Faced with a massive and expensive fight to combat the novel coronavirus, Huntsville Hospital this week began taking steps to reduce costs by trimming payroll.

Those cuts include nurses in some departments of the hospital that are seeing a sharp drop in patients, CEO David Spillers said Wednesday.

Spillers did not share specific numbers about how much of the hospital's workforce is being affected by furloughs, layoffs and a reduction in hours but said staff for patient care would not be compromised if the hospital experiences an expected surge in patients from the coronavirus.

"We're going to do this as thoughtfully as we can because we're going to make sure this doesn't impact patient care when we need people to come in and take care of patients," Spillers said.

Those most affected at this point are hospital contractors and support staff, Spillers said. Examples include the cleaning staff as well as the hospital cafeteria and all hospital construction except for the patient tower being built across Madison Street from the main hospital building.

Related: Laid off health workers? Industry feels strain even as pandemic shows need

The cuts, Spillers said, are the results of rising costs for medical equipment as well as a dramatic drop in patient load as, for example, all elective surgeries have been stopped. Emergency room traffic has also diminished. The cuts are also temporary with the hospital looking at 30-day blocks for scaled back employees, Spillers said.

Spillers said that nurses frequently work on a flex schedule – allowing for an increase in hours when there is an increase in healthcare demand as well as a drop in hours when that demand fades. And at this point, that demand has dropped as people have been urged to stay home and most work places have closed their doors.

Clinicians can seek work elsewhere in the hospital but they may be in areas they prefer not to work – such as the intensive care unit – or over during weekends or overnight shifts that may be less desirable. Spillers said that there are typically vacant nursing shifts that are available to be worked.

Employees also receive "generous" accrual of paid time off and sick leave that they can take advantage of during this slow period, Spillers said.

"We've still got to manage the financial side of the business," Spillers said. "We've been here for 125 years and we need to be here another 125 years. We're going to have to manage this because the financial impact is going to be pretty devastating."

Huntsville Hospital is a not-for-profit operation and its pursuit of needed equipment to brace for the COVID-19 patient surge has depleted the hospital's finances, Spillers said. That's coupled with some of the more lucrative revenue streams for the hospitals – such as elective surgeries – being eliminated.

"It's the absolutely worst financial situation you could think about," Spillers said. "We've eliminated your business and probably the business that pays you best, all that elective business, and your costs have gone up preparing for this wave, this surge of patients that's still not here. So we're going to have to make some hard decisions."

Amid the effort to protect the hospital's financial position, Spillers said there is a parallel effort to have healthcare workers available once patient load increases. The expected surge in COVID-19 hospitalizations is expected to come in about two weeks.

"Our clinical team is working on that every day," Spillers said. "Many of the people in the hospital work in various locations so they can go back and work in those locations. (Hospital human resources) is working with the operations team to see who would be available to fill direct patient care areas when and if those positions come available (for the surge).

"We're also working with organizations like The Surgery Center (next to the hospital in downtown Huntsville), which we're a part-owner of, a lot of that staff is not working. We've got those nurses in the queue to work."

While Spillers said clinicians who have seen their hours drop or have chosen to take paid time off are available for a patient surge, he said it's possible some may not come back.

“I do worry about that,” Spillers said. “If you are in an area that’s flexed down, if you work in an area that primarily does elective surgery, we don’t do elective surgery right now. So that person, if they haven’t decided to do something that’s available in the hospital somewhere else and they may be looking at other opportunities, but you can’t go do elective surgery anywhere else in the country either. So you have to do something different.”