Idaho Activates Crisis Care Standards Statewide

Idaho has activated crisis care standards throughout the state.

EDITOR’S NOTE: The Idaho Stateman reported Thursday that the Idaho Department of Health and Welfare has activated crisis standards of care for the entire state, noting that this development is the state’s battle with COVID-19.

As I write this update the news on the conditions of all of Idaho’s hospitals continues to be dire. There have been continual pleas by Gov. Brad Little for citizens to get vaccinated, multiple updates on the percentage of unvaccinated people in ICU who are dying, and an ongoing media blitz on the ease of obtaining and the safety of the vaccine. 

Still, there is little end to the crisis in sight in Northern Idaho – and, realistically, anywhere in Idaho. Idaho’s neighbors – Washington State for northern Idaho, and Utah for southern Idaho – have also voiced concern over the spike in cases in Spokane, Wash., some of whom are coming here, while Intermountain Healthcare (with 30 hospitals in Utah and Idaho) is suspending elective surgeries due to the continued drain on resources within their hospitals.

Intermountain CEO Marc Harris also shared: “our ICU at our largest medical center, which is in Murray, Utah (by SLC), has three ICUs, and every single one of these is running at 90 percent capacity – and many days (they) are at 100 percent.”

Let’s hear from those patients and communities who are being impacted, as approximately 99 percent of all admissions and ICU patients are unvaccinated. The emotional drain is constant, with no end in sight. Consider the following:

• A CFO of a 25-bed rural northern hospital said: “we always transfer to Kootenai. Now we are looking for places to transfer our patients – maybe Seattle, or even Boise, but that is not really an option any longer. (Note: What about the impact to the patient’s family, which would then have to drive to Seattle to see/be with their loved ones? Even Boise is approximately 6-7 hours away. Rural access to care heavily impacts these families.)

• Kootenai IT specialists are now emptying patients’ garbage bins every three hours daily.

• There has been repurposing of some providers, along with related staff, impacted by the cancelled surgeries.

• Patients are waiting – in all parts of Idaho – for elective surgeries. (Example: Say a patient has gallstones. Paused surgery means even though the patient would be in great pain, there is no ability to do the procedure. Another example: say a Boise high-school football player needs an ACL repair from a recent football injury. Paused surgery means the patient’s family is told they must wait. They could try to find another orthopedic surgeon, but with insurance/out-of-network concerns and limited resources, the family is looking into going to Oregon or Washington. Cost and ability for the family to get there are real concerns in rural communities. One more example: an 80-year-old woman has a new diagnosis of “three leaky valves” in her heart. She found a surgeon willing to take the case, but due to her “non-emergent current status,” she will wait for up to three months, or until it becomes life threatening.)

Idaho’s stats and key facts include the following: 

• Rural southern Idaho elementary schools are closing for a week due to high COVID positives and quarantines.

• Idaho already had a 33-percent shortage rate for nursing before the pandemic. If traveling nurses can be found, the rate is close to $200 per hour. Finding supplemental financing is essential, if possible.

• A Boise-area Walmart announced today that it will close to clean and sanitize amid the COVID-19 surge.
  
  
• In 2020, half of all COVID deaths were patients 80 and older. In 2021, half of all deaths are of patients 50-79. Deaths doubled in the 18-49 age group, from last year.

• In June, Idaho had 1-3 deaths per day. Now there are 10-20 deaths per day.

• The fastest-growing rate of positive COVID tests are found in those ages 13-17. That’s unprecedented for the entire pandemic.

• Idaho added 25 deaths and 2,700 cases this past Monday. Hospitalization rates also hit a new peak, with more than 600 COVID-19 patients hospitalized; this figure is about 20 percent higher than the previous peak in December 2020.

• A Washington hospital representative said: “their crisis is becoming our problem.”  Only 40 percent of Idaho residents are fully vaccinated, compared to 61 percent of residents in Washington.

• The Idaho Department of Health & Welfare: “we are not in this situation because our hospitals are not prepared necessarily, or because they wouldn’t normally be able to keep up with the volume. We are in this situation because COVID-19 has advanced the need for care so dramatically in the last month or two that our hospitals, at this point, are struggling to keep up.” 

• Gov. Brad Little: “Idaho hospitals are beyond constrained. Our health system is designed to deal with the everyday realities of life. However, hospitals are reaching capacity statewide.’

• Crisis of Care Standards could easily be implemented in multiple Idaho hospitals.  As Department of Health & Welfare Director Dave Jeppesen said, “we think we have a little wiggle room in other hospitals, but we are closely watching.”

The hospital staffs, the ER doctors, the hospitalists, the support staffs, CNAs, housekeepers, therapists, etc. – they are exhausted, and sound defeated. Let’s hope for an awakening of Idaho residents before more damage is done for those who cannot get care to reduce suffering, as well as the real potential of deteriorating conditions with long-term impacts.