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Health Systems In An "All Hands On Deck Situation" As Idaho Nears Care Crisis

Vurus Outbreak New York
Craig Ruttle/AP
FR61802 AP
FILE - In this Jan. 10, 2021 file photo, Sarah Gonzalez of New York, a Nurse Practitioner, displays a COVID-19 vaccine card at a New York Health and Hospitals vaccine clinic in the Brooklyn borough of New York. Workers in New York City-run hospitals and health clinics will have to get vaccinated or get tested weekly under a policy announced Wednesday, July 21, to battle a rise in COVID-19 cases fueled by the highly contagious delta variant. (AP Photo/Craig Ruttle, File)

On Tuesday, Governor Brad Little announced the reactivation of the Idaho National Guard to assist overwhelmed hospitals across the state. The announcement comes after Little's tour of a Boise ICU filled with COVID-19 patients — which he said was nearly full with unvaccinated patients. The average age of patients, he said, was 43.

St. Luke's and Saint Alphonsus have now announced a pause on some elective, non-emergent surgeries due to the newest surge. Two medical experts join Idaho Matters to talk about overwhelmed hospitals, treatment misinformation, how children could be impacted and more:

  • Dr. David Pate is the former CEO of St. Luke's Health System and a current member of the governor's coronavirus task force
  • Dr. Patrice Burgess is the Executive Medical Director at Saint Alphonsus and Chair of the Governor's Vaccine Advisory Committee
"It's not a vaccine supply issue anymore. It's more misinformation and distrust around the vaccine that we're fighting."
Dr. Patrice Burgess, Executive Medical Director at St. Alphonsus and chair of the Governors Vaccine Advisory Committee

Read full transcript below:

Gemma Gaudette: This is Idaho Matters, I'm Gemma Gaudette.

Governor Brad Little: All of them were struggling to breathe and most were only breathing with the help of a machine.

Gemma Gaudette: That was Governor Brad Little on Tuesday sharing his experience of touring a Boise intensive care unit filled with COVID 19 patients. The ICU was nearly full. All were unvaccinated, and the average age of those patients, he said, was 43 years old.

Governor Brad Little: We were teetering on the brink. And there's only one real solution to the crisis. We need more Idahoans to choose to receive the safe, effective COVID 19 vaccine.

Gemma Gaudette: As Idaho nears a health care crisis that we have never experienced before, our medical experts are joining us today to talk about this dire situation. Doctor David Pate, former CEO of St. Luke's Health System and a current member of the Idaho Coronavirus Task Force, as well as Dr. Patrice Burgess, executive medical director at St. Alphonsus, as well as the chair of the Governors Vaccine Advisory Committee. I want to thank both of you for joining us today.

Dr. David Pate: Hi, Gemma.

Dr. Patrice Burgess: Good morning.

Gemma Gaudette: And remember, if you have questions for our doctors, you can send us an email at idahomatters@boisestate.edu. Dr. Pate, I want to start with you, Governor Little held that news conference at 12:30 yesterday and to say that he looked grim, I think is an understatement.

Dr. David Pate: Well, I think that's right, because I think he actually understands what this all means, and I'm afraid the general public does not understand how bad and how scary this is going to get.

Gemma Gaudette: And Dr. Burgess, what are your thoughts on what the governor said yesterday, I mean, you are the chair of the Vaccine Advisory Committee for the governor's office?

Dr. Patrice Burgess: Well, he's absolutely right, and, you know, the fact is that most people obviously don't get to come tour because of our restrictions and all of that and don't really see up close what's going on. I know there's some videos out there that were taken in New York and some other ones in Oregon that do show what's going on. But it really is a, you know, a crisis situation. Nothing... I've never seen anything like it in my 30 year career. And it is at this point a preventable illness. And that makes it even more tragic. As far as the vaccine goes, you know, my committee was really charged with prioritizing--in the early stages when we had a low supply--and we got our elderly folks vaccinated early, as well as our health care workers and teachers and frontline people. But for quite some time, the vaccine has been available to anybody that would like to have the vaccine. That's age 12 and up. And so now we're really in that tough, tough spot where it's not a vaccine supply issue anymore. It's more misinformation and distrust around the vaccine that we're fighting.

Gemma Gaudette: And I want to talk a little bit more about this misinformation and the distrust, because that does seem to be such a huge factor in people not choosing to be vaccinated. And Dr. Pate, after a Governor Little asked, people--begged people--yesterday to get the vaccine. The lieutenant governor came out and called it shameful for him to suggest that Idahoans need to make this medical choice in order to show they care for their community members. Frankly, I think that's misinformation.

Dr. David Pate: Oh, yeah. Yes. The lieutenant governor is not being a help and I think that our elected leaders--people who are have the privilege and honor of being a leader-- have a responsibility to care for and protect those that they are honored to serve. It is absolutely disheartening and appalling to hear the kinds of things that the lieutenant governor--and a want-to-be governor--what she would actually do when faced with a public health emergency, when Idahoans are dying, when not all Idahoans feel safe to go out and frequent businesses, when children are in harm's way. I mean, let's just forget a minute for a second that she's the lieutenant governor. What kind of person does that? It's just absolutely appalling. And, of course--what's worse--is she's not the only one.

Gemma Gaudette: Dr. Burgess, during the governor's news conference, he seemed very shaken by the average age of the COVID ICU patients, as we mentioned, he said the average age was 43. I believe he also said two of these patients were pregnant. I am assuming this is also what you are seeing at St. Alphonsus. I mean, this is threatening the lives of younger and younger people.

Dr. Patrice Burgess: Absolutely, we actually have two pregnant women in our ICI right now as well. And this goes back to my comments about our prioritization. And we actually had very good uptake of our 65 and over population of the vaccine. And we just don't see people in that age range is commonly hospitalized anymore. There are some, of course, that are immunosuppressed that didn't have as a strong of a robust of a response. But 98% of our patients with COVID in the hospital are unvaccinated. And the majority of them are under 65. You know, because, again, we have a pretty high vaccination rate in the 65 and over population. It truly is tragic. Again, preventable. And it's just heartbreaking for families, for the patients themselves, and certainly for our staff that are exhausted and now see people that, you know, could have this could have been prevented.

Gemma Gaudette: I want to talk about schools right now. Dr. Pate, I know you're being inundated with media requests in regards to this, but we are seeing all kinds of things happening. Now granted, if we go back a couple of weeks ago, Dr. Pate, we talked about what we were seeing in the southeast in regards to schools and kids needing to quarantine, schools shutting down. Now, here we are and we are now in this same spot. We have, I believe, a charter school that had to close down. We have the Caldwell School District who is now mandating masks. We know of a teacher who passed away from COVID 19 complications. I am assuming Dr. Pate, you are not surprised by any of this.

Dr. David Pate: I'm not surprised. In fact, I was warning school boards this was what was going to happen based on what we were seeing in the southeastern part of the United States. What is surprising to me is that people either don't care or aren't taking the trouble to understand these risks, because it's all predictable. We saw this happening. And you either have to convince me that the virus will behave differently in Idaho or Idahoans will behave differently if you want me to believe that what we are seeing down there was not going to happen here. And of course, we know neither of those is correct.

Gemma Gaudette: And Dr. Pate, as we look at school districts, you know, Caldwell for, for example, deciding that they're going to now put a mass mandate in place at least through October 14th. We know that by doing that, this is what kept certain schools physically in session last year.

Dr. David Pate: Well, that's right. If you look to last year with less contagious variants and with universal masking in our schools, the in-facility infection rate--in other words, if somebody in a classroom or a school building gets infected, what percent of other children will get infected--last year was about 1%. That was with a light, less contagious form of the virus and with everyone wearing masks. Now, what's stupefying to me is to hear board members say that they think the answer when we're confronted with a far more contagious variant is that we should do less than what we did last year. That just makes no sense. And knowing that I was going to be asked about what to expect with Delta, I was looking at what was happening over the summer, what was happening at summer camps, gymnasium camps, all kinds of things. And what we saw is that unlike the one percent transmission rate in facility transmission rate last year--with Delta and with not masking or inconsistent masking, that in-facility of infection rate was 20-33%. Now, look at the Caldwell schools. Now, they're not overly transparent, so I can't really tell, you know, how many of those are infected, how many are quarantine, you know, exactly why people are out. But let's just look at the numbers. If you look at most of those schools, they've got 20-29% of the students out. That is exactly in the range that I predicted and warned of.

Gemma Gaudette: Dr. Pate, last week, we spoke a little bit about ivermectin..and I want to go back to this for a moment, because once again, there is so much misinformation around this. And we are hearing anecdotally that here in Idaho, it is being bought up off the shelves at, you know, animal supply stores.

Dr. David Pate: Oh, yes. This is incredibly dangerous. I think the other thing, besides just being dangerous and not appropriate, you can understand that people may be confused because they're being told misinformation and that somehow ivermectin is either going to prevent COVID, which it does not, or it's going to make your COVID better if you get it, which it does not. But what is particularly surprising to me is the internal inconsistency of people's thinking. So just explain to me, why were you unwilling to get a vaccine that the FDA authorized and now has approved, but you weren't willing to take it because it wasn't approved. But you are now willing to take ivermectin, which does not have approval for COVID, does not even have emergency use authorization for COVID, And in fact, the FDA has come out publicly and said, please do not take this medicine for COVID. It is dangerous. And yet people are willing to take that, but not get a safe and effective vaccine that would give them protection for a long period of time, unlike ivermectin. It's just mind boggling.

Gemma Gaudette: Dr. Burgess, Whitney wrote this...

Dr. Patrice Burgess: Can I dovetail on that?

Gemma Gaudette: Oh, go ahead... please add to it.

Dr. Patrice Burgess: We've also had patients in the hospital that came in that took, you know, hydroxychloroquine or ivermectin as an outpatient--from whatever source they got it--and then would refuse remdesivir or some of the newer therapies that we have because they're experimental. So the same inconsistency, you know, the Dr. Pate was referring to...beyond the vaccine, but even some of our other treatments that we have actual science behind. It is very disheartening.

Gemma Gaudette: I just can't imagine that. Dr. Burgess, Whitney wrote in and she says this, 'I have had the flu vaccines three times every time I got very sick afterward and more sick at each subsequent shot. So my doctor has advised me not to get the COVID shot. What do your guests agree? I really would like an honest answer. I am a healthy, otherwise vaccinated person who is really on the fence about this, but I'm worried about the burden on our health care system.'

Dr. Patrice Burgess: Yeah, thank you for the question, and you know, that's obviously... I can understand your concern. This is a different vaccine than the flu vaccine. The flu vaccine is an inactivated virus. And this is a different vaccine where you're producing the spike protein only, and then your body is creating antibodies to the spike protein. So I can understand your concern. But at the same time, I would get the COVID vaccine, even if you had side effects from a flu vaccine, you were clearly, you know, recovered from those. And that could have been your immune response. That could have been something specific to the flu vaccine. All of our vaccination sites have 15 minutes of observation and we're able to treat any particular side effects that you might have. I still think the benefit of the vaccine would outweigh the risks to you and I'm interested if Dr. Pate would agree.

Gemma Gaudette: And Dr. Pate, Petra wrote in, she says, 'I hear from many that the reason why they won't get vaccinated is because they have had COVID in the past and they think they have immunity. Do we know the percentage of people who are now hospitalized or who have died that had a previous COVID infection?'

"I'm afraid the general public does not understand how bad and how scary this is going to get."
Dr. David Pate, former CEO of St. Luke's Health System and a current member of the Idaho Coronavirus Task Force

Dr. David Pate: Not to my knowledge. Gemma, I don't see that that is reported anywhere. Now, with that said, there is a site that's for voluntary reporting, so you don't get a complete picture, but does report so-called reinfection where somebody had it before it gets reinfected again. And what they have shown is that the risk of death with reinfection was around one and a quarter percent. Now, the problem is you also can't really tell the time of the reporting. And I think a lot of that was reported before Delta. So I don't know if that's still a good number and it's certainly an incomplete number. So I think the answer is we don't know. Certainly, having had COVID...I think it's clear it does give you some protection. It's probably better protection than what we thought last year. But the studies are still very conflicting. We've got some studies that suggest it gives you very good protection. We've got others that show there's a lot of holes in that protection. I think the sweet spot is going to be having had COVID and getting probably one dose of our MRNA in a vaccine, although those trials are going on right now and the FDA has not approved it that way. But I think that's probably where we'll end up... somewhere in the middle. But past COVID is not complete protection, it's probably some protection. But we would certainly at this point, until we do get clarity in the data, we would still recommend people get vaccinated.

Gemma Gaudette: And Dr. Burgess, I want to go on and talk a little bit more about that because Sean has this question and he says, 'can you speak of protection from severe illness, hospitalizations and deaths in groups of people that are vaccinated versus those that were previously infected with the original SARS-CoV-2 virus.'

Dr. Patrice Burgess: Yeah, just like Dr. Pate, I don't have, you know, really specific statistics to support, but I do know, I mean, I've definitely seen patients that have gotten COVID more than once.And the severity of it, again, I don't have the statistics, and I agree exactly with Dr. Pate. Dr. Pate said that there is some protection, but the vaccine's statistics are very, very strong against severe illness and death. And it does make sense that the COVID infection, you would be immune to whatever strain you were infected with versus the new strains that are coming out. So the vaccine seems to be covering people better against the new strains, particularly against severe illness and death. And I remember hearing a talk about--from one of our infectious disease doctors early on in the pandemic--that the virus itself produces a protein that blocks our immune response and kind of dulls it so we don't get as robust of an immune response as we would to maybe some other infections and certainly not as robust as we do to the vaccine. So I still...everything I've read shows the vaccine showing a better immune response than the natural infection.

Gemma Gaudette: Dr. Pate, I think it's fair that a lot of parents are very concerned about their children... sending them back to school, especially what we're seeing now with some schools having to close down for a week, some schools now mandating masks after they've had to quarantine, et cetera. So a mom wrote in, Mel, and she has a two year old and she says, 'I've been hearing about the uptick and COVID cases in young children locally, but I haven't been able to find many details as to the ages and severity. I have a two year old that attends a daycare in the Treasure Valley. We specifically selected the facility because they seem to have better COVID protocols compared to other places.' She goes on to say, 'But I am getting very nervous about sending him back, especially as schools continue to open up.' And she wants to basically know, you know, should they keep him home longer term?

Dr. David Pate: Wow. Well, this is a really tough question because the virus has changed. So, last year I might have told Mel that she had little to worry about. This year, different with the Delta. And because, you know, it was easy last year to anticipate who was going to be risk of getting serious disease and hospitalization. It was the elderly--like me. It was people with chronic medical conditions. But I think Dr. Burgess would probably tell you-- she's already commented about the patient's in her ICUs-- probably half of those people, at least, I bet, even in retrospect, Dr. Burgess wouldn't have been able to predict that that person would end up so seriously ill. We have lots of children now getting sick that otherwise seem to have been perfectly healthy. And so while we haven't seen, at this point, huge numbers of children getting seriously ill in Idaho, again, what I did is I looked very closely at what's happening in the southeastern United States, expecting that they are weeks or a month ahead of us and then look to see what happened. Well, one of the large children's hospitals in Louisiana, in June, average age of a pediatric patient admitted with COVID--16. In July, average age 12. In mid-August, average age five. This week? Half of the pediatric patients that are hospitalized are two or less. So, I don't know what is going to happen with children, and I don't have any idea how to predict.

Dr. David Pate: I think we're going to have far fewer children that are seriously ill than adults. But it is still going to happen. So I think given that all of this--and it's not just Covid we have to worry about. We are seeing a lot of RSV here in Idaho, which we do every year this time. And a lot of people end up in the hospital just with RSV. But we're certainly hearing from physicians in the south that when children get both COVID and RSV-- which they are prone to do--they get even more severely ill. So my recommendation to Mel is... if Mel has the luxury of keeping the child home, I would do that for right now just till the surge comes down. Now, if Mel doesn't really have that luxury and really needs to do it, then the best protection, for children, is for all of the adults around them to be vaccinated. And that would include the caregivers at the child care center. And for every one over the age of two, that is not part of their household to wear masks when they are indoors with your child. So I think you need to talk to the child care center and see what are they willing to do and are they willing to get to where they would be in compliance with these guidelines.

Gemma Gaudette: Dr. Burgess, I know that St. Alphonsus does not have a children's hospital per se, but what are your concerns as we continue to see the average age of ICU patients go down? What is your level of concern in regards to, you know, children getting sick? And, yes, we talk about well, they're not... they won't be, you know, many children won't be as severely sick, but they can still get sick. They can still spread it.

Dr. Patrice Burgess: Yeah, I'm very concerned and it's two parts. So part is what Dr. Pate was just talking about. The children themselves are getting sicker with the Delta variant. And again, they might have a co-infection with RSV or the flu or any other respiratory illness. So I'm concerned for them for their own safety. And remember, it's not just going to the hospital. I mean, that's our worst fear, righ...is going to the hospital or the ICU or obviously dying. But there are also other effects that--even if you don't get hospitalized--you know, chronic fatigue, there's cardiomyopathy, there's blood clots, there are all kinds of things that can happen with a COVID infection that may or may not lead to hospitalization, but are still significant and impact people's quality of life. So I'm very concerned for the children. And then also, again, as we've discussed all along with the pandemic, is their ability to spread to other people, adults in their life that could be even at higher risk because they might have chronic medical conditions or other things that put them at more risk for severe disease. Dr. Pate is absolutely right. We are seeing people with less risk factors get hospitalized, but we still have the same problem that those people that are over 65, overweight, have chronic medical conditions are still at high risk for severe disease. So those children can spread to those people in addition to the risk, you know, for their own health.

Gemma Gaudette: Mm hmm. Before we get to more questions, and we have a lot of them, Dr. Burgess, we briefly touched on at the beginning of the show Crisis Standards of Care, and that in your 30 years of experience, this is something you have never seen. We've talked about crisis standards of care on the program before, but I believe it is critically important that we once again reiterate what this means, because I think that there is a misnomer that when we talk about it, it just means COVID patients. And that is absolutely not true.
Dr. Patrice Burgess: Yeah. Gemma, we're obviously trying really hard to avoid that, although we have some semblance of that happening now across our systems in the sense that we have already held back on elective procedures. You know, we're trying to do only what we call 'time sensitive surgeries' because we need to hold our ICU beds and our ventilators to be available. So it's not crisis standards of care, but it's certainly different than our normal operations. And if you're somebody that's been waiting for, you know, an elective surgery-- and that elective surgery might be a knee replacement because you have really bad arthritis and it's hard for you to walk--so it's elective in the sense that it's not life-Threatening, but it's certainly something that's inconvenient and affects your quality of life. Crisis Standards of Care is much worse than that. And that's where, you know, I think the governor said yesterday there were four ICU beds in the state that were available at that moment. So that's where somebody comes in, you know, with a car accident and somebody comes in with COVID pneumonia or somebody comes in with a heart attack, and we have to have a committee to decide if we have one ICU bed, who gets that ICU bed. And that's a horrible position for anyone to be in. And, you know, that's what we're trying to avoid is having to basically figure out who the person is that gets that ICU bed.

Gemma Gaudette: Mm hmm. Dr. Pate, Scott sent us this email in and he says,'How does prostate cancer surgery fall into the curtailment of elective surgery? Is it considered nonelective and therefore not subject to the surgery curtailment?' And he goes on to say, P.S. I'm fully vaccinated and I wear a mask at work and in public, and I'm proud of it.

Dr. David Pate: Well, you know, it would not be decided just based on the fact that this prostate cancer. So when we talk about elective, elective doesn't mean optional, elective doesn't mean, you know, it'd be nice, but it's not needed. What elective means is that we have the luxury of scheduling it. So somebody who comes in with a car accident and has bone sticking out of their skin, that's not elective. We got to get you to the OR soon. But you can even have a lot of serious heart conditions and we will still make the procedure scheduled. And so in that sense, it's elective, even though it's very much needed. Now, someone with prostate cancer, that's going to be very needed to have the surgery. However, it's usually not an emergency like bone sticking out of your skin. So, what we would do is evaluate that in concert with the patient's physician to understand how much time do we have without putting that person at risk for worse outcomes. And so, yes, they could certainly be impacted by this, because obviously, if we need the bed for someone that's got to go on a ventilator, they don't have a choice. We got to do that right now, whereas we can delay the surgery a little while. I just hope we can all work together to bring this under control so that we don't have to put these surgeries off for a long time. Because I can tell you, as a cancer survivor myself, that once I was diagnosed with a cancer, I wanted to out the next day. And it's emotionally troubling for these folks. So, we all need to pitch in to try to bring this under control quickly.

Gemma Gaudette: Yeah. Dr. Burgess, Alex wrote in saying, 'what is the risk to attend outdoor events like Art In The Park? The adults in our family are vaccinated, but we have a six year old that cannot be. We do plan on wearing masks and distancing where possible.' And Dr. Burgess, I ask this question because I think a lot of people are back in that situation of, you know, what's safe and what's not.

Dr. Patrice Burgess: Yeah, it's really hard. You know, we just got done with the fair...and I personally didn't feel comfortable going to the fair. I've obviously had my vaccine. I would wear my mask. But what you don't know is all the people walking around and who's vaccinated, who's wearing their mask.. are they going to be close to you? You know, outdoors is obviously safer than indoors. I guess I would judge it based on your ability to be distanced from people and your comfort and whether or not they're vaccinated. And, you know, Art In The Park is an example where you probably are going to be close because you're gathering around pieces of art to look at them, and it's hard for all of us to avoid some of these things that we enjoy doing. It's part of our quality of life and part of what makes this such a great place to live. But we do have a raging Delta variant going on right now, our test positivity rate is quite high, our cases per 100000 are quite high. And we have a pandemic that's really out of control at this point in time. And if we can be a little bit patient and do all the right things, we should be able to get it under control and then get back to the things that we love doing. So I personally would avoid that right now and try to participate in things where I know I can keep distance. And I know that the people around me are vaccinated and wearing their masks.

Gemma Gaudette: Dr. Pate, Michael sent this in and he says,' My daughter just started kindergarten. We are two weeks in and we've gotten three letters from the school district stating that there have been three separate COVID cases in her school so far. But the school district will not tell us if the cases were in her classroom. Do we have a right to know that information? They do say they will notify you if your student has been in close contact, but their definition of close contact is six feet, 15 minutes, no mask.' Well, I'm curious about that because I must say, Dr. Pate, in my children's school, if they're--last year and this year-- if there's a case in your child's classroom, they let you know. They don't let you know who the kid is, but they let you know, but they don't send it out to the remainder of the school.

Dr. David Pate: Yeah, and you know, my philosophy, Gemma is the more that we can be transparent, the more information that we can give, the more we're going to have our parents trust. And right now, we're dealing in a period of this last year and a half of unprecedented distrust. And so I think the answer to that is frequent and accurate and complete transparency to the extent that is appropriate. Obviously, there are things that one shouldn't be disclosing. But I think unless there's a legal reason or a strong other reason why we shouldn't tell parents about stuff, I think you should be more transparent. And frankly, if a chid..if one of, you know my grandchildren, there was a case in their classroom, I'd want to know. And the reason I'd want to know is if I didn't think there were any cases in my grandchild's classroom and they just got to feeling...you know, feel worn out and maybe they have a little runny nose...I might not pay attention to that as much as if I know, oh, there was a case in his or her classroom last week and now my kid's feeling a little off. I think I'll just get my kid tested. So I think it does make a difference.

Gemma Gaudette: Well, and I will tell you this, that when your kiddos are a little bit older, guess what? They know who has COVID in their class way before a letter ever comes out.

Dr. David Pate: Oh, yeah, kids are the best source of intelligence...data. Yeah.

Gemma Gaudette: I mean, literally, they will know and all you need to do, at least when they're a little bit older, kindergarten is probably a little too young. But they know they talk to each other. They know. Dr. Burgess, Mike sent this in just a couple of minutes ago. And I think this is a really important question. He says 'I'm currently a student nurse. And after listening to Governor Little's conference yesterday, I'm curious about one aspect of his address. Briefly, does the panel have ideas from the hospital side of things about how current student nurses may be tapped as a resource in the near future?' And for folks maybe who didn't listen to the news conference yesterday, Governor Little said that they are doing things to expedite student nurses and even retired nurses to be able to to work in the hospitals much sooner than they would normally.

Dr. Patrice Burgess: Yeah, we are in an all hands on deck situation. We are actively--and I think I think I can speak for St. Luke's as well, and probably every institution--we're actively looking at people that can be helpful in any number of ways. We have our administrative people helping transport patients, for example. Some patients need what we call a 'sitter' just because they need somebody to be right there with them to help make sure their oxygen stays on or to help with safety issues. So we're using clinical people to be 'sitters'. If we have the ability to bring up students or people that are retired, we can do that in a team structure where, you know, the more experienced nurses direct in the care with these helpers. We're bringing physicians in from the clinic to help in the hospital. So, absolutely anybody that has skills that we can use, we are using them in a safe way, in a supervised way, but certainly bringing them in to help where our needs are the greatest.

Gemma Gaudette: Dr. Burgess, Tracy wrote in and she says, 'can or rather, will hospitals tell patients if a staff member is vaccinated or not when asked? And are there rules in place in our health care facilities to allow patients to ask for a provider that is vaccinated?' She goes on to say 'there is misinformation regarding HIPPA floating around, so I want to know what I can ask.'

Dr. Patrice Burgess: Well, that's an interesting question. You know, all of our facilities have a vaccine requirement for employment that is in the process of being implemented. So, at Saint Alphonsus after September 21st, everyone in the facility will be vaccinated. You know, I don't have a hard and fast rule about whether or not you...obviously, anyone can ask. I think that employees, it's their individual, you know, decision whether to divulge that information. I will say all of our staff, you know, are screened every single day. When they enter the building, they have a temperature check. They have to ask a set of questions about whether they have any symptoms or exposures. And if they do, they have to stay home and get tested. Every single person is wearing a mask, plus eye protection. So there are a lot of other safety measures in place. But after September 21st, every person that's working in our building will be vaccinated.

Gemma Gaudette: And speaking of that, Dr. Pate, Nicole said, 'I have heard that several hospitals in the area are requiring all their employees be vaccinated by September, as we just heard from Dr. Burgess at Saint Alphonsus by September 21st, or they will lose their jobs. I am wondering if this is going to prompt employees who may not be willing to be vaccinated to get falsified vaccine records. Is that a concern? And can hospitals verify the validity, I guess, of a vaccine record?'

Dr. David Pate: Yeah, so obviously it has happened in other settings. People have tried to use falsified vaccination records and some people have already been arrested for doing so. I don't know what each hospital's procedure's going to be, but yes, we do have a way of verifying it. We can access the state vaccination repository of information and confirm that somebody has been vaccinated. I would just say, you know, a good reason for employees not to do that, regardless of whether the hospitals are verifying or not...first of all is, it's much easier for me to fire you for lying than for not getting vaccinated. I'm going to win that court court case every time. So I don't think it's a good employment strategy. Second, if you do get fired for lying, you're not going to be eligible for unemployment insurance.

Gemma Gaudette: Dr. Burgess, this listener wrote in saying, 'I received my Pfizer vaccinations early. Can I get my booster from Moderna?'

Dr. Patrice Burgess: So first of all, right now, the only people eligible for the boost are the people that are immunocompromised. We're still waiting for the final advisory committee on immunization practices recommendation for the rest of us. The White House has recommended eight months after the second dose, but we haven't heard the final recommendation yet from the advisory committee. The CDC is recommending you try to stick with your same original series. So if you got Pfizer to get Pfizer, if you got Moderna to get Moderna. But they also said it was acceptable to get the other one. So I think once we have that approval for that third dose, you could get the other one, even though the preference would be to get the one you originally had.

Gemma Gaudette: Dr. Pate, this listener wants to remain anonymous, and they say, 'my niece is 13 and has not been vaccinated because her parents will not allow it. She wants to get vaccinated. Does she have any recourse?'

Dr. David Pate: It depends on where she lives. If she lives in Idaho, essentially no recourse. Unfortunately, in Idaho, parental consent is required. The exception would be an emancipated minor, but I very much doubt she could qualify as that. So basically, no. I think it's a sad situation. And I've also told the high schools that I advise that are kind of taking the approach, 'well, kids had the opportunity to get vaccinated'...I've reminded them that there are a lot of kids that have more common sense than their parents and that want to get vaccinated but can't. And so in this period of time, you still need to protect them.

Gemma Gaudette: Dr. Burgess, can you talk about addressing vaccination for breastfeeding moms, Dorothy has a question and she says 'it says all the data is safe, possibly very beneficial, but this conclusion is based on a very small study.' And she says, you know, we want the doctors to talk about the safety for breastfeeding moms to get vaccinated.

Dr. Patrice Burgess: Yeah, so I do absolutely believe it's safe, and the reason is because of the mechanism of how these vaccines work. So the vaccine itself is not likely to be transmitted into breast milk, but the antibodies that that the person produces do go into breast milk. And those antibodies then can be helpful for the infant. Just like we see that with other illnesses where breastfed infants have more immunity against illnesses because they are receiving some antibodies from the breast milk. So for that reason, I would feel very comfortable and as a matter of fact, think it would be a good thing for the infant, for the breastfeedingmom to get vaccinated.

Gemma Gaudette: Dr. Pate, we have just a couple of minutes left, and I know you wanted to take a minute or two, at the end of the show...

Dr. David Pate: Thank you Gemma... I do. I have just a couple of things. First of all, Dr. Burgess, I think everyone in Idaho owes you a debt of gratitude. Few people probably understand the amount of time commitment and the amount of stress and lobbying that Dr. Burgess endured while helping us navigate the distribution of vaccination. So, we are very grateful to you. The second thing I want to say is to all of the health care workers out there. I know it's getting really bad. And I want you to know many of us are thinking about you and trying to do what is right so we don't add to your burden. And then finally, to those listeners that are of faith. Let me just ask you, please pray for our hospitals, for our health care workers. They are at the breaking point, and it will be psychologically devastating to them when we get to crisis standards of care and they can't help some people. Please keep them in your prayers. Thank you, Gemma.

Gemma Gaudette: And I thank both of you and reiterate what Dr. Pate said. Thank you to our health care workers. Dr. Burgess, thank you for everything you have done with the vaccines. And let's remember--it is federally approved. Get your vaccine. I want to thank Dr. David Pate, Dr. Patrice Burgess. We will, of course, be back here next week with our medical experts. If you have questions, get them to us, idahomatters@boisestate.edu. I'm Gemma Gaudette. We'll see you back here tomorrow.

Samantha Wright is a news reporter and producer for Idaho Matters.
Gemma is the host of Idaho Matters, Boise State Public Radio's daily show which broadcasts live Monday-Friday at noon. She is an award-winning journalist and has spent the majority of her broadcasting career in Idaho. Gemma was a television news anchor and reporter in Boise for close to 15 years. She came to Boise in 1999 to start Fox 12.