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Unnecessary Deaths, Reduced Care: Idaho Health Leaders Describe Crisis Scenes

St. Luke's Health System

Dave Jeppesen, the director of the Idaho Department of Health and Welfare, opened the weekly briefing on COVID-19 Tuesday with a personal story.

“My mom had a stroke Thursday morning, just a few hours after crisis standards of care was activated statewide," he said. "Not only was it stressful that my mom had a stroke, there was added worry about the availability of health care when she went to the ER.”

Jeppesen held back tears as he spoke about how the St. Luke’s emergency department looked different. Patients were receiving care in the waiting room; his mom fell from her stroke and the X-rays weren’t done in the usual room and took longer than normal.

She was sent home that day, instead of staying for overnight observation. She’s recovering well and the ER team at St. Luke's was caring and empathetic, Jeppesen said.

“We're happy she's doing okay," said St. Luke’s Chief Physician Executive Dr. Jim Souza. "But she did not get the same sort of care, the same timeliness of care as she would have otherwise received."

Souza said this story emphasized what crisis standards of care could mean for anyone seeking medical resources — not just those with COVID.

"Everybody is going with a little bit less," he said.

St. Luke's is not at the point where it's had to take one patient off a ventilator to give it to someone else, for example, Souza said. But if the surge continues, those will be real decisions, he said. The health system set up the team this week that helps with those ethical considerations.

Hospitals in Idaho are overwhelmed by the number of patients needing critical care. Admissions are continuing to rise. The tally of COVID-19 patients on ventilators — 112 statewide — is nearly double what it was during last winter's surge.

Of the patients in St. Luke's intensive care unit beds, 98% are unvaccinated.

"These patients are dying more frequently," Souza said of the ICU patients, compared to last year.

The health system has had 80 COVID deaths since the beginning of September.

"That's four every day the sun comes up," Souza said.

Twenty-three of the September deaths were in people younger than 60; 12 among people under 50; six in people under 40; and three in people young than 30 years. Almost half of the deaths occurred in the past week.

Souza calculated that, assuming average life-spans, those deaths in the past three weeks represent a loss of 1,100 "life-years."

"For the people who say we all die sometime: Yes, we do," he said. "But these people didn't need to die now and they didn't need to die like this."

Find reporter Rachel Cohen on Twitter @racheld_cohen

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