Crisis standards

Chart from the Idaho crisis standards of care plan, via the Idaho Capital Sun.

Don’t get sick. Don’t get in a car crash. Don’t have a stroke. Don’t develop cancer.

Not for the foreseeable future.

Because if you do, you might be out of luck. You have lived your whole life in a context where, if these things happen, there was a hospital bed that could take you, a nurse who could look after you, and a doctor who could determine the best course of treatment.

In north Idaho, that assurance is gone. Any day now, it will be gone here too.

A report by Audrey Dutton of the Idaho Capital Sun detailed how an overwhelmed emergency room would categorize patients and the treatment they will receive under Crisis Standards of Care.

There’s the green category, those who are “walking wounded.” If you have a minor illness or injury, you’ll be last in line to receive any treatment. Maybe you wind up with a bad scar instead of stitches.

There’s the yellow category, people with serious illnesses or injuries, who need medical treatment but are not at immediate risk of dying. Think a broken arm or leg or pelvis. With the ER overwhelmed, they may go untreated for quite a long time.

If you’re in the red, that’s good, in a sense. It means you are at serious risk of death, but doctors believe you can be saved. You get an ICU bed and a ventilator if you have COVID-19 and you need one, supposing it’s available.

But you better start showing improvement fast. Because more COVID-19 patients are flowing through the door, many as sick as you. Maybe one is younger and has more years to live if they can be saved. Since you aren’t improving, someone will have to decide between denying that person a ventilator and keeping you on one.

You don’t want to be classified in the black category. Black means you’re unlikely to live, and with so many other lives to save, you will receive comfort care. Some morphine for the pain, maybe. Some oxygen to temporarily relieve the feeling of suffocation. Only if a new bed opens up, likely because the previous occupant died, could you be upgraded to red and an attempt made to save your life.

Put yourself for a minute in the shoes of the doctors and nurses who have to make these decisions over and over again. To stand on the line between red and black, and sort people. Caring people who chose a profession of healing, now forced instead to choose who is worth trying to save.

The physical, mental and emotional toll this pandemic has taken on them is unimaginable. So it isn’t too surprising when you hear a doctor or nurse is planning to leave the state, disgusted that people don’t care about them and won’t take care of themselves.

The decision not to get vaccinated is not simply foolhardy. It’s cruel.

Because all of this was avoidable.

It is not too late to stop it from happening again. If you are not vaccinated, go schedule your first shot now. You don’t have to risk winding up in an overwhelmed hospital, with an exhausted doctor or nurse forced to decide whether to stamp your card red or black. Very few cases, hospitalizations or deaths come from the vaccinated population.

And if most of the population finally gets vaccinated, we stand a much better chance of stopping the next wave, when and if it comes, from bending our health care system past the breaking point.

The Post Register’s editorial board consists of Publisher Travis Quast, Managing Editor Monte LaOrange and editorial writer Bryan Clark. Clark can be reached at 208-542-6751.

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