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Massachusetts hospitals continue to face bed space issues this fall as a worrisome winter looms, the head of the state hospital association said Friday.

“Capacity remains a serious challenge within hospitals and ICUs across Massachusetts, and they are each preparing for what will likely be yet another difficult winter,” said Steve Walsh, president and chief executive of the Massachusetts Health & Hospital Association.

As the second winter of the COVID pandemic approaches, hospitals are under “a multitude of intense pressures that have emerged in the past several months,” he said.

Walsh said hospitals were dealing with severe staffing shortages, an influx of patients who deferred care because of the pandemic and now require longer stays, and a “worsening behavioral health crisis,” referring to the children and adults flooding emergency rooms seeking mental health help — only to languish for days or weeks before they receive psychiatric treatment.

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Walsh said COVID-19 cases have been “more manageable” for hospitals recently, but “the virus will remain a concern for as long as it is with us. Hospital leaders are tracking public health data on a daily basis, working closely with our state leaders, and stand ready to adjust their operations based on how those trends evolve.”

In a worrisome development, COVID-19 cases have turned upward in recent days. But COVID-19 hospitalizations dropped after a mid-September peak and have been generally edging downward in recent weeks, according to state data.

The state hospital association and several hospitals sounded the alarm in September about capacity problems.

Justin Precourt, chief nursing officer at UMass Memorial Health, the largest health system in Central Massachusetts, said Friday his system continued to be under stress.

He said he was also “really nervous” about an influx of new patients as cold and flu season arrives — and he was keeping an eye on COVID-19. “We’re watching that really closely,” he said.

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Maura Hughes, chief executive of Boston MedFlight, the critical care medical transportation service, said hospital capacity is “definitely a huge challenge right now. You have huge medical institutions with one ICU bed or zero ICU beds, and obviously that capacity fluctuates not just daily but hourly.”

She said that in some cases, due to a lack of ICU beds, MedFlight has had to transport people out of state and that has “really picked up in the past two months,” with a half-dozen in just the past week.

The coronavirus pandemic has exacerbated systemic issues such as the need for more psychiatric beds, said Hughes.

She was concerned about what will happen as COVID-19, flu, and RSV, the respiratory virus that can hit hard in children, arrive this winter.

“You’re looking at a health care system that is already very busy. Extremely tight. So I just don’t know what the next couple of months are going to bring,” she said.

The non-profit operates ground units, helicopters and an airplane, providing $5 million in free services a year. The fiscal year that ended Sept. 30 was the busiest year in its 36-year history, she said.

A spokeswoman for the state Executive Office of Health and Human Services said the state had one of the lowest COVID-19 hospitalization rates in the country, due to its success in vaccinating people, and there were only 527 COVID-related hospitalizations out of more than 9,000 across the state.

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Walsh, the hospital association chief, asked the public to help by getting vaccinated against COVID-19 and the flu, keeping up with regular medical appointments, and seeking care from their doctor or local urgent care center if they don’t have a medical emergency.

“It’s important for our community members to understand that this crisis is not over for our healthcare organizations and caregivers,” he said.

Material from prior Globe stories was used in this report.



Martin Finucane can be reached at martin.finucane@globe.com.