Crisis standards enacted in northern Idaho

The Idaho Department of Health and Welfare activated crisis standards of care in the two northern Idaho health districts Tuesday because of a severe shortage of staffing and available hospital bed space.

Clearwater Valley Health and Clinics in Orofino, Gritman Medical Center in Moscow, St. Joseph Regional Medical Center in Lewiston, St. Mary’s Health and Clinics in Cottonwood, and Syringa General Hospital in Grangeville fall under the umbrella designation, but will decide individually whether to implement those standards, hospital officials said Tuesday.

“This doesn’t mean that COVID-19 is not significantly impacting our hospital,” said Samantha Skinner, spokeswoman for St. Joseph Regional Medical Center. “In fact, our current COVID-19 situation is worse than it has ever been. Like most healthcare facilities in our region, St. Joe’s is operating at the very edge of our capacity. We are seeing more patients who are very sick, requiring intensive care and patients requiring treatments and hospitalization for longer periods of time. More than half of our (intensive care unit) patients are being treated for COVID-19. We are doing everything we can to manage the increase in patients being treated for COVID-19 while also continuing to provide care for the ongoing, non-COVID-19 healthcare needs of our community.”

Skinner added that 88 percent of St. Joe’s COVID-19 patients in the past 30 days were people who were unvaccinated. As of Monday, there were 13 patients hospitalized with the virus.

Crisis standards of care guidelines help health care providers and systems decide how to deliver the best care possible under the extraordinary circumstances of an overwhelming disaster of public health emergency, according to the Idaho Department of Health and Welfare. The guidelines may be used when there are not enough resources to provide the usual standard of care to people who need it.

The designation was sought by Kootenai Health in Coeur d’Alene on Monday and approved by Dave Jeppesen, director of the state health department.

In a news release, Idaho Gov. Brad Little said the state has reached “an unprecedented and unwanted point in the history of our state. ... We need to ask more Idahoans to choose to receive the COVID-19 vaccine ... so we can minimize the spread of the disease and reduce the number of COVID-19 hospitalizations.”

Other hospital representatives in the region echoed Skinner’s assessment of their capacity to deal with the current COVID-19 situation.

Peter Mundt, communications director for Gritman Medical Center, said it’s important for people to know that the Moscow hospital is safe and open for care “and people shouldn’t delay care. The crisis standards decision can give the impression that some things are wrong. We don’t want people to stay home and not seek care when they need medical care.”

Even so, Mundt added, Gritman staff members have been feeling the stress. A COVID-19 care unit that was opened several weeks ago has been operating at capacity several times. It has been difficult to recruit medical workers, and medicine and supplies have also been strained.

“There may come a time in the not-too-distant future where we may also have to move to Crisis Standards of Care but we’re not there yet,” Mundt said. “We are in contingency standards of care ... because we’re stretched on staffing, space and supplies.”

St. Mary’s Health and Clearwater Valley Health also are dealing with a shortage of staff and have requested help from the Idaho National Guard.

In a news release, the hospitals said elective surgeries have been canceled and contingency levels of care have been adjusted to accommodate patient surges and volume demands. This “could also mean that St. Mary’s Health and Clearwater Valley Health have to keep patients they would normally transfer to a higher acuity hospital due to the inability to find a hospital (that) can accept transfers.” Hospital staff and other health care providers who are caring for more patients than usual might be forced to monitor vital signs less frequently.

“Only in extreme instances will hospital care teams need to make decisions about who will or will not receive needed resources,” the news release said. Both hospitals have established protocols to guide such decisions.

Abner King, chief executive officer for Syringa, said the state designation will reduce “our ability to transfer patients needing a higher level of care to larger facilities. In addition, Syringa will most likely be accepting patients from other hospitals in our region to free up their capacity to take patients needing a higher level of care. ... Currently Syringa is adequately staffed for this influx; however that could quickly change if any of our staff get sick or quarantined. At this time Syringa is not receiving any additional staffing from the Idaho National Guard or other state or federal sources.”

Public Health – Idaho North Central District reported 207 new COVID-19 cases since Friday, which is the fifth-biggest single-day total of the pandemic. The total is from the three-day Labor Day weekend. That includes two deaths, both from Idaho County: a woman in her 60s and a man in his 80s.

Lewis County had six new infections, Clearwater County reported 31, Idaho County had 27, Latah County added 44 and Nez Perce County recorded 98.

Whitman County reported 31 new cases and Asotin County has added 51 cases since Friday for a 14-day county of 270. That includes four hospitalizations and 82 breakthrough cases since July 1. Garfield County had no change in its count.

The Lewiston School District reported four new COVID-19 infections among students, with eight cases active. That includes three at McGhee Elementary, one at Orchards Elementary, one at Sacajawea Middle School and three at Lewiston High School.

Among staff, there are three active cases; one each at Orchards Elementary, Lewiston High and operations.

Hedberg may be contacted at kathyhedberg@gmail.com or (208) 983-2326.