{child_flags:featured}Idaho hospital crisis changes health care as hospitals brace for worse

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By KYLE PFANNENSTIEL

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One large hospital has plans for a morgue overflow area as it stops many surgeries and runs out of beds.

Another hospital expects the COVID-19 situation to get even worse.

These are the realities during Idaho’s unprecedented statewide hospital crisis declared Tuesday.

With hospitals entering Crisis Standards of Care, the state’s hospital crisis plan, people in Idaho can now expect longer wait lines in emergency rooms, care in makeshift rooms or being transferred to other facilities that have room.

“These are unchartered waters,” Brian Whitlock, president and CEO of the Idaho Hospital Association, said during a media conference Thursday afternoon. “We have never been in this situation before as a state. Other states have with hurricanes, earthquakes or terrorist attacks. But never in Idaho.”

The crisis plan gives hospitals legal guidance and protection for providing scare health care with too many in need of treatment. According to the plan, scarce and potentially life-saving treatment can be rationed with a focus on saving those with the best chance of living — in hopes of saving the most lives possible.

Issuing the declaration doesn’t shift every hospital into crisis care. But at least three hospitals — one health care system in the Boise-Nampa area, and two hospitals in north Idaho — have used the standards, Whitlock said.

In eastern Idaho, many hospitals are full or at capacity but have not used Crisis Standards of Care, said Jordan Herget, CEO of Portneuf Medical Center in Pocatello. He said hospitals are at risk of using the plan if COVID-19 trends continue.

St. Luke’s Health System’s request for a crisis standards declaration on Wednesday led Idaho’s top health official to active the plan for the entire state. Patients who need surgeries that have been stopped by the hospital may risk “permanent disability,” said Jim Souza, chief physician executive at St. Luke’s.

“We’re not able to continue to provide conventional care,” he said.

And the system’s top leader said it pulled all stops for more than one year in hopes of staving off rationed care.

“If we continue on this course, over the next several weeks, St. Luke’s Health System will become a COVID health system. It will consume every single bed and every single resource we have,” said Chris Roth, president and CEO of the system.

“Our ICUs are not only full, they’re overflowing,” Roth said.

The hospital is “out of actual beds” and has planned for morgue overflow units, said Sandy Gehrke, vice president of operations for St. Luke’s.

A record-setting surge of both regular and COVID-19 patients has strained two medical systems in Boise, said administrators for St. Luke’s Health System and Saint Alphonsus, which has not used Crisis Standards of Care yet, said Dr. Steven Nemerson, chief clinical officer.

But with incredibly high rates of coronavirus tests that return positive, Nemerson expects things to worsen fast.

“All these things tell us while it’s bad today, it’s going to get much worse, and we can expect this for at least the next two weeks,” he said. “And I am scared. I am scared for all of us. While we’re are currently able to tread water and ... continue to deliver a reasonable standard off care, it’s going to decline simply because the caregiver can’t get to a patient fast enough.”

On Tuesday, Idaho state health department director Dave Jeppesen said there was “no peak in sight,” meaning that cases are expected to continue rising for the foreseeable future.

Getting vaccinated, wearing a mask and avoiding crowds are all key to fighting the pandemic, hospital administrators say.

“I think the only thing that could make things worse is to act like this is not happening,” Souza said. “If you went out and got a vaccine today, it’s not going to help us for weeks, but it’d be a start.”

Health officials and hospital administrators still encourage people to come to the hospital if they need treatment, but officials have asked that members of the public be careful to avoid activities that could result in hospitalization.

{div class=”subscriber-only”}Crisis standards were first declared last week for two public health districts in north Idaho. That came after a Coeur d’Alene hospital requested the standards be activated.{/div}

{div class=”subscriber-only”}The standards will remain in effect until hospitals have enough resources to provide routine care to all patients, the state health department said.{/div}

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Reporter Kyle Pfannenstiel can be reached at 208-542-6754. Follow him on Twitter: @pfannyyy. He is a corps member with Report for America, a national service program that places journalists into local newsrooms.

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