Doctors Answer Your COVID-19 Questions After Returning To Stage 3

Oct 28, 2020

Idaho once again hit new records yesterday for hospitalizations and ICU usage as our state added over 800 new COVID-19 cases and five deaths. And even with a rollback to Gov. Brad Little's stage three re-opening plan, Idaho isn't looking good. 

Joining Idaho Matters to give us the latest in coronavirus news, updates and research are: 

  • Dr. David Pate, former CEO of St. Luke's Health System and a current member of the Idaho Coronavirus Taskforce.
  • Dr. Kenny Bramwell, Administrator at St. Luke’s Children’s who specializes in pediatric emergency medicine.
  • Dr. Patrice Burgess, Executive Medical Director with St Alphonsus Health System and chair of the governor's vaccine advisory committee. 

Read the full transcript here:

GAUDETTE: You're listening to Idaho Matters, I'm Gemma Gaudette. Idaho once again hit new records yesterday for hospitalizations and ICU usage as our state added almost 700 new COVID-19 cases and five deaths. And even with a rollback to the governor's phase three reopening plan, Idaho, let's be honest, isn't looking good. And as we've been doing every Wednesday since the spring, we are once again bringing in Idaho medical experts to give their scientific expertise on this pandemic and also answer your question. So if you have one, you can email us right now at idahomatters@boisestate.edu and we will do our best to get those questions answered in the next hour. Joining us live today, Dr. David Pate, former CEO of St. Luke's Health System, as well as a current member of the Idaho Coronavirus Task Force, Dr. Kenny Bromwell, who is the administrator of St. Luke's Children's Hospital. His specialty is pediatrics and pediatric emergency medicine. And Dr. Patrice Burgess, executive medical director for St. Alphonsus Health System, and she is the chair of the Governor's COVID-19 Vaccine Advisory Committee. Hi, everyone.

 

ALL: Hi, Gemma. Hi, Gemma. 

 

GAUDETTE: Hi, Dr. Bromwell and Dr. Burgess, are you there too?

 

BURGESS: Yes, ma'am.

 

GAUDETTE: All right, OK. I don't know about all you, but I feel like a broken record. Cases are on the rise and I am curious Dr. Pate with the governor making his announcement earlier this week to roll our state back to phase three. I know we are hopeful that that will make numbers go back down, but what does this really mean? Because Ada County, for example, is still in phase three, never came out of phase three.

 

PATE: Well, you're right, Gemma, and I'm not overly optimistic, I hope that at least it sends a message to Idahoans that because we are taking a step back, that we need to realize we are having a problem and things are not good. I'm not sure that is going to change behaviors. I hope it will. I hope we can get people to finally take this serious. But, you know, it comes back to the very basics. And lots of things have changed over the past few months as we've learned more about this virus. But things that haven't changed for the last six or more months is: we need to be avoiding getting in large gatherings. We need to keep our distance. And when we can't keep our distance, we need to wear masks. And that's it in a nutshell. And it's not overly complicated. And our refusal to do so or our magical thinking that regardless of not following the advice that the virus is somehow going to go away are just wrong.

 

Now, we're in a worse mess because we came off the second spike. We were coming down from the second spike, but we started our third spike before the second spike had even gotten down to as low as the peak of the first spike. And what that meant is as we began our third spike, we were experiencing all the hospitalizations from the second spike. Now we're into our third spike and we are starting to see the hospitalizations from the third spike. And so today we have record numbers of people in the hospitals. And what we have been seeing over the past few weeks is some of our hospitals struggling with capacity. And keep in mind that it's not just the number of beds that are available, it's the number of staffed beds. What we have nurses and doctors and respiratory therapists and others to be able to staff. And one of the consequences of high community spread like we're having right now is it also affects health care workers. And so they get infected or they're exposed to somebody who is infected and then they have to quarantine. So then we don't have enough staff. And this could really become a serious, serious issue for Idaho in a relatively short time. And whereas we might oftentimes, depending on what part of the state people are in, we might rely on overflow to go to Utah or Montana. Those two states are struggling in their hospitals. In fact, Utah is in a really bad spot right now. So it's not good. I'm hoping people will say, look, we got to get our act together. I don't have a great deal of confidence. If we don't, we're in for more restrictions.

 

GAUDETTE: So I want to delve into a little bit more about Utah, because just last week, the Utah Hospital Association said it will likely need to start triaging care because hospitals are being overwhelmed. So Dr. Burgess and Dr. Bramwell. Well, I'm curious from your standpoint at your hospitals. First off and Dr. Burgess, maybe we can start with you, can you explain what triage care means, first and foremost? So people understand the severity of what that really is. But then how close is Idaho to being like Utah and potentially having to go down this path?

 

BURGESS: Well, Gemma, I think triage care is similar to what happened in Europe during the first large wave that they experienced, where they literally ran out of ICU beds and had to determine who would get the ICU or the ventilator and who wouldn't. So triage just means -- the word actually means sort. And you basically sort people by, usually by the level of severity. So you triage, Dr. Bramble's very familiar in the emergency room, you triage the sickest people to be seen first. But in this scenario, if you had really a shortage of ventilators, you would triage who had the most likelihood to benefit and survive. And that's a horrible place to be in. We're very accustomed to doing everything we can for everyone. Our Idaho hospitals are getting more full. But fortunately, we've been able to, I think, keep our ventilators available. We also have some opportunities to expand and in more creative ways to make room for patients. So we're not at that point. But as Dr. Pate said, we don't want to get at that point. And the more we can do to avoid spread, the better off we'll be to preserve those resources so we don't have to make those difficult decisions.

 

GAUDETTE: And Dr. Bramwell at St. Luke's, I mean, we know St. Luke's Magic Valley, for example, is quite overwhelmed. I mean, similar to what we saw in the Wood River Valley back in March. But to the point that just last week, I believe last week, the days went together, is that the Magic Valley, as St. Luke's had to say, we can't take pediatric patients, they have to come to Boise. So it seems that I mean, we're already seeing some of our hospitals that capacity.

 

BRAMWELL: Sure, you're exactly right, Gemma currently Magic Valley is not able to admit patients, say a five-year-old who has a severe go of a COVID illness, they can certainly be seen. And we still want patients to be seen there if that's where they live. But if that five-year-old patient in this example needs to be admitted to the hospital, they would have to be transferred to our Boise campus for our children's hospital because currently the Magic Valley St. Luke's Hospital is at capacity. They don't have the ability to continue to take care of pediatric patients. They didn't kick anybody to the curb. They didn't expel anybody from the hospital. Well, what they stopped doing -- what we stopped doing -- Friday morning after talking about this a number of times last week was as of seven o'clock last Friday morning, they no longer admitted new patients to the hospital outside of the newborns that they were being birthed there.

 

So we are in a tough spot in the Magic Valley. And if I can go back to what Patrice was saying a second ago. You know, there's a whole framework that's called crisis standards of care, and it's sometimes called triage, sometimes it has other names, but it's in essence sort of a total catastrophe panic resource problem where we are either out of ventilators or we are out of ICU beds or we are out of hospital beds. And you have to start making really uncomfortable, unpleasant decisions that we've never really had to do in my career and maybe in many other people's careers outside of other countries earlier this calendar year. So we really hope not to get to the point where the governor would need to declare that level of an emergency, where all the hospitals would then enact these crisis standards of care. But that's what Utah is contemplating right now. They are at the point where they're just running out of beds, running out of both physical beds and staffed beds, as David pointed out.

 

GAUDETTE: And Dr. Pate, last week, we mentioned that you are now helping the West Ada School District with a plan of action, and you were, you know, in a board meeting with the school district last night and you were really pushing as much as possible when it comes to kids being back in school or not being back in school full time versus not. And in fact, a board member asked you, is it safe right now for children to go back full time? And you said no. Yet they, if I have this right, are bringing fourth and fifth graders five days a week as well as younger students. So still going against scientific data.

 

PATE: Yeah, well, you're right, Gemma, you know, I tried to make a case that I do realize the importance of children being in person in school and I certainly talk to a lot of educators. I don't have any vocational expertise, so I'm certainly in no position to speak. But I've talked to educators who tell me that there certainly are children that can do well on remote or virtual learning, but there are others who don't. And that in-person learning is important. And I think the American Academy of Pediatrics has come out and said that. And so my goal in this whole process has been to figure out, OK, for those parents who don't want to take the risk, and for those teachers who don't or can't take those risks, let's provide them a remote or virtual opportunity. For those parents who do want their kids in person, let's figure out how we do it safely. We've got to protect the staff, the teachers, the students and ultimately the families all these people go home to. And there's ways to do that. But I emphasized that the way to do that is by creating distance and wearing masks, wearing proper masks properly. And so that was the case that I made. And then we certainly had the administration leaders talk about the challenges with maintaining that distancing and that they are having challenges in some classrooms doing that today. So when I was asked, could we bring all the kids back, I said, not at this time. We've got to figure out the distancing piece, and if we can't do it now, we certainly can't do it with more kids. And so surprisingly, after all of that, the board did make the decision, as you mentioned, to bring the fourth and fifth graders back. We -- the teachers, the administration and I had indicated it would certainly be safe and reasonable to do K through three, but they decided that on four and five. So, you know, that's going to be a huge challenge. And it may be short-sighted because in their efforts and I'm sure they're getting a lot of pressure from parents, but in their effort to bring back kids, if you bring back the kids in too large of numbers, which this is going to do, unless we can figure out some way to do it that we haven't thought of yet, you're going to have cases. And then when those cases are identified, then everyone in that classroom is going to be a close contact and they're going to be quarantined. So this may be a solution that can only work for the next week or two before it falls apart. So it's a little short-sighted.

 

Now, with that said, I was clear last night, and I want to be clear again, I don't think doctors and I certainly don't think I myself should be making the decision whether schools are open, whether schools are closed, how we teach kids. That's not our expertise. I can certainly tell them what the risks are and I can tell them how to make the risks less. But that's not my call and it shouldn't be. Nevertheless, I think the real problem at West Ada is we have a problem with transparency, we have a problem with communication, and we have and all of that has resulted in trust problems. They have trust problems with every stakeholder group. The administration is taking positive steps. I've been working with them and making suggestions to them. They've been very receptive and we've been making positive steps to try to improve that communication and transparency, which is the beginning of the journey to gain back trust. But I think when the board makes decisions that go against the advice of teachers, the advice of administration and the advice of medical experts, which is certainly their prerogative, and there might be situations where there's very good reasons to do so. But when they make that decision and they don't explain themselves and they don't suggest what is the compelling reason why they should disregard educational experts and health experts, then it just amplifies this issue of trust. It looks like they're making arbitrary decisions. It makes it look like they're making political decisions. And I don't know whether that's the case or not. I don't know how they made their decision, but it's not helping. And so that's something that hopefully can improve through this whole process.

 

GAUDETTE: You're so right, Dr. Pate, though, transparency is so critical and I hate always harp back on my children's school because they do go to a private school, which is so different than what the public schools are dealing with. However, our school has been incredibly transparent. We get a weekly update on how many students have been in quarantine. I mean, and you as a parent, you feel so much more comfortable because you have knowledge to make a decision about your own child. And that I mean, at the end of the day, that's honestly what I think, what every parent wants. So hopefully they will get there. We're going to take a quick break. We'll be back more with our medical experts.

 

Dr. Burgess, before we get on to listener questions, can you talk a little bit about what quarantine really means when you're exposed to COVID or if you test positive and why it's 14 days if you're a nonessential worker? And I ask this because we've heard 14 days then we've heard 10 days. I think it can be a bit confusing, actually.

 

BURGESS: Sure, happy to discuss that, because I agree there is some confusion around that, so if you have a high-risk exposure and you're a noncritical worker, the 14 days is advised because that's the incubation period. So the time between your exposure and when you may become ill and until that 14 days is up, we don't know for sure if you're going to become ill. Obviously, if you develop symptoms, you could go get a test and find out. But otherwise, that 14 days is the insurance policy that you have escaped without becoming ill from your exposure.

 

The 10 days that you're talking about is really more after a positive test. So you go get a test for whatever reason you're positive. Then you need at least 10 days of isolation from others and twenty-four hours without symptoms, not using anything to reduce your symptoms like Tylenol, ibuprofen, et cetera, before you can then go back out and interact, go back to work, whatever the case may be. So that's the 10 day versus the 14-day difference. And I think what we are discovering, I think was mentioned earlier, our health care workers that are getting sick or getting infected are really out in the community that they're getting exposed. And so if you have a family member that is ill, even if they haven't had a test, we want to isolate them from other people in the family, have them, if possible, in their own part of the house, have them even use their own restroom, wear a mask when they're out and about and that and the other parts of the house, obviously, hand washing, washing surfaces, not sharing utensils or towels or anything like that is going to be very important so that it doesn't spread among the household and then isolating yourself from being out and about in the community as well.

 

GAUDETTE: Dr. Pate, Penelope has a question and she wants to know if you can get COVID twice. But also, how does the virus shed, and then how long does the virus shed?

 

PATE: So on the first question, yes, it is possible to be reinfected, we do have some very convincing evidence that there are a number of individuals who have been reinfected and it's not many. And this may not be common and it is difficult to prove. In these instances, it happens fortuitously that there were actual viral samples so we could look at the second infection and compare it to the first to see, it really was a different strain. Therefore, it was a reinfection. We usually don't have actual viral samples with most of the testing that's being done. So I'm sure there are many more people that have been reinfected than those reported, but it probably is not very common. I think we'll understand that a lot more as we move through the fall in the winter because we have many people that were infected when this pandemic first occurred that have not been reinfected. But now we're going into these dangerously high levels where their risk of getting reinfected is greater. So I think by the early part of next year, we'll have a better idea of just, you know, what chance there is of getting infected. And it probably is different for different people. It looks like the immune response lasts for different periods of time in different people, but it probably is somewhere in the order of months and so much more to see.

 

And then the other question was about shedding. You can shed the virus in your stools, your bowel movements, and you can shed the virus through your nose or your mouth. What what we think happens is that the shedding in the nose and mouth starts and gets kind of it is highest-level around the twenty four, perhaps thirty six or forty eight, but particularly in the day before you become symptomatic. And then it typically lasts a matter of days to a week. There are some people that can shed longer, but that's typically what we see. There have been reports of people shedding virus for more than a month but that doesn't seem to be the usual case. So what we recommend to people is once you become infected, as Dr. Burgess talked about, it's very important for you to be isolated. And then even once you finish isolation, you need to be careful. You need to use these precautions. You still need to wear a mask. You still need to wash your hands because you could still be shedding to some degree. And and then, of course, eventually there's going to come a point in time when presumably you could be reinfected. So you still need to take precautions.

 

GAUDETTE: And then Dr. Bramwell, Nate sent us this question over Twitter and he wants to know: 

 

LISTENER QUESTION: Why are we not testing more, but also why do people feel like it's so hard to get tested?

 

BRAMWELL: Those are really good questions, you know, early on in the pandemic, we we had trouble getting reagents and getting people to the places where testing could occur. I think those problems have largely been solved now. And patients who are symptomatic should be able to be tested without too much difficulty. Within St. Luke's, we have a hotline set up. We have certain clinic sites that are doing this predominantly. We have online tools through our electronic medical record that people can access and help them find ways to get tested. So I think we've come a long way in getting people the ability to get tested. We do not yet have the ability to readily test people who are asymptomatic. We are hoping that in the next month or two here with the antigen testing coming online and with additional supplies from various sources, that we'll have the ability to test people more readily. But but it is an ongoing problem that I think is getting better week to week.

 

GAUDETTE: Dr. Burgess, before we get to some more questions, I am curious about the governor's COVID-19 Vaccine Advisory Committee, because I think many of us are waiting anxiously for a vaccine, but we know that it's probably not going to be readily available to the general population until spring, possibly summer.

 

BURGESS: Yeah, so one thing I just wanted to mention, the advisory committee is looking into exactly that. How would we distribute the vaccine once it's available? This group is not evaluating the safety of the vaccine itself. There are other entities out there that are doing that work. So our task is once we know how many doses are allocated to Idaho, how would we go about prioritizing and distributing those doses? So we're looking at high risk groups and people that have a lot of contact with the public. And we have a broad representation on this committee to do the very best we can to prioritize who gets the vaccine. The other thing I think to understand about vaccines, as Dr. Pate was discussing reinfection, is we don't yet know. We're learning a lot about COVID and we'll probably know a lot more in the next year or so, but we don't yet know how long the immunity would last. So just as we do with flu vaccines, we get a vaccine every year and we adjust it based on the strains that are present. So it's quite possible that might be the case with coronavirus vaccine. We just don't know yet how effective and how long the immunity will last. But we do hope that it will help make a difference in fighting the curve and helping us with the spread that we're experiencing.

 

BRAMWELL: Dr. Bramwell, we have a question from Dave and he is curious to know your opinion on sports teams, middle and high school specifically, traveling from state hotspots, as the latest data shows that 13 to 18 year old student children are as high as 69% asymptomatic compared to the rest of the public being at around 40&. One example Dave gives is that there was a huge soccer tournament up in north Idaho recently and soccer players from the eastern side of the state, from Ada County, from Canyon County, from north Idaho, all got together and played a big soccer tournament.

 

BRAMWELL: Yeah, I think sports represent a really contentious issue for a lot of people right now. There are people who feel that sports need to go on regardless of anything else that's happening. And there are other people who feel like sports should only happen if they can convince the rest of us that it can be done safely. I happen to feel like sports are an essential part of everybody's life. Physical activity is important to all of us. I know that for for all of us, to be totally honest. But but the idea that all the sports teams can get together and be in a bus or be in a hotel room and sort of let their guard down worries me a bit. It's not so much that the on-field football or volleyball represents the real risk. I think for me, the bigger problem is, you know, the team in a few cars or in one big bus with 30 kids, I think that it's unlikely that they're wearing masks during those transports. It certainly is ideal if they are. But I think that sports represent something that we haven't really figured out how to make it safe for everybody. Similar to what we do in my workplace, similar to what we're advocating gets done in schools. I think we should have the same standards for sports where you need to socially distance, where you need to wear a mask when you're not able to socially distance and you need to be really vigilant about washing your hands and cleaning your environment. You know, there's on one extreme you have I'm going to say cross country where kids run. And other than the mass start, they're not in each other's space for particularly long. On the other extreme, you have wrestling where the entire match of nine minutes is in somebody else's bubble the entire time. So there probably are a variety of things that we could put into place. But I don't know how much of that has happened yet other than recommendations about social distancing and the other things we mentioned.

 

GAUDETTE: Dr. Burgess, this is an anonymous email. The person will stay anonymous. But yesterday in his news conference, the person writes: 

 

LISTENER QUESTION: Governor Little said, quote, We're past people being COVID deniers, unquote. However, just yesterday during a Southwest District health meeting, people giving public comments said they do not believe the virus is real. Some said it was real, but not as bad as, quote, health officials are making it out to be. So their question is, how will we ever come out of this if people don't believe in science?

 

GAUDETTE: And I should add on that, if we recall up in north Idaho at a health district meeting there late last week, a health district board member literally said it is not COVID that is getting people sick, looking at doctors and telling them to figure out what is making people sick because it can't be coronavirus, because it's not real.

 

BURGESS: Yeah, Gemma, that's tough, I mean, I know we've mentioned the word trust several times in several different connotations throughout this this show, and it's disheartening that folks can't trust the medical community, the scientific community. And I don't know how to fix that. I think I hope that people will continue to educate themselves, to read, to look at what's happening. We do not have our ICUs fill up with the flu, for example, like we are seeing with COVID. We have scientific tests that show us that people are sick with COVID. And I think it's just a basic lack of trust of science and the medical profession that hopefully will change over time. We've had some very prominent naysayers that have later become sick and been in the hospital, and perhaps that's something that will convince them or their family members, which I certainly wouldn't wish on anyone. But as this disease gets closer and closer to people, they'll probably become more aware of its impact, unfortunately.

 

GAUDETTE: Dr. Bramwell, Nancy wrote in wondering if the panel has heard of the so-called mom code in Utah. She writes,

 

LISTENER QUESTION: It's a group of moms who are pledging to not get their kids tested for COVID in order to keep COVID numbers down. The group does ask that people keep their kids home from school if they have symptoms, but to not get them tested.

 

GAUDETTE: I myself did a little bit of research into this. It's certain counties in Utah, it looks like that it's kind of like this little maybe underground thing. But since Nancy, asked Dr. Bromwell a) Have you heard of it, but also b) thoughts on not getting your kids tested if they've got symptoms.

 

BRAMWELL: So to be honest with you, before I got this email from your team yesterday, I had not heard of the mom code. I have heard of other sort of crazy things where kids in college try to get themselves sick so that they will become COVID positive so they can donate plasma and make more food money. But I haven't heard of the mom code where people have taken an oath not to have their children tested. You know, to be fair, if we back up a minute and talk about some of the different numbers that we're seeing, certainly the number of people who test positive on any given day is one of the data points that we follow. We also follow the number or the percentage of patients who have a positive test in the twenty four hours out of the total of the tests that are done. And then the last number that I think I follow very closely each day is how many patients we have within the St. Luke's health system, the total of all of our COVID positive admissions. And we follow that very closely. And I would say that for me, the thing that gets most worrisome is the number of patients who are in the hospital, because that's a very small subset of patients. It's the sickest patients who have the most difficulty dealing with the illness. So while the number of positive tests on any given day is helpful, I don't find it quite as critical for me to understand as the number of patients inside the hospital where we are moving resources around and trying to ensure that we have the ability to care for people when they need that level of attention. So while I understand the idea of we're going to make this better by not getting tested, I think you're just avoiding the problem, which is this is a very contagious disease with potentially serious consequences for some patients. And the fact that you don't get tested doesn't fix the problem, doesn't even address the problem of social distancing and the need for being vigilant on behalf of our neighbors.

 

GAUDETTE: And I, Dr. Bramwell, I'll take it one step farther, because I just as a mom, we had an incident here at our home just these last couple of days where my eight year old woke up on Thursday with a sore throat. And fast forward to Saturday. And he had a very bad sore throat. We had gone to the pediatrician on Friday. He said his throat looks fine. I took him to urgent care Saturday and he did get a COVID test. And here's the thing. I was sitting there saying-- and I asked for the test because my children are in school and their school has been doing a phenomenal job. Masroor required these social distance. You know, they they have been doing such a good job. And I was befuddled as to how my child could have even potentially been exposed because they go to school. I mean, we don't allow them to do organized sports right now. But I felt that I could not in good conscience send my child back to school without a test. And it was a very stressful couple of days. And, you know, everybody had to hunker down with nobody, you know, and we stayed home. Fortunately, the test was negative, which our pediatrician said, I bet you if you get him tested, it's going to be negative. But it goes back to what you said, Dr. Bramwell, about this isn't just about us, it's about doing what's right for our community.

 

BRAMWELL: Yeah, I applaud you for what you did there, Gemma. I think that you demonstrated what I'd really like people to understand. It's not so much whether or not your eight-year-old has COVID. It's whether or not your eight year old should go back to school or can play with his friends or whatever else you would normally be doing with him. I think what we really want to try and help people understand is we have to focus on the 'we' here and not just the 'me.' We need to be conscious about what we can do to help other people stay safe. And the other thing Gemma that I think is something I'd like to draw attention to as well is, you know, if you have had a significant exposure and you think that you have COVID, in my mind, it's important to start the quarantining as soon as you have had the exposure. We've heard of a fair number of cases where people have had a significant exposure and then two days or three days later, they develop symptoms and they get a test. And they said, oh, I think I know where I got it. You know, in a perfect world, after you've had an exposure, you should just start quarantining. I think there are times where people don't feel the need to do a quarantine until they have a positive test. And then they've had three or four or five days of being out around everybody.

 

BURGESS: Just wanted to go real quick on the mom group that you talked about. I think I would want to applaud them for keeping their kids home when they're sick. That's a good thing. Yeah. But also for people to understand the more tests we do, then the bigger that denominator is of negative tests and the overall percentage is actually more accurate. So it's actually good to get tested for the reasons that we already discussed about knowing if you're positive, but also adding to that denominator of negatives. So we really know what our true prevalence is. And the state is actually working on expanding testing with some high throughput machines. So hopefully, like Dr. Bramwell said, we'll be able to do more testing of even asymptomatic people at some point, which should help us make better decisions about some of the school and sporting events that we talked about.

 

GAUDETTE: That's such a good point. You made Dr. Burgess just about those numbers. Right. So I really, really appreciate that. We can take a quick break back with our medical experts right after this.

 

More with our medical experts right now, we have about six and a half minutes left in the show, so I'm not given all your titles because they're super long and I'll take the whole six minutes.

 

So Dr. Pate, Ray just sent us this e-mail and he's curious about whether at a federal or a state level, what will it take to get a mask order in place? And if so, wouldn't that give health districts, school districts and businesses cover for themselves, requiring masks to be used?

 

PATE: Well, yes, certainly. I've long been a proponent of mask orders. I do understand why some have not chosen to do that, but I favor them. There are issues about whether in some cases that would actually make people that were wearing masks, not do it in protest for there being a government mandate. And there's also the issue of even if you pass a mandate, how do you enforce it? Who would enforce it? And certainly we've seen the disturbing messages from some sheriffs around Idaho and other law enforcement agencies that if there was a mask mandate, they wouldn't enforce it. So, you know, at the end of the day, I think the while we can all have our differences of opinion about whether the governor took the right action or enough action or too much action, at the end of the day, his comment about at the end of the day, this is a matter of personal responsibility and are we going to be a society? Do we want everybody to do the right thing so that that hospital is available when yours or my spouse or parent has a heart attack or stroke, you know, it's time for us to put all the nonsense away and just say, listen, as a matter of personal responsibility, let's not make the government mandate us to do this. Let's do it because it's the right thing.

 

GAUDETTE: Well, and Dr. Pate I mean, that goes back to even what I was saying in the last segment about you do what's right for the community. Right. Even if it means you go get a test.

 

PATE: That's right.

 

GAUDETTE: It's just going on to what Dr. Pate said about, God forbid, someone's family member gets sick even if it's not COVID. We have an anonymous email front from our inbox.

 

And Dr. Burgess and Dr. Brummell, I'd like your input on this, but the email says: 

 

LISTENER QUESTION: One of my parents is terminally ill. For the time being my parent is working and living relatively normally, but that could change. A big fear I have is that hospitals will have to go on lockdown again. And there is potential for my parent to be alone in the hospital. So what are you hearing in terms of hospital policies and visitors? Are there any changes on the horizon? So, Dr. Burgess, could you talk in terms of St. Alphonsus?

 

BURGESS: Yes, so we constantly are reevaluating our visitation policy with our incident command structure, just like we are bed capacity and everything else, and we are doing everything we can to allow one visitor, at least at this time. And we have exceptions for people that are at end of life or have an impairment where they need someone to communicate for them. So that will always be the case that, you know, in those extreme circumstances that we would allow visitation. But with, you know, the visitor wearing a mask, washing their hands, you know, doing all the appropriate things to avoid traveling to other parts of the hospital, et cetera. So end of life is one of those special situations where we would be hard pressed to not allow visitation.

 

GAUDETTE: And Dr. Bramwell with St. Luke's?

 

BRAMWELL: Yes, similar to what Patricia just said. We've recently relaxed some of our policies and started to allow more patients to have one person with them while they are inside the hospital. We've long allowed that for our minor patients and for our laboring patients, but we've extended that now to other patients who are neither a child nor a pregnant mother. And I think that has been a very good thing. I will say that the visitors sort of lockdown that we had to go through was probably the most unpopular thing I've seen in my medical career. But I also think it was the right thing to do, both for patient safety and for staff safety in very real terms. We had to shut down one of our hospitals because so many of the staff were exposed when we got caught on our heels early on in the pandemic. So it's something that we talk about all the time. And we want to make the hospital as safe as possible, both for the people who are receiving care and the people who are providing care. So the challenge right now at a point when we say, well, let's can we open this up anymore, the challenge is we have more community prevalence of the disease than any other time so far. So it's not really something we're looking to expand currently. We do talk about it all the time, but we're still at a point where the amount of this disease in the community sort of precludes us from opening up the hospital too much.

 

GAUDETTE: Well, as always, I want to thank all three of you for your time, but also for your expertise, for sticking with us through all of this as well, to be here to answer people's questions every week. Just really appreciate the work that all of you do.

 

 

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