Idaho promulgates crisis hospital care standards amid COVID outbreak



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Ann Enderle RN checks a COVID-19 patient at St. Luke’s Boise Medical Center in Boise, Idaho on August 31. Idaho’s public health officials have activated “crisis care standards” for upstate hospitals because there are more coronavirus patients than institutions can handle. (Kyle Green, Associated Press)

BOISE, Idaho – Public health officials in Idaho have activated ‘crisis care standards’ for upstate hospitals because there are more coronavirus patients than institutions can handle. to manage.

The Idaho Department of Health and Welfare quietly adopted the decision on Monday and announced it publicly in a statement Tuesday morning – warning residents they may not receive the care they would normally expect if they were to be hospitalized.

It came as confirmed cases of the coronavirus in the state have skyrocketed in recent weeks. Idaho has one of the lowest vaccination rates in the United States

The agency cited “a severe shortage of staff and available beds in the upstate caused by a massive increase in the number of COVID-19 patients who require hospitalization.”

The designation includes 10 hospitals and health care systems in the Idaho Panhandle and north-central Idaho. The agency said its goal was to expand care to as many patients as possible and save as many lives as possible.

The move allows hospitals to allocate scarce resources like intensive care unit rooms to patients most likely to survive.

Other patients will continue to receive care, but they may be placed in hospital classrooms or conference rooms rather than traditional hospital rooms or without vital medical equipment.

Idaho Department of Health and Welfare Director Dave Jeppesen made a decision to adopt the Crisis Standards around 5 p.m. Monday after the Crisis Care Standards Activation Advisory Committee of the state determined that all other measures taken to help alleviate staffing and bed shortages had been exhausted.

The department waited until Tuesday morning to make the public announcement “out of respect for the hospitals,” department spokeswoman Niki Forbing-Orr said in an email. She did not elaborate or immediately respond to questions asking for more details.

The crushing of patients in Idaho hospitals was anticipated with dismay by health care providers across the state. Medical experts have said Idaho could have up to 30,000 new cases of coronavirus per week by mid-September if the current rate of infections persists.

“Standards of care in a crisis are a last resort. It means that we have exhausted our resources to the point that our health systems are unable to provide the treatment and care we expect,” said Dave Jeppesen, director of Idaho Department of Health and Welfare, in a statement. .


Standards of care in a crisis are a last resort. This means that we have exhausted our resources to the point that our health systems are unable to provide the treatment and care that we expect.

–Dave Jeppesen, director of the Idaho Department of Health and Welfare


He added: “It was a decision I very much hoped to avoid. The best tools we have to remedy the situation are for more people to get vaccinated and wear masks indoors and in crowded public places outdoors. Please choose to get vaccinated as soon as possible. as possible – it’s your best protection against hospitalization with COVID-19. “

The designation will remain in effect until there are sufficient resources – including hospital staff, beds and equipment, or a drop in patient numbers – to provide normal treatment levels for all.

More than 500 people were hospitalized statewide with COVID-19 on September 1 – the most recent data available on the Department of Health and Welfare website – and more than a third of between them were in intensive care unit beds.

Hospitals in Idaho have struggled to fill nursing, housekeeping and other health care vacancies, in part because some staff have left because they are exhausted from the pressure pandemic and because others have been quarantined because they have been exposed to COVID-19.

More than 500 people were hospitalized statewide with COVID-19 on September 1 – the most recent data available on the Department of Health and Welfare website – and more than a third of between them were in intensive care unit beds.

Hospitals in Idaho have struggled to fill nursing, housekeeping and other health care vacancies, in part because some staff have left because they are exhausted from the pressure pandemic and because others have been quarantined because they have been exposed to COVID-19.

Late last month, Little called in 220 medical workers available under federal programs and mobilized 150 Idaho National Guard soldiers to help hospitals weather the tide.

Two hundred of federal workers are medical and administrative personnel available through contract with the US General Services Administration. The US Department of Defense has agreed to send a 20-person medical response team to northern Idaho. Idaho National Guard soldiers will provide logistical support such as screenings and lab work.

On Tuesday, the governor called the decision to limit care “an unprecedented and undesirable point in the history of our state” and urged residents to get vaccinated against the coronavirus.

Data from the United States Centers for Disease Control and Prevention shows that full vaccination with any of the currently available coronavirus vaccines significantly reduces the risk of requiring hospitalization for coronavirus infection.

“More Idahoans must choose to receive the vaccine so we can minimize the spread of the disease and reduce the number of hospitalizations related to COVID-19, many of which involve younger Idahoans and are preventable with safe and effective vaccines said Little, who is a Republican.

Jack Kingsley RN cares for a COVID-19 patient at St. Luke's Boise Medical Center in Boise, Idaho on August 31, 2021. Public health officials in Idaho have activated "standards of care in crisis" for hospitals in the upstate, because there are more coronavirus patients than institutions can handle.
Jack Kingsley RN cares for a COVID-19 patient at St. Luke’s Boise Medical Center in Boise, Idaho on August 31, 2021. Public health officials in Idaho have activated “Crisis Care Standards” for hospitals in the upstate, because there are more coronavirus patients than institutions can handle. (Photo: Kyle Green, Associated Press)

When the pandemic first arrived in Idaho in early 2020, Little ordered a partial state shutdown – ordering some businesses to temporarily shut down or switch to takeout-style services, banning some large ones. gatherings and asking residents to stay home as much as possible. possible.

The move was intended to ensure that hospitals would not be overwhelmed with patients. Idaho was on the verge of adopting crisis care standards during a major coronavirus surge last winter, but narrowly avoided doing so – making it the first time the state has taken the drastic measure.

Little reopened the state in stages over a period of months and did not reimpose restrictions limiting gatherings. Most businesses operate normally.

State crisis guidelines are complex and give hospitals a legal and ethical model to use while rationing care.

Under the guidelines, patients are given priority scores based on a number of factors that affect their likelihood of surviving a health crisis.

People considered to be most in need of care and most likely to benefit from it are put on priority lists for scarce resources like intensive care beds.

Others in need but less likely to survive will receive “comfort care” to help them stay pain free, whether they succumb to their illness or recover.

Other patients with serious but not life-threatening medical problems will experience delays in receiving care until resources are available.

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