 378 beds. Harvard’s study of hospital bed availability includes Cape Cod within the Boston area Hospital Referral Region(HRR). Even with the low estimated caseload of 20% of the adult population becoming infected with Covid-19 there will be a widespread shortage of beds across the United States, regardless of geographic area. In the Boston referral region, there is a total of 10,239 hospital beds and has a total adult population of 4,022,208 for a total of 2.55 beds per 1,000 adults. In 2018 Cape Cod (Barnstable County, MA) had an estimated adult population of 180,568, giving the Cape 2.09 beds per 1,000 adults. By this measure, the Cape’s hospitals have a total capacity of 82% of that within the larger Boston HRR.
Cape Cod’s demographics may increase the caseload requiring hospitalization if transmission rates are equivalent to other areas. 34.4% of Cape Cod’s population is 65 or older compared to the average in the Boston HRR (including Cape Cod) of 19.44%. In the event of a widespread outbreak, Cape Cod has fewer hospital beds per capita and would see a higher percentage of total cases requiring hospitalization due to the increased risk factors of the 65 and older cohort.
| Boston, MA HRR* | Manhattan, NY HRR* | Cape Cod | |
| Total Hospital Beds | 10,239 | 14,834 | 378*** |
| Total ICU Beds | 1,157 | 1,427 | 36**** |
| Adult Population 18+ | 4,022,208 | 4,173,437 | 180,568** |
| Population 65+ | 782,014 | 725,342 | 62,183** |
| Percent of Adult Population 65+ | 19.44% | 17.38% | 34.44% |
| Hospital Beds Per 1000 Adults | 2.55 | 3.56 | 2.09 |
| ICU Beds Per 1,000 adults | .288 | .342 | .199 |
The below graph shows the impact of additional adult population on the number of hospital beds per 1,000 adults in increments of 10,000.
The standard practice in the event of a medical emergency on Cape Cod is for the patent to be taken to either of Cape Cod’s two hospitals. From there the most complex cases are often sent to Boston area hospitals. The full caseload is not normally retained on Cape.
Update on Bed Numbers
Cape Cod Times is reporting that Cape Cod Health Care has a surge plan to increase the total bed capacity from “from approximately 380 to 500 inpatient beds” according Cape Cod Healthcare’s CEO Michael K. Lauf. In addition the number of ICU beds has been dramatically increased “Cape Cod Hospital now has 72 intensive-care unit beds and Falmouth Hospital has 45.” Part of the increase in ICU beds at the Falmouth Hospital are a result from closing its maternity and pediatric units.
The Harvard study included regional totals for additional bed capacity based on pre-existing facilities, the publicly available data from that study does not include a hospital by hospital summery. Additional bed capacity is reported solely on the Hospital referral regions. .
Sources:
Harvard Global Health Institute. March 17, 2020. Caring For COVID-19 Patients Can Hospitals Around The Nation Keep Up? https://globalepidemics.org/2020/03/17/caring-for-covid-19-patients/
Harvard Global Health Institute. March 17, 2020. HRR Scorecard: 20% / 40% / 60%
https://docs.google.com/spreadsheets/d/1xAyBFTrlxSsTKQS7IDyr_Ah4JLBYj6_HX6ijKdm4fAY/edit#gid=0
US Census Bureau. 2018 American Community Survey 5 Year Estimates, Barnstable County
Wikipedia. 03/23/2020. Cape Cod Hospital. https://en.wikipedia.org/wiki/Cape_Cod_Hospital
Wikipedia. 03/22/2020. Falmouth Hospital. https://en.wikipedia.org/wiki/Falmouth_Hospital
Personal Communications. 3/22/2020
The Cape Cod Foghorn 
Very well put together.
There is a missing factor. The Cape has seasonal variability, so far as medical personnel are concerned. They usually hire extra medical staff in Season.
They usually hire from off Cape, but under the current circumstances, they have nowhere to beg, borrow, or steal staff from, and that means a reduction in care.
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A better question is whether seasonal homeowners and tourists are putting Cape Codders at risk. Those who can afford a second residence come from highly populated areas where the threat of infection is higher.
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