One day, four public health district meetings, a patchwork of approaches.

By Melissa Davlin, Idaho Reports

Four of Idaho’s seven public health districts held Board of Health meetings Thursday, with each approaching the pandemic in markedly different ways. 

The day’s series of meetings and votes was emblematic of the patchwork local approach that has defined Idaho’s efforts to control the COVID-19 outbreak, as Gov. Brad Little continues to defer to cities, counties, and public health districts for decisions on mitigation. Meanwhile, the state’s hospitals continue to stagger under record-breaking COVID admissions and lurch closer to crisis standards of care.

In north Idaho, the Panhandle Health District voted to impose a 60-day mask mandate throughout its five county region. The district-wide mandate is the first of its kind in Idaho; Previously, other Boards of Health have put mandates in place county-by-county, while others have declined all mandates. 

The debate wasn’t without contention, with Kootenai County’s Jai Nelson telling board members to abstain from voting if they weren’t willing to make difficult decisions. Bonner County’s Glen Bailey, who voted against the mandate, accused Nelson of using scare tactics, and Boundary County Commissioner Walt Kirby abstained from the vote and threatened to resign. 

In eastern Idaho, the Board of Health received an update from three regional hospitals and the Idaho Falls fire chief. The board then unanimously voted to place Custer County under a public health order that includes a mask mandate after rising cases there. (Read more about the meeting here.)

After lengthy public testimony and discussion from the commissioners, South Central Public Health District’s board narrowly turned down a district-wide mask mandate. In one of the more confusing moves of the day, Gooding County Commissioner Helen Edwards voted against a motion to table the mandate proposal, then voted against implementing the mandate itself. Ultimately, the proposal failed on a 4-5 vote. 

South Central District Health, or Public Health District 5, had a positivity rate of 24 percent the week of Nov. 1, the most recent week for which data is available. 

The Idaho North Central District Board of Health voted to loosen restrictions in one of their categories to align with language in Gov. Brad Little’s Reopening Idaho plan. The change was minimal, and was mostly made to minimize confusion between the state and local approaches, but was the only action the board took, other than rescheduling an upcoming meeting.

The board’s light agenda didn’t have updates from any of the regional hospitals, which include facilities in Grangeville, Orofino, Lewiston and Moscow, nor did they get an update from the state hospital and prison in Clearwater County.

There was no discussion of a district-wide mandate or penalties for businesses that don’t follow recommendations, though Latah County Commissioner and board chairman Dave McGraw suggested holding bar owners accountable by pausing liquor license renewals. 

“If any bar owners are known to not be following the guidelines — there’s  a certain bar in Kendrick we’ve had a problem with — we have no problem calling bar owners into the courthouse” to explain what improvements they would make, McGraw said. 

For the week of Nov. 1-7, Public Health District 2 reported a 23 percent positivity rate.

Individual communities within Public Health Districts 2 and 5, including Moscow, Blaine County, and the Nez Perce Tribe, have instituted their own restrictions throughout the course of the pandemic. Other city councils have voted down or tabled proposals.

Meanwhile, hospitals and physicians in small communities are warning that regional hospitals are at or near capacity, which limits their ability to transfer patients who need intensive care.

“It has dramatically affected our ability to transfer critically ill patients,” wrote Orofino’s Dr. Phil Petersen in a recent Clearwater Tribune column. “The usually tertiary referral hospitals have been consistently at, or near, capacity. Patients have been transferred to more distance hospitals for the lifesaving specialty care needed when our usual resources were at capacity and not accepting new patients.”

Petersen’s column echoes what Grangeville’s Syringa Hospital and Clinics CEO Abner King told Idaho Reports last week. The hospital had to transfer one cardiac patient to Coeur d’Alene after the nearest facility, in Lewiston, couldn’t take them. (Listen to the interview here. The discussion with King starts at 4:40.)

“There is a definite risk of non-covid mortality directly related to the pandemic secondary to medical system overload,” Petersen wrote. 

On Thursday, the Idaho Department of Health and Welfare reported 1,543 new cases and 23 new deaths, bringing the statewide total to 87,978 known cases and 835 deaths. 

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