Idaho ration health care statewide amid massive COVID surge

The Idaho Department of Health and Welfare made the announcement after the St. Luke Health System, Idaho’s largest hospital system, asked health officials in the Idaho on Wednesday. State to authorize “crisis care standards” because the increase in the number of COVID-19 patients has drained the state’s medical resources.

Idaho is one of the least vaccinated U.S. states, with only about 40% of its residents fully vaccinated against COVID-19. Only Wyoming and West Virginia have lower vaccination rates.

Crisis care standards mean scarce resources such as intensive care beds will be allocated to patients most likely to survive. Other patients will be treated with less effective methods or, in extreme cases, will benefit from pain relief and other palliative care.

Thursday’s decision came a week after officials in Idaho began allowing health care rationing at hospitals upstate.

“The situation is dire – we do not have enough resources to adequately treat patients in our hospitals, whether you are there for COVID-19 or a heart attack or because of a car accident,” said Dave Jeppesen , director of the Idaho Department of Social Affairs. in the statement.

He urged people to get vaccinated and wear masks indoors and in crowded outdoor places.

“Our hospitals and health systems need our help. The best way to end the standards of crisis care is to get more people immunized. This dramatically reduces your chances of having to go to the hospital if you get sick with COVID-19, ”Jeppesen said.

One in 201 Idaho residents tested positive for COVID-19 in the past week, according to a count from Johns Hopkins University. The predominantly rural state ranks 12th in the United States for new confirmed cases per capita. More than 1,300 new cases of the coronavirus were reported to the state on Wednesday, according to the Idaho Department of Health and Welfare.

Hospitalizations have exploded. The most recent data available from the state on Monday showed that 678 people have been hospitalized statewide with coronavirus.

Meanwhile, the number of COVID-19 patients in intensive care unit beds has remained mostly stable over the past two weeks at 70 people per day – suggesting the state may have reached the limit of its ability to treat intensive care patients.

While all hospitals in the state can now ration health care resources as needed, some may not need to take this step. Each hospital will decide how to implement the standards of crisis care in its own facility, public health officials said.

Kootenai Health in the town of Coeur d’Alene was the first hospital in the state to officially enter crisis care standards last week.

At the time, chief of staff Dr Robert Scoggins said some patients were being treated at a conference center that had been converted to a field hospital. Others were treated in corridors or in converted emergency halls. Urgent and elective surgeries are on hold across much of the state.

As of Wednesday, nearly 92% of all COVID-19 patients in St. Luke hospitals were unvaccinated. Sixty-one of the hospital’s 78 intensive care patients had COVID-19. Doctors in St. Luke have pleaded with Idaho residents for months to get vaccinated and take action to slow the spread of the coronavirus, warning hospital beds are quickly running out.

Public health officials have warned Idaho residents for weeks to take extra precautions to ensure they do not end up in hospitals. Last week, Jeppesen said residents should take their medications as prescribed, wear their seat belts and reconsider their participation in any activity such as biking that could lead to injury.

The healthcare crisis isn’t just impacting hospitals – primary care physicians and medical equipment suppliers are also struggling to cope with the crushing demand from coronaviruses.

A major medical supplier, Norco Medical, said demand for oxygen tanks and related equipment has increased, sometimes forcing the company to send patients home with fewer cylinders than they normally would. High-flow oxygen equipment – normally used in hospitals or hospices – is also more frequently in demand for home patients, said Norco president Elias Margonis.

“It appears they are aggressively unloading themselves to free up beds for new patients entering hospitals,” Margonis said. “What this means is that we have seen an increase in the flow of oxygen in liters at home.”

Margonis has spent much of her morning on the phone with public health and hospital officials, trying to figure out how crisis care standards will change the way patients leave hospitals. Already, the company has seen an increase in the number of customers seeking specialized oxygen equipment that delivers at a rate of 8, 12 or 20 liters per minute rather than the standard 4 or 5 liters per minute, has t -he declares.

“When someone comes home, we bring their bed, we bring their wheelchair, we bring their cannula, their oxygen,” said Margonis. “This is where we say, it is important that you cannot just fix the problem, even if the patient is on the mend and on the verge of being healthy. To recover, he needs the right support. “

Primary Health Medical Group, Idaho’s largest independent primary and emergency care system, was forced late last month to shorten hours of operation because its waiting rooms were so crowded of patients that the staff stayed for hours after closing to see them all. Meanwhile, the company was facing a higher than normal number of staff members sick because they had been exposed to the coronavirus in the community or had symptoms and were awaiting tests. Vaccination offers strong protection against severe coronavirus disease, but the highly contagious delta variant can still cause “breakthrough” cases in those vaccinated.

As the number of cases continued to rise, three of Primary Health Medical Group’s 21 clinics in southwest Idaho had to go out of business over the weekend, CEO Dr David Peterman said.

Now the medical group is also preparing to monitor its patients who are released earlier than they normally would be from the hospital after emergencies, Peterman said.

“We will see more visits with patients who are avoiding emergencies and patients who are sicker and need more care,” Peterman said. “We are currently putting a system in place to make sure this weekend that we are immediately notified if any of our patients are discharged early from the hospital so that we can make sure those patients are okay.”

Resources have been exhausted throughout the medical system, Peterman said.

“It’s heartbreaking. I practiced medicine in southwest Idaho for 40 years and have never seen anything like it, ”he said. “I am sorry for the doctors, nurses and hospital staff who are making very difficult decisions.”

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