If a patient needed to be hospitalized for symptoms of coronavirus in the Wood River Valley today, they’d most likely be transported — by ambulance or helicopter — to a hospital in Twin Falls an hour and a half south, or one in Boise two and a half hours west.
Last week, St. Luke’s Wood River Medical Center, Blaine County’s 25-bed, critical access hospital, suspended normal operations.
“Basically what we went down to is the walk-in clinic, the screening tent, the emergency department and the operations that support those,” said Joy Prudek, the public relations manager for the Ketchum-based hospital.
Blaine County — home to Sun Valley, with a population of about 22,000 — is the epicenter of Idaho’s coronavirus outbreak. Its 82 lab-confirmed cases make up nearly half of the state's total. Two of the first three people to die due to coronavirus in Idaho were Blaine County residents.
Healthcare workers there have already taken a hit from the coronavirus. At least 14 have tested positive, including two of the hospital’s eight emergency room physicians. More are out of work self-isolating because they have symptoms or have potentially been exposed, according to the South Central Public Health District.
The hospital has two intensive care units and one ventilator in the emergency department, but taking care of very sick patients requires a lot of time and attention by specialists.
“So currently any patient who would be that sick would not be maintained up here. We would be transferring them either down to Magic Valley or Boise,” said Dr. Frank Batcha, a family physician at the St. Luke’s clinic in nearby Hailey.
Patients seeking care for routine check-ups, cancer screenings or caesarean sections are also being directed to other hospitals.
“Are we concerned about not having enough resources? Absolutely. And that’s why we’re trying to conserve what we have right now, particularly our manpower,” said Batcha, who, these days, is typically clad head to toe in personal protective gear as he screens patients for COVID-19 in the parking lot of the Ketchum hospital.
St. Luke’s Wood River is part of the statewide St. Luke's Health System with seven hospitals, which means staff and supplies can, and are, being dedicated to the Ketchum hospital.
Dr. Brent Russell, an emergency physician at St. Luke’s Wood River who has COVID-19, said things would likely look different if the hospital wasn’t part of a larger network.
“If we were an isolated, rural hospital, we would be crippled right now, because we have so many people who are out with the illness,” Russell told Boise State Public Radio’s George Prentice.
But strains extend beyond the hospital. Bill McLaughlin, the Ketchum Fire Chief who also oversees EMS services for the north half of the valley, said around a quarter of his paramedics are out because they have coronavirus symptoms or have potentially been exposed in the community.
“We only have a couple paramedics on each day, and if, for some reason, one of them gets sick, then that entire shift would be knocked out for 14 days,” McLaughlin said.
Many volunteers who used to help out are staying home, too.
Much of this, McLaughlin said, has to do with limited coronavirus testing and how long it takes for test results to come back.
“We have to treat everybody that has symptoms in the community as a presumed positive,” said McLaughlin, because of confirmed community spread in Blaine County.
Now ambulance crews from the Magic Valley and Boise are helping transfer patients between hospitals.
Other rural communities in Idaho are watching Blaine County, and are planning for a similar situation.
“I could see us getting overwhelmed the way that Wood River has gotten overwhelmed by cases and very, very sick people,” said Dr. Gregory Irvine, an orthopedic surgeon and the Chief of Staff at the St. Luke’s hospital in McCall, a mountain town north of Boise. There’s currently one confirmed coronavirus case in Valley County, where McCall is located, according to the Idaho Department of Health and Welfare.
Irvine recently wrote a letter pleading people not to travel to McCall. Many of Blaine County’s earliest positive cases were tied to visitors. With spring break approaching and the weather warming up, Irvine knew he needed to get the message out: Help us avoid becoming another Blaine County.
“An influx of people from elsewhere risks overwhelming the limited resources at our hospitals,” Irvine wrote.
Another 25-bed critical access hospital, the St. Luke's in McCall would also send patients to larger facilities for more intensive care, if there’re beds available, Irvine said.
“That's the nightmare scenario that we're continuing to try to avoid.”
On the eastern edge of the state, the 13-bed Teton Valley Hospital in Driggs produced a mathematical model this week, predicting low and high ranges for coronavirus patients in the county needing hospitalization and ICU beds, and the number of patients who might die. The hospital also put a call-out this week for retired or out-of-work doctors and nurses to volunteer.
“We’re further behind on the curve right now than Ketchum is, and that’s a good thing,” said Teton Valley Health CEO Keith Gnagey. Teton County has two confirmed cases.
“That’s why we’re building the models now while we can because once we get to that stage, then it really is, who has beds available where and how do we get the right patient into the right bed and get them taken care of,” Gnagey said.
Finding bed space might soon be a challenge for rural health systems. The Idaho Statesman reported that there could be between one and 14 COVID-19 patients in Idaho for each of the state’s ICU beds.
And according to John McCarthy, the assistant dean of rural health programs for the University of Washington School of Medicine, sharing resources between rural areas and cities isn't always possible, especially as the number of confirmed cases in places like Ada County rises.
“If we don’t flatten the curve, we're going to be in that situation where somebody's going to have COVID in Driggs, and Boise is going to say, ‘We're not taking them’ and everybody else is going to say, ‘We're not taking them,’” McCarthy said.
And that, he said, might overload health systems in places like Driggs, McCall and Ketchum, and could mean worse health outcomes, too.
Find reporter Rachel Cohen on Twitter @racheld_cohen
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