SILER CITY, N.C. (WTVD) -- Whether it's WakeMed or Warren County, bed space at hospitals in North Carolina is already at a premium.
Even a small surge of COVID-19 positive patients seeking treat at rural hospitals could be devastating to the hardworking staff of healthcare providers.
Consider the statistics comparing hospitals in Wake County and that of nearby Chatham County: Wake, home to three major hospital systems, has 1,607 hospital beds, or about one for every 684 residents. Chatham Hospital, the lone clinic in the county, has just 25 beds, or one for every 2,858 residents.
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Chatham Hospital, moreover, is also under construction, reducing bed capacity to 20 -- and there are 18 filled on an average day.
"We don't have high numbers to begin with," Jeff Strickler, Chatham Hospital's president, told ABC11. "As a critical access hospital, those types of patients we would usually send to a medical center like UNC or others and in a pandemic situation. While that's still our plan, we may have to hold those patients for a period of time."
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Strickler added that Chatham Hospital does have ventilators, but they do not feature the kind of technology that trauma centers have that could support patients in prolonged comas.
"Our ventilators are fairly basic in its capabilities," he explained. "Someone that needs to be on a ventilator for 10 days, it just requires a different level of technology that we haven't needed in the past."
As far as other supplies go, Strickler and other health officials maintain Chatham County is at an advantage because of its proximity to the Triangle, plus the hospital's relationship with the UNC system.
"Because of the infrastructure of the UNC system and their presence in the community and other things, I can't say that we're that different than other counties," Layton Long, Chatham County Health Director, told ABC11.
According to the latest count from the North Carolina Department of Health and Human Services, Chatham County has 17 positive cases of coronavirus and the disease it causes, COVID-19.
Like other counties, Long said issues related to testing mean there is no widespread availability.
"So much of the outcome of this is in the control of the general public and how well they respond to public health message," Long said. "Social distancing is critical."
Elsewhere in North Carolina, rural hospitals are struggling with the true source of their survival: cash.
The North Carolina Healthcare Association counts 12 independent hospitals in rural counties that are more like islands of access to health care.
"Southeastern Health in Robeson County is one of those we're hearing from," Leah Burns, NCHA's Director of Government Relations, told ABC11. "They operate in one of the poorest counties in the state."
Burns said the reason these hospitals are on life support is because preparing for the surge means limiting or canceling elective surgeries, which are the main sources of revenue.
"It depends on the type of hospital, but those surgeries can be hip replacements, knee replacements, those types of things," she added.
Congressman Greg Murphy, himself a physician who represents North Carolina's 3rd District, has joined Sen. Thom Tillis, among many others, urging President Donald Trump and his administration to send funds from the recently passed CARES Act to rural hospitals fighting coronavirus.
"We are hearing from rural hospitals from across the country that have only days left of cash on hand -- money needed for payroll and supplies," the lawmakers write in a letter to HHS Secretary Alex Azar. "Rural hospitals need access to financial resources immediately and in the most streamlined manner."