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Here’s what Idaho’s statewide crisis standards of care will mean for you

Kristen Connelly, R.N. of the Surgical intensive care unit (SICU) at St. Luke's Boise Medical Center in Boise, Idaho holds back tears as she talks about the pressure of dealing with the influx of patients to the hospital because of COVID-19 on Tuesday, Aug. 31, 2021.
Kyle Green
Kristen Connelly, R.N. of the Surgical intensive care unit (SICU) at St. Luke's Boise Medical Center in Boise, Idaho holds back tears as she talks about the pressure of dealing with the influx of patients to the hospital because of COVID-19 on Tuesday, Aug. 31, 2021.

Idaho Department of Health and Welfare Director Dave Jeppesen authorized hospitals statewide to use crisis standards of care if needed as many are buckling under the weight of an influx of COVID-19 patients.

The Boise State Public Radio News team has gathered resources to help you understand what this could mean for you, your family and your friends in these unprecedented times.

Where do these crisis standards of care guidelines come from?

Idaho’s crisis standards of care were finalized in June 2020 by a team of dozens of doctors, nurses and health care workers from the Idaho Department of Health and Welfare, as well as those from the private sector. They outline how hospitals will prioritize care with scarce resources during disaster situations, including the COVID-19 pandemic. You can read through the entire set of standards here.

Who will get care and who may not?

Patients will be prioritized based on the severity of their illness or injury as followed:

  • Immediate: Those with life threatening conditions or need lifesaving interventions
  • Delayed: Those with serious, but not life threatening conditions where delaying treatment won’t affect the outcome
  • Minor: Those with minor injuries or illnesses, still conscious, able to breathe and walk
  • Expectant: Those who aren’t expected to survive their illness or injury will only be given comfort care, though they may be upgraded to immediate care if bed and staffing levels improve

Hospitals will use this triage system based on their real-time space and staffing capacities. Not all Idaho hospitals will operate under these standards depending on their resources, but may now do so.

Why are unvaccinated people still getting treated at the hospital when the COVID-19 vaccine has been widely available for months?

A person’s vaccination status is not considered while triaging patients under the state’s crisis standards of care that were approved last year. 

Boise State Public Radio recently asked Dave Jeppesen, the director of the Idaho Department of Health and Welfare directly if he’d consider approving a request to prioritize a patient based on their vaccination status.

“What we will follow is what we have in those standards. They were written based on national best practices,” Jeppesen said.

What does this mean for the elective surgery I was supposed to get? And what is defined as an elective surgery?

The short answer is: it depends. Saint Alphonsus and St. Luke’s health systems paused some elective surgeries at the beginning of September, though life-saving surgeries are continuing. 

While “elective” surgeries can include things like knee replacements that would improve a patient’s quality of life, they can also include early cancer treatments.

What should I do if I have a heart attack/stroke/get in an accident?

If you have a serious condition or accident, health leaders still want you to go to the hospital for care. However, former St. Luke’s CEO Dr. David Pate said on Sept. 15 during Idaho Matters that you may not get the kind of care you would in normal circumstances. He said this could be frustrating for people who have received the COVID-19 vaccine and have followed other health guidelines during the pandemic. 

What are health officials saying about going to outdoor sporting events this fall, like Boise State football games?

Dr. David Pate, the former CEO of St. Luke’s health system and a member of Gov. Brad Little’s coronavirus advisory committee is urging organizers for large events to cancel them for a few weeks until healthcare capacity improves.

Dr. Steven Nemerson, Chief Clinical Officer for Saint Alphonsus, said Thursday, "The short answer is no, it's not safe to have those events, but we don't know that we can change the trajectory."

Outdoor transmission of the virus is rare, though the risk for spread increases the longer you spend in close contact with others who may or may not be vaccinated. Just 50.4% of eligible people in Idaho are fully vaccinated compared to 63.2% of all eligible Americans.

What are health officials saying about attending indoor concerts or events, like at Treefort Music Fest?

Dr. Steven Nemerson of Saint Alphonsus Health System discussed this topic on Idaho Matters Wednesday Sept. 15 — the day before statewide crisis standards were enacted. He urged people to practice what he characterizes as “COVID safety,” and discouraged people from attending concerts at this time. Dr. Laura McGeorge of St. Luke’s Health System expressed concern on Sept. 8 over Treefort Music Fest. She said she fears the multi-venue festival in downtown Boise could potentially lead to more hospitalizations due to COVID-19, and that she “personally would not go to a large gathering even if it were outdoors and everyone's masked. It's just such a ... such an unsafe time right now.”

How many vaccinated people are in the hospital being treated for COVID-19 in Idaho?

As of Sept. 15, the most recent data available, 40% of St. Luke’s patients were hospitalized for COVID-19. 91.8% of those were unvaccinated. COVID-19 patients made up 78% of St. Luke’s ICU patients on Sept. 15 and 96.7% of them were unvaccinated.

For Saint Alphonsus, COVID-19 patients account for 31.5% of all hospitalized patients as of Sept. 15. It’s unclear how many of them are unvaccinated and what the ratio of COVID-positive patients are in the Saint Alphonsus’ICU.

Has the state ever enacted crisis standards of care statewide?

No. This is an unprecedented step. On Sept. 7, the state Department of Health and Welfare announced it had activated crisis standards of care in North Idaho. This statewide declaration is an expansion of that original declaration. 

I think I may have COVID-19. Where can I get tested?

There are many places available in Idaho to be tested, though many require patients to make an appointment beforehand. Some may not test you if you’re not showing symptoms, while others might if you have a referral from another healthcare provider.

Find a testing center near you.

Correction: A previous version of this story incorrectly captioned the nurse in the photo as Ann Enderle. The caption has been updated to correctly name the nurse as Kristen Connelly.

Follow James Dawson on Twitter @RadioDawson for more local news.

Copyright 2021 Boise State Public Radio

Member support is what makes local COVID-19 reporting possible. Support this coverage here.

I cover politics and a bit of everything else for Boise State Public Radio. Outside of public meetings, you can find me fly fishing, making cool things out of leather or watching the Seattle Mariners' latest rebuilding season.
Frankie Barnhill was the Senior Producer of Idaho Matters, Boise State Public Radio's daily show and podcast.

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