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BOISE, Idaho (AP) – Sorting patients through parking lots in a capital city is normally science fiction.
Yet that’s the reality in Boise, where troops are leading people outside an emergency care clinic redeveloped into a coronavirus patient facility as infections and deaths increase in Idaho and across the country.
In the Primary Health Medical Group clinic, physician assistant Nicole Thomas works extra 12-hour shifts to help. She dons goggles, an N95 mask, an overhead surgical mask, gloves and body blanket to examine 36 patients a day with symptoms. On some days, she says, half of them test positive for COVID-19.
“I’ve had patients crying in the car because they thought they were going to die,” Thomas said last week, leaning against a desk between patients. “There are people who are just a mild cold, and there are people in intensive care in intensive care. We don’t know, medically, how it will affect them.
What was once a facility with family doctors and urgent care that dealt with things like cuts and colds has now become a COVID-19 clinic, showing how a crush of patients infected with the virus is straining people. intertwined health systems. In a conservative state where many resist pandemic restrictions, overworked staff themselves fall ill or leave to avoid stress.
Idaho’s attempt to control the coronavirus fails, health officials say. To date, just over 1,000 people have died from COVID-19, about four to five times the annual number of deaths from influenza and pneumonia. Confirmed infections have exceeded 100,000.
Most elective surgeries have been discontinued to save bed space and staff. COVID-19 patients have been sent home with monitoring devices to take care of themselves. After Thanksgiving gatherings, officials fear a wave of infections that could force tough choices about what to do with patients when there is no more room or no one available to treat them.
“When can we reach absolute capacity? I just don’t know. But we’re nervous, ”said Barton Hill, vice president of St. Luke’s Health System, which has hospitals in southwestern and central Idaho.
“I never imagined we would be faced with such a challenge,” said Steve Judy, COO of Primary Health Medical Group, as he visited the clinic where Thomas works.
He was interrupted by a young woman there for a COVID-19 test who wandered out of an examination area, looking confused. She had blood drawn and didn’t know where she was supposed to be, she said through her mask, her eyes glassy. Judy, after determining that her exam was not complete, led her gently past a row of workers taking phone calls and returned to the exam area.
The clinic was full of workers, supporting Thomas and two other medical assistants who examine patients. Together, they see nearly 110 people a day, ordering chest x-rays and blood tests to make a diagnosis. Seventy more people without symptoms are tested for COVID-19 while driving in the parking lot every day.
The 20 primary health clinics in southwestern Idaho normally offer emergency care on one side and family physicians on the other. Eight have been turned into facilities that only receive patients with COVID-19.
It takes at least two days for patients to get an appointment for an exam. Primary health will turn three more facilities into COVID-19 clinics by December 30 and plans to change more if necessary.
“I’m not in hospitals,” said Dr David Peterman, pediatrician and CEO of Primary Health Medical Group. “But I tell you, we are at the maximum in primary health. We are so close to rationing care here. We’re probably 10 to 15 days away. “
About 20% of its employees are absent because they are self-isolating or have tested positive for the virus. Judy said he was trying to fill 50 positions after workers could no longer take the stress and quit smoking. He increased the front desk wage from $ 2.50 to $ 14 an hour.
Calls to clinics have gone from 30,000 per month before the pandemic to 80,000 today. The Boise clinic has half a dozen workers who take calls. When they’re not on the phone, they pack test kits.
“We work hard for them,” said Judy, who is concerned for her staff. “They almost all work overtime.”
In the St. Luke hospital system, an increasing number of workers are absent due to COVID-19, officials said. In addition to canceling elective surgeries, hospitals have tried to save space by sending 160 patients – 140 with COVID-19 – home with devices to measure oxygen in their blood.
Now hospitals are planning what to do if there aren’t enough workers or beds available in an entire area. Health care workers should choose who receives treatment and who does not.
“This is really when we are exposed to what are called ‘crisis standards’,” Hill said, noting that the state would decide when to put them in place. “We are very worried over the next two weeks.”
Idaho’s crisis plan divides the sick into categories, prioritizing those with life-threatening illnesses or injuries who should survive and giving only comfort care to those who do not.
Rural areas have generally avoided large numbers of COVID-19 infections for months, but they are now widespread. Recently, a wave of infections in southern Idaho filled hospital beds and forced some patients to be transferred to the Boise area.
When people started to get sick in March, Republican Gov. Brad Little issued a stay-at-home order that lasted just over a month and stopped the spread of the virus. But unemployment fell from less than 3% to almost 12%.
The restrictions were gradually lifted, but as infections and deaths rose again, Little reinstated some rules last month, including limiting gatherings to 10 or less. He also activated 100 National Guard soldiers to free medical personnel, training them in mobile testing support, facility decontamination and COVID-19 screenings.
Nickolas Orr was one of two soldiers meeting patients in their car outside the primary health clinic.
“Some people seem a little nervous,” he said, telling them where to go based on whether they were sick and had an appointment or whether they were feeling well but wanted a test.
Although Little was among the first governors to publicly wear a mask last spring, he declined to issue a statewide warrant, saying more people would wear it if it was a choice.
There is a lot of resistance. About 64% of Idaho voters backed President Donald Trump, who rejected wearing a mask and ridiculed President-elect Joe Biden for wearing one during the campaign.
Some sheriffs say they will not enforce mask requirements. A lawmaker compared Little to Hitler for issuing pandemic restrictions. The Republican-dominated legislature is planning legislation next month limiting the governor’s ability to declare emergencies.
And in Boise, who has a mask warrant, protesters recently took to shops and restaurants without face masks to complain about the violation of their rights.
Meanwhile, inside the primary health clinic, Thomas, the physician’s assistant, put on sterilized protective gear as workers disinfect an examination room before the next patient.
The clinic no longer has time to call everyone who tests positive for COVID-19. Most receive a text. Only those members of the high-risk groups who are most likely to die receive a phone call, that human voice.
“Not infecting others is kind of the name of the game right now,” Thomas said. But she doesn’t have much hope. “I think we’re going to get busier and busier.”
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