Nearly two months into the coronavirus pandemic, few Americans have fared as poorly as nursing home residents, who account for just .5% of the U.S. population but make up about a fifth of all COVID-19 deaths.

Now, MIT economist Jon Gruber warns that, tragically, patient deaths may only be the beginning of woes for America’s nursing home industry.

On Wednesday, Gruber joined Boston Public Radio to explain longstanding issues with how U.S. nursing homes are funded, and how the current health crisis is exacerbating those problems and putting the entire system at risk. He described the situation as "a real nightmare.”

“The way that nursing homes have managed to fight back the tide of bankruptcy over several decades… is by taking on more and more short-term patients that are paid highly by medicare… the problem is, those patients have suddenly gone away, 'cause no one’s getting knee surgeries. No one’s getting those surgeries where they have to recover in the nursing home.”

Read More: Discharging COVID-19 Patients To Nursing Homes Called A 'Recipe For Disaster'

Adding to concerns, Gruber said, are the number of low-wage staffers who have shrinking incentives to show up for work.

"We haven’t realized what a crisis we’re creating 'til you’re trying to get someone to go to work for 13 bucks an hour where they might catch an illness that could kill them,” he said. "And basically, then, people are saying no– and you can’t blame them.”

"It’s a long run problem that we have to deal with, but it’s also a short run problem,” he said. "I’m hoping the next round of negotiations in Congress include a big discussion of hazard pay for these individuals to try and get them back to work. "

Gruber is Ford Professor of Economics at MIT. His latest book is "Jump-Starting America: How Breakthrough Science Can Revive Economic Growth and the American Dream."