PROVIDENCE — Rhode Island is opening two field hospitals and public health officials are pleading with residents to stay home as a sharp spike in COVID-19 cases pushed hospitalizations to near-record levels.
A 335-bed field hospital run by Care New England opened Monday in Cranston, while a 594-bed facility at the Rhode Island Convention Center in Providence will begin receiving COVID patients Tuesday. Fewer than a dozen patients were expected to be admitted in Cranston on Monday, while the Providence site anticipates about two dozen on its first day.
The field units are functioning as a relief valve so hospitals can continue treating other ailments, according to Dr. James V. McDonald, a medical director at the Rhode Island Department of Health. “This can get so much worse before it gets better,” he said. “When you look at the numbers, every day they’re constantly going in the wrong direction.”
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The number of hospitalized patients in the state stood at 365 on Monday, down from a record 381 on Nov. 23. The previous peak for hospitalizations was 352 in May, though more patients ended up in intensive care in the spring than during the fall surge.
On a per capita basis, Rhode Island has been hit harder than any other New England state. It has averaged 850 new cases per day over the past week, or 80 cases per 100,000 people, according to New York Times calculations. In contrast, Massachusetts is seeing from 10 to 48 cases per 100,000, depending on the county. Throughout Maine, the case count is 12 or fewer per 100,000.
Hospital officials said it was hard to pinpoint one reason for Rhode Island’s steep infection rate.
“We are much more densely populated, obviously,” said Cathy E. Duquette, executive vice president and chief nursing executive at Lifespan, the health system that is overseeing the Providence field hospital. “We have 1 million people in a very small geographic location.”
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She noted that some of the state’s most densely populated cities, such as Central Falls and Providence, have COVID-19 rates higher than the statewide average.
Dr. Selim Suner, director of disaster medicine and emergency preparedness at Rhode Island Hospital, said he doesn’t know exactly why Rhode Island’s rate is higher. “But it could be because we are not following the instructions.”
He emphasized that people can help lower the rate of spread by wearing face masks, social distancing, and avoiding large gatherings. Also, he said the spread could be curbed with a new medication, called a monoclonal antibody treatment, that can be prescribed for people with underlying conditions.
Regional differences in COVID-19 can often be explained by differing approaches to public health restrictions, such as mask mandates and closing bars. But the New England states have adopted similar tactics to controlling transmission.
Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security, said workforce composition can also affect infection rates, if many workers are in jobs that can’t be done from home. And, indeed, a high percentage of Rhode Islanders work in health care, service, and retail jobs.
Since the pandemic started, more than 50,000 Rhode Islanders have come down with COVID-19, leaving 1 million still vulnerable.
As case counts climb throughout the region, Vermont is building field hospitals. The Massachusetts National Guard on Monday began constructing a 250-bed field hospital at the DCU Center, to be staffed by UMass Memorial Health Care when it opens this Sunday.
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Monday began with Rhode Island officials issuing a statewide public safety alert, sent to cell phones around 9:30 a.m.
“Hospitals at capacity due to COVID,” the alert read. “Help the frontline by staying home as much as possible for the next two weeks. Work remotely if you can, avoid social gatherings, get tested. If we all decrease our mobility, we will save lives.”
Dr. Megan L. Ranney, an emergency physician at Brown University who specializes in public health research, retweeted the public safety alert, saying, “This is my state right now. To all the people (who I don’t tag, bc they don’t deserve the notoriety) who accused me of ‘fear mongering’ — I hope you don’t get sick, from #covid19 or anything else, because WE HAVE NOWHERE TO TREAT YOU.”
But Department of Health spokesman Joseph Wendelken said COVID-19 patients will be able to go to field hospitals in Rhode Island, and very sick patients will be sent to intensive care units in Rhode Island hospitals. He said there will be no need to send COVID-19 patients to hospitals in other states.
“Today is the first day of the pause,” Wendelken said, referring to a two-week economic step back that Governor Gina M. Raimondo announced Nov. 19. “And we wanted to be sure people understood the new restrictions in place and reiterate the message we have been sharing — that people need to wear masks, practice social distancing, and keep their groups small and consistent.”
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During the pause, recreational businesses including bowling alleys, theaters, casinos, indoor sporting facilities, and gyms must close. Bars and bar areas in restaurants are also required to close, while restaurants are limited to 33 percent of indoor capacity and only people in the same household may sit together at a table. Manufacturing and construction jobs, as well as personal services businesses, such as hair salons, are also allowed to stay open with proper precautions, and houses of worship are limited to 25 percent capacity. Residents are being asked to limit their social circles to only people in their households.
“This will not be easy, but I am pleading with you to take it seriously,” Raimondo said in a statement. “Choosing to gather with those outside your household will have ripple effects that will increase the strain on our hospitals and put lives at risk.”
To help businesses and workers affected by the pause, the Democratic governor last week announced $100 million in aid, including an additional $200 per week for those who are already receiving unemployment. Raimondo did not rule out another economic shutdown if the pandemic get worse.
At the convention center on Monday, Lifespan’s Duquette and Rhode Island Hospital’s Suner led a tour of the 100,000-square-foot field hospital.
Instead of dinners and keynote speeches, the space is filled with row after row of hospital beds, with oxygen and power at each bedside. The ballroom is split into large wards.
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In an only-in-Rhode-Island touch, the aisles bear the names of streets from each of the state’s 39 cities and towns. Interstate 95 is a main thoroughfare, and the tour began and ended on a positive note — on Hope Street.
Edward Fitzpatrick can be reached at edward.fitzpatrick@globe.com. Follow him on Twitter @FitzProv. Felice J. Freyer can be reached at felice.freyer@globe.com. Follow her on Twitter @felicejfreyer.