BOISE, Idaho — Boise Mayor Lauren McLean promised to unveil a plan to deal with the city's burgeoning coronavirus caseload as doctors described the increasingly-dire situation at hospitals throughout the region.
Dr. Jim Souza, the Chief Medical Officer for St. Luke's Health System, warned that COVID-19 admissions are threatening to outpace St. Luke's ability to handle them.
In the first week of October, St. Luke's had an average of 35 COVID-19 positive patients in the hospital. A week later, it was 50 patients. Then 75. 90. 110. 120.
"It hit 135 yesterday," Souza said.
In addition, a total of 197 clinical staff are out sick as of Tuesday: 133 of those have confirmed coronavirus.
"We're pulling out the stops on incentives for employees to take more shifts, longer shifts, night shifts - and honestly, they're running out of gas," Souza said. "We've started to pull clinic doctors into hospital rotations to staff the beds. So we are now well beyond normal staffing operations and approaching the limits of what we're going to be able to do. We've also been preparing to increase our capacity: In the last week, we've opened two new units and filled them."
Souza and other health leaders addressed McLean Tuesday morning as part of a briefing on the COVID-19 situation, scheduled after Idaho Gov. Brad Little on Friday ordered the state rolled back to Stage 2 of the coronavirus reopening plan. As he has at previous press conferences, Little touted "personal responsibility" and asked Idahoans to adhere to coronavirus precautions, but did not order a mask mandate, close stores, restaurants, churches, or bars, or impose any travel restrictions.
Souza said that if the people of Idaho do not begin practicing social distancing, mask-wearing, and other precautions at a higher rate, the situation is poised to grow even more desperate.
As cases rise, hospitals will be converted more and more into COVID-19 facilities in which non-emergency surgeries and screenings are halted or postponed, a move both St. Luke's and Saint Alphonsus have already begun to make.
Pushing back these procedures will have deadly consequences for some, Souza said.
"We're going to have curable conditions that can be found early become incurable ones that we find late," he said.
Worse yet, if coronavirus cases continue to balloon, hospitals will reach their limit and be forced to enact "crisis standards of care," in which healthcare is rationed, going to the youngest, healthiest, and those most likely to survive.
Souza stressed that healthcare often operates as a "just in case" model - one that people expect to be there when their parent falls and breaks a hip, when a grandparent has a stroke, or when a spouse falls dangerously ill. If crisis standards have to be implemented, not being able to get the help they need will catch many by surprise, he said.
But that scenario is still preventable if members of the community can act together, he said.
"When you see a train coming down the tracks toward you, I suppose you tell yourself it might stop, but it probably won't so you get out of the way," he said. "We've been giving this message as healthcare providers since April, and I'm beginning to wonder if anyone is listening."
Saint Alphonsus President and CEO Odette Bolano agreed.
"I count ten months of having the same conversation," she said.
Bolano said it was "disheartening" to see Idahoans ignore the mask and social distance restrictions that ensure the safety of nurses and doctors working long, ragged shifts to treat the dangerously ill.
Although fatigue with pandemic restrictions is understandable, she said, Bolano implored residents to stick it out for two to three more months in order to allow health officials to get a handle on the virus.
"This is where we just have to hunker down and not let our foot off the pedal. There is light at the end of the tunnel," she said. "If we've been doing and preaching what we need to do for the last ten months, is it really too much to ask to save lives, to have compassion for our healthcare workers, to ask you to double down and help us for the next 60 days?"
Chief Clinical Officer Dr. Steven Nemerson said that Saint Alphonsus hospitals currently have 60-odd COVID-19 positive patients, a number expected to double by Christmas, then triple in January if the state continues on its current path.
"That's the point at which we then begin to take care of patients in areas of our facilities that are not traditionally used for clinical care, things like conference rooms and so forth," he said. "God forbid we get to that situation, but we're prepared to do so."
Traditional hospitals are not the only ones being overloaded. Dr. David Peterman, CEO of Primary Health Medical Group, said that he had received word just that morning that all Primary Health locations were completely full Tuesday, and that half of the locations are already full for Wednesday.
Calls to the clinics jumped from a normal 1,800 per day to 3,000 per day, he said, and Primary Health locations are testing an average of 600 people for COVID-19 each day - double the testing volume in July.
"We're the tip of the spear and so as our numbers go up, it's what the hospitals will see in ten or 12 days," he told McLean. "And so when I tell you, and I tell the public over the phone how busy we are, we should be very, very concerned because it is the most accurate data that there is as to what is happening on the community on a normal day in November."
His staff is exhausted, pulling extra shifts and answering endless phone calls from people who are increasingly desperate for help.
Providers at the clinics are also becoming infected with COVID-19 - not at work, but out in the community, Peterman said - and six Primary Health sites have had to shut down at various times because there were not enough people left to staff them.
The surge in coronavirus cases is also leaving Primary Health with fewer resources for the other kinds of small emergencies that send people to urgent care.
"If we can't take care of your children who have earaches, if we can't take care of your grandparents who now has a minor illness and shouldn't be in the emergency room, we're in trouble," he said. "If we have to default to sending you to the emergency room, I don't know how to say it, that's not going to work today."
"I have never seen anything like this, and it is very, very worrisome," Peterman continued.
The health officials urged McLean to help keep the number of new infections at bay by enforcing the mandates that are already in place and working with businesses to ensure they are abiding by coronavirus restrictions.
McLean assured the panel that the City of Boise is currently working on a plan "that will enable us to protect the public through enforcement of orders." The mayor said she would review those ideas with the healthcare community over the next few days before releasing the plan to the public.
"While one city cannot have the impact our region and state deserves, there are things we can do," she said.
At KTVB, we’re focusing our news coverage on the facts and not the fear around the virus. To see our full coverage, visit our coronavirus section, here: www.ktvb.com/coronavirus.
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