Idaho is once again in a health care crisis.
The state’s health and welfare director on Monday announced he re-activated Idaho’s “crisis standards of care” rationing protocol that morning.
Saint Alphonsus Health System requested the activation last week, and Idaho Health and Welfare Director Dave Jeppesen convened the Crisis Standards of Care Activation Advisory Committee virtually on Jan. 21, according to a news release Monday.
This crisis declaration applies only to Southwest District Health, Central District Health and South Central District Health, which surround the Boise-Nampa metro area, the Twin Falls metro area and the Ketchum-Sun Valley area.
Other regions of the state are likely to move into crisis standards, too, if current COVID-19 trends continue, the release said.
“The highly contagious Omicron variant has thrown us a curve ball,” Jeppesen said in the release. “Once again, the situation in our hospitals and health systems is dire – we don’t have enough resources to adequately treat patients. Please get vaccinated and boosted if you can and wear a high-quality protective mask in public places. Omicron is so much more contagious than previous variants, and even though a lower percentage of cases are ending up in the hospital, the record number of cases is still putting strain on our healthcare system.”
The health care rationing protocol is meant to help health care providers make decisions on how to use scarce resources. It does not mean that patients will be left to die.
The state’s prior crisis declarations — from early September through late December — resulted from a surge of unvaccinated, critically ill patients with the delta coronavirus variant. There were too many sick patients, and not enough hospital staff or beds.
Other states, including Montana, were driven to crisis standards by the delta surge. Now, Idaho’s neighbor Washington is also teetering on the edge of crisis standards as omicron surges there.
This crisis is more complicated.
Not only do hospitals have too many patients coming in with COVID-19, and not enough nurses and beds for all of them, hospital workers themselves are out for COVID-related reasons.
Jeppesen said this month that “10 times as many (hospital) staff are out now as they were at the end of December, during the delta surge,” which made the staffing struggles worse.
Idaho hospitals on Sunday reported 506 patients with COVID-19. There were about 250 when the month of January began.
Idaho Deputy State Epidemiologist Dr. Kathryn Turner recently shared data showing that omicron infections are more than 2.5 times more prevalent among Idahoans who aren’t fully vaccinated; and, even with breakthrough cases, that divide between vaccinated and not is growing fast.
Hospitals also don’t have enough blood to give people who need a transfusion, causing a shortage of that lifesaving resource.
Idaho Division of Public Health Administrator Elke Shaw-Tulloch this month issued a plea to the public to donate blood. “According to the American Red Cross, we are facing the worst blood shortage in over a decade, posing concerning risks to our patient care,” Shaw-Tulloch said. “I have my appointment to donate blood tonight, and I encourage you all to make an appointment today.”
Blood products help patients survive and recover from a wide variety of injuries and illnesses, from women who lose blood in childbirth, to car crash and burn victims, to cancer patients.
Dr. James Souza of St. Luke’s Health System, in a recent media briefing, echoed that call to action. “We’re doing everything we can,” he said, explaining that St. Luke’s was taking steps “to ration blood products” and postponing elective surgeries that can create a need for blood transfusions.
On top of hospital staffing, bed and blood shortages, there is a logjam of patients in Idaho’s hospitals.
Long-term care and rehabilitation centers can’t take patients who are ready to leave the hospital, but not ready to go home.
That is “dramatically” slowing the movement of patients through the hospital, Jeppesen said this month.
“The reason is that long-term care facilities are struggling in general just to hire staff … coupled with (high rates of COVID-19) among their staff, causing them to be out of work,” Jeppesen said. The staffing problems are worse than at any point before in the pandemic, he said.
“That is actually causing patients who are ready for discharge to stay at hospitals until either something opens up at a long-term care facility or they get well enough that they can be discharged to home,” he said. “… So, that causes them to be housed at the hospital.”