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Hospitals In Northern Idaho Begin Rationing Care After COVID-19 Surge


Northern Idaho is so overwhelmed with COVID cases, hospitals there have activated what are called crisis standards of care. That means hospitals are rationing care for everyone, no matter their diagnosis. Idaho has one of the lowest COVID vaccination rates in the country, it bears noting. Here's Jonathan Miller. He's an ER doctor at St. Alphonsus in Boise.

JONATHAN MILLER: Nineteen out of 20 patients that come into the hospital are unvaccinated. It's just - the story keeps repeating itself. And it's so frustrating to see person after person and kid after adult after elderly person - it's affecting everybody - coming to the hospital.

KING: Dr. Miller says that at the current rate of infection, hospitals in other parts of Idaho might have to start rationing care very soon.

MILLER: I'd say that most of us are probably depressed, if you ask. It's hard to see the light at the end of the tunnel. And every time you get through a surge and you think that we're making some progress, the next surge happens, and it feels like you're back to square one.

KING: Nate Hegyi with the Mountain West News Bureau is following this story. He's in Coeur d'Alene this morning. Hi, Nate.

NATE HEGYI, BYLINE: Hey. Thanks for having me.

KING: This surge has been going on for weeks. How did northern Idaho get to this point?

HEGYI: As you said, this has been building for a long time. Idaho is famously skeptical of COVID. Only about half of all eligible residents have gotten vaccinated. Meanwhile, cases began really ramping up in early August, and almost all of them are from the delta variant. And now hospitalizations for COVID are at an all-time high. Robert Scoggins is head physician at Kootenai Health here in Coeur d'Alene, one of the biggest hospitals in north Idaho. And he's struck by just how many young, unvaccinated people are getting seriously sick from delta and even dying.

ROBERT SCOGGINS: They're what I would consider healthy. They're normal, everyday north Idaho people. Honestly, we've had patients with really no significant past medical history who have died from this delta variant.

KING: Normal everyday people dying - how significant is this declaration, this crisis-standards-of-care declaration?

HEGYI: We've seen hospitals in other states do this a handful of times during the pandemic. So it's rare but not unprecedented. And this declaration is for 10 hospitals in mostly rural north Idaho. And officials here say they don't know how long it will have to last. And they're essentially guidelines for doctors in these overburdened hospitals. They help them decide who gets immediate treatment and who has to wait. And right now hospitals are already transforming hallways and conference rooms into COVID wards. But this isn't just bad news for unvaccinated people at risk from the disease; it also means everyone else needs to take extra precautions not to wind up in a hospital. Here's Elke Shaw-Tulloch of the state Division of Public Health at a press conference yesterday.


ELKE SHAW-TULLOCH: Be cautious about driving and bike riding and all the things that might cause a significant event where you need to go in for care. Of course, all this comes with a caveat - if you need care, please seek it. But do your best to avoid going to the emergency room.

KING: And a minute ago, we heard from Dr. Jonathan Miller in Boise. Here's what he told us is happening in his emergency room.

MILLER: We get calls from as far away as the Dakotas and Missouri asking if we can take their patients, and we don't even have room to take care of our own. I had a patient today in the ER that had been there for 100 hours waiting for a bed.

KING: One hundred hours - that is remarkable. Nate, have you talked to physicians who are dealing with scenarios like this one?

HEGYI: Yeah, I mean, patients might have to wait longer in line. You might get treated in an untraditional space, like a classroom. Scoggins, that doctor from the fairly big hospital here which has about 300 beds, said they've so far been able to give critical emergency care to people who need it, but they aren't doing urgent or elective surgeries right now. And the real worry is for COVID patients who arrive at smaller rural hospitals in north Idaho that don't have access to top-tier care. Normally, these patients are transferred to a bigger hospital, but those hospitals are rapidly losing space because of the surge, which means these rural patients are either getting transferred further out of state or they're having to wait, you know, a really long time, a hundred hours, for intensive care.

KING: Is northern Idaho getting any help?

HEGYI: Yeah, there's a 20-person response team from the Department of Defense that's getting set up now, and that's in addition to 150 National Guard troops and a couple hundred federal contractors who were sent in recently. But the state says that's not enough to cover the current surge of patients. And they expect things are going to get worse before they get better, especially because school just started. I mean, many districts don't have mask mandates, and vaccination rates among adults are low, and much of the rest of Idaho isn't far behind. I mean, many hospitals, including the state's largest in Boise and other cities, could see this crisis declaration extended to them if things don't turn around quickly.

KING: You mentioned that people in Idaho are skeptical of how serious COVID is. So now you've got this situation unfolding. And how are people reacting?

HEGYI: Well, I'm heading out today actually to talk to some folks, but throughout the pandemic, people here have been skeptical of COVID. Vaccination rates are low. Mask mandates have been protested at every step during the pandemic. And there are people who don't believe that the delta variant is very serious. But then there's also folks - right? - that take it seriously because they've lost friends or loved ones. I mean, more than 2,000 people have died in Idaho since the pandemic began.

KING: Nate Hegyi from the Mountain West News Bureau, a public radio collaboration. Thank you, Nate.

HEGYI: Thank you. Transcript provided by NPR, Copyright NPR.

Nate is UM School of Journalism reporter. He reads the news on Montana Public Radio three nights a week.