March 19, 2020 / MERRILL GOOZNER
Let’s be honest. Most American hospitals are unprepared to treat a sudden surge in very sick and contagious COVID-19 patients.
Most hospital emergency departments are not laid out to instantly isolate possible coronavirus carriers. Most ED beds, general hospital rooms and surgical suites cannot be quickly converted into temporary intensive-care unit beds. The number of existing ICU beds, like hospital beds generally, have been in slow, steady decline. 
This is by design. Over the past decade, government officials, healthcare payers and hospital leadership have focused on shrinking hospital bed capacity. More care is moving to home, hospice and outpatient settings. Complex procedures that once required a prolonged stay can now be done in a day. Cost-cutting and cost-effectiveness have been uppermost in the minds of hospital planners, not emergency preparedness.
Now, with the coronavirus pandemic pummeling the U.S. economy, hospitals across America are scrambling to prepare for an influx of very sick patients. A team of Harvard-based researchers estimated that only under a best-case scenario—a 20% infection rate stretched out over a year’s time—will the U.S. have enough beds to meet the demand, and that assumes half of the hospital beds are not used for their usual purposes.