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What The Move To Crisis Standards Of Care Means For Idaho Residents

Staff at St. Luke's in Boise are in PPE as they prepare to treat COVID-19 patients.
St. Luke's Health System

The two public health districts in North Idaho are now in “crisis standards of care,” the Idaho Department of Health and Welfare announced Tuesday morning, as record numbers of COVID-19 patients — most of them unvaccinated — are requiring hospitalization.

Kootenai Health in Coeur d’Alene requested the state activate the policy, which gives health care providers guidelines for how to ration care, such as ventilators, ICU beds and staff resources, in a public health emergency. The hospital was caring for 108 COVID-19 patients on Tuesday.

It’s the first time Idaho has ever utilized its Crisis Standards of Care Plan that it created in 2020 during the coronavirus pandemic.

“If you go to the hospital, you should expect a longer wait time,” Department of Health and Welfare Director Dave Jeppesen said during a media briefing Tuesday. “You may not be seen in a traditional space. In fact, you may be seen in a classroom or a hallway. Or, you may be sent to a different hospital that has more capacity.”

Kootenai Health is now treating some patients in converted classrooms. It’s expanding its emergency department so there’s more room for patients to wait while the hospital tries to find them an open bed. It’s moving doctors into roles they normally don’t have. And it’s creating teams of nurses, so more experienced nurses can supervise ones with less training in a given unit.

Elective surgeries, even urgent ones, are being put on hold.

“Things that we would normally take care of very quickly, we may have to hold that off until we get more resources available for those patients,” said Dr. Robert Scoggins, the chief of staff for critical care at Kootenai Health.

Idaho hospitals have already been rationing care to a certain degree, but the Crisis Standards of Care Plan takes triaging to the next level. Health systems in North Idaho will follow state guidelines for prioritizing care such as oxygen therapy, ventilators, medications and hospice services.

Patients are given “priority scores” to determine if they’d be given a ventilator. The goal is to save as many lives as possible.

Kootenai Health is still able to see patients who show up, Scoggins said, though wait times are longer. The large regional hospital has also had to turn down transfers from smaller facilities.

“We usually take those, and we haven’t been able to function in that fashion very well over the last few weeks,” Scoggins said.

Some outside help for North Idaho is on the way. The Joint Force Land Component Command — a multi-branch military division of the U.S. Army North — has dispatched a 20-person military medical team to Kootenai Health. Similar teams are already working in hard-hit hospitals in Louisiana, Mississippi, Arkansas and Alabama

Jeppesen said other regions in Idaho are very close to needing to activate crisis standards of care, as case numbers and hospitalizations are expected to increase in the next few weeks.

“It's hard to say exactly when we would tip over and a hospital would request that we move to crisis standards of care in the Treasure Valley, but that is a distinct possibility,” Jeppesen said.

Jeppesen recommended Idahoans be careful as they move about their daily lives because hospital capacity is greatly strained.

“Wear your seat belt, take medications as prescribed, reconsider high-risk activities that could land you in the hospital. Because that’s where we are in terms of hospital capacity at this point,” he said.

Find reporter Rachel Cohen on Twitter @racheld_cohen

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