By Melissa Davlin, Idaho Reports
At a Thursday news conference, Dr. Jim Souza of St. Luke’s Health Systems said the fourth surge of COVID-19 cases is on track to be worse than December’s surge, which nearly triggered the state to declare crisis standards of care.
It’s becoming more clear just how bad that surge could get. According to modeling being shared by the Idaho Department of Health and Welfare, Idaho could see 2,500 hospital admissions weekly and 30,000 new cases per week by mid-October.
That’s more than 4,000 new cases per day. The previous high, reached in December, was 2,298.
IDHW’s Division of Public Health is presenting that projection to elected officials and community leaders around the state. Those figures, obtained by Idaho Reports, are averaged from several different models via the COVID 19 Scenario Modeling Hub.
The modeling shows four scenarios: High vaccination rates with low transmissibility, low vaccination rates with low transmissibility, high vaccination rates with high transmissibility, and low vaccination rates with high transmissibility.
Right now, with just 47 percent of its eligible population fully vaccinated, Idaho is tracking with the fourth model.
“This is the projection we are sharing. It is not a “worst-case” scenario,” the Division of Public Health said in a statement to Idaho Reports. “The ensemble projection is an amalgamation of different projections. Some projections are much higher, some are much lower. The Ensemble Projection essentially ‘averages’ the projections.”
The Division of Public Health has used this modeling before, and it’s been fairly accurate, said Kelly Petroff, communications director for IDHW. It began sharing these specific numbers with stakeholders and other public health officials across the state last week.
Delta making patients more ill, more quickly
Of course, modeling isn’t a crystal ball, and there is no guarantee that Idaho will hit those high numbers. Some models upon which the amalgamation is based show much lower hospitalizations and cases.
But throughout Idaho, hospital leaders and public health officials are sounding the alarm about an upcoming healthcare crisis, driven by staffing shortages, low vaccination rates and the Delta variant, which is more contagious than other variants and is making some patients more ill.
Last winter, when Idaho neared crisis standards of care — in other words, statewide rationing of healthcare when the hospital system is overburdened and short-staffed — Idaho hit a high of 498 hospitalized patients statewide in one day, on December 1. That same day, 105 people were admitted to intensive care units.
Currently, a higher percentage of hospitalized patients are becoming critically ill and landing in the ICU. Last Wednesday, 322 COVID-positive Idahoans were hospitalized statewide, and of those, 108 were admitted to the ICU.
Those numbers line up with what Kootenai Health in Coeur d’Alene is currently experiencing. On Monday, the hospital had 80 COVID-positive patients; 33 of those were in the ICU.
Dr. Robert Scoggins, chief of staff for Kootenai Health and medical director for Kootenai Health’s critical care, said he had seen similar projections to IDHW’s at a presentation at his hospital.
“It shows we’re at the beginning of the surge, and that’s very concerning,” he said. “It’s concerning because the hospitals in the region are already full.”
Rep. Fred Wood, the Idaho Legislature’s only physician and a member of the IDHW’s Board of Health and Welfare, told Idaho Reports that he hadn’t seen those specific projections, but added he wasn’t at all surprised, as Delta is significantly more transmissible.
“One of the things about this particular variant also is that there’s more people that are getting more serious disease on a percent basis,” the Burley Republican said. “Even if you had the same total number of cases daily, you’re going to end up with more patients in the hospital with severe disease.”
“If you look at the rate of increase of patients going in the ICU, I mean that curve is almost straight up,” Wood said. “Way steeper than the curve was with the last big surge. That gives me real pause that we’re in for it. We’re in for a tougher road than we had last winter.”
Scoggins said the same is true for his patients in Coeur d’Alene. “They come in sicker, they progress more rapidly to requiring higher levels of oxygen and requiring mechanical ventilation sooner, and they’re younger too,” he said.
“Honestly, this nursing staff is worn out.”
Hospital admissions aren’t the only measure of how strained a healthcare system is. A hospital also needs nurses and doctors to care for its patients. Kootenai Health announced last week that it has requested traveling nurses to help after a north Idaho COVID surge, and is reassigning nurses and rescheduling some non-emergency procedures.
“Honestly, this nursing staff is worn out, and the physicians taking care of the patients are worn out,” Scoggins said. “It really has been a battle at the hospital to care for these patients. They’re difficult patients to take care of.”
During a media call on Thursday, Souza said St. Luke’s is also dealing with an influx of patients for non-COVID reasons as well: RSV infections in children, patients who put off care during the pandemic and are more ill now, and summertime accidents from recreation.
But the influx of COVID patients is adding additional, and largely avoidable, stresses to the system. According to numbers released last week by the Idaho Department of Health and Welfare, unvaccinated Idahoans are being hospitalized at 13 times the rate of vaccinated Idahoans.
Geri Rackow, director of Eastern Idaho Public Health, said IDHW had shared its projections with her, but she hadn’t yet presented them to her board of health, which is scheduled to meet this week. Eastern Idaho hospitals aren’t currently facing the same COVID stresses as hospitals elsewhere in the state, but “that doesn’t mean it’s not coming.”
“It’s getting concerning if the numbers keep rising and hospitalizations continue to increase,” she said. “We still have the same struggles of not enough staff to meet the demands of patients coming in, not just for COVID but for all reasons,” she said.
Vaccines and public health measures
“I think the modeling is concerning because it’s showing an outbreak that’s more significant than we had in the first year of the pandemic,” Hailey City Councilman Sam Linnet told Idaho Reports on Monday. Linnet received the information from the Division of Public Health last week. “If that’s the case, I’m going to be seriously considering what kind of public health measures we need to take so our hospitals remain open and our schools remain open and people can go to work.”
At the moment, almost no local government agencies in Idaho, with the exception of a few school districts, have orders regarding masks or group sizes. Linnet said he doesn’t want to return to “draconian” measures like business closures and stay-at-home orders, but said overwhelmed hospitals affect everyone in the community.
He added that his wife is due with their second child at the end of September. The couple’s first baby had to be life flighted to Twin Falls, making Linnet nervous for how hospitals will look in early fall. If residents had to go back to wearing masks, people would be frustrated he said, but “the frustration would be we’re in this position and it was preventable, and it’s due to misinformation and politicizing public health.”
Wood said people need to choose to get vaccinated, as well as avoid unnecessary gatherings and wear masks — both indoors and outdoors, he said. That includes school children, he added.
“I mean, the whole rest of the world understands this,” he said. “We’ve transferred this from a public health issue to a political issue and people just lose if that happens. It’s so sad. It really is so so sad. There’s no need for this. At all.”