Doctors describe “the most extreme healthcare delivery situation” Idaho has ever faced

By Melissa Davlin, Idaho Reports

In a Thursday media call, Treasure Valley hospital leaders warned that healthcare delivery will continue to suffer as hospitals are inundated with unvaccinated COVID-19 patients.

The message was similar to what healthcare professionals across the state have said since mid-August: Idaho is veering dangerously close to crisis standards of care. But even without an official declaration of crisis standards, healthcare services are already stretched to their breaking point, which will affect nearly all patients seeking help at hospitals in the coming weeks. 

“It’s time to expect that things are going to be different when you need healthcare for the short term foreseeable future,” said Dr. Steven Nemerson, chief clinical officer of Saint Alphonsus. “It’s not going to be as quick and there’s going to be a prioritization… You should be prepared to take care of yourself at home when possible.”

Nemerson described the current situation in hospitals as “the most extreme healthcare delivery situation” the state has ever faced, with higher than ever nurse-to-patient ratios. The influx of unvaccinated COVID-19 patients, as well as patients needing care for other ailments, has forced hospitals to convert other care spaces to COVID-19 wards. 

“We are putting our caregivers in the position of caring for more patients than they normally would,” Nemerson said.  

Dr. Frank Johnson, chief medical officer for St. Luke’s Health System in Boise, Elmore and McCall, echoed Nemerson’s sentiments. 

“If you have an emergent condition, if you need to come to the emergency room, please come,” Johnson said. But patients who have urgent, but not emergent, needs, should expect a long wait.

“WE ARE TIRED.”

Johnson teared up as he described the strain on his employees. 

“I can’t help getting emotional when talking about it… how impressed we should be with health care workers in crazy, ridiculous circumstances to help provide healthcare for their community,” Johnson said. “We’re putting people in positions that they ordinarily wouldn’t be doing. They are stepping forward with tremendous commitment” to caring for patients. 

Dr. Richard Augustus, chief medical officer for West Valley Medical Center, said the same of his colleagues. 

“They’re being asked to do it again and again and again. And we are tired,” Augustus said. 

The strain isn’t isolated to Treasure Valley. Last week, Kootenai Health in Coeur d’Alene announced it had converted a classroom to a patient care center in anticipation of running out of space in its traditional hospital setting. On Thursday afternoon, Gritman Medical Center in Moscow posted that its new COVID care facility has already been at capacity several times in the last few weeks. 

Nemerson said 95 percent of the hospitalized patients at Saint Alphonsus are unvaccinated. For critically ill patients needing care in the ICU, that jumps to 99 percent, he said. Johnson and Augustus said their facilities have the same flood of unvaccinated patients filling their beds.

All three expressed grave concern over what the next few weeks will bring. Nemerson pointed to the high test positivity rates in hospitals — 22 percent at Saint Alphonsus today, he said — and the steep upward trajectory of new hospitalizations. 

Those figures mirror statewide numbers. ICU admissions hit a new high of 162 on Monday, and the statewide test positivity rate reached 14.2 percent last week.

“The major concern I have right now is there is no evidence we are reaching a peak at this point,” Nemerson said. 

Augustus agreed. 

“We are not even close to the worst. And that scares us,” he said. “Because we went into this to care for people, to help people, to save them, and we can’t.”

Idaho Reports is airing a second special on the state’s hospital crisis, featuring medical professionals from around the state. The program airs 8 pm in both Mountain and Pacific time zones, Thursday, Sept. 9 on Idaho Public Television.

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