"We've reached our limit"

In an emergency meeting Thursday afternoon, county and health officials developed a coordinated COVID-19 response plan to alleviate strain on local facilities amid a surge in hospitalizations.

Representatives at the meeting included: Kootenai Health, Panhandle Health District, county, state and emergency service officials. 

Following the discussion, officials outlined three actions:

• Working with Northwest Specialty Hospital and Kootenai Health Urgent Care Centers to develop tiered dispatching protocols for accepting COVID-19 patients 

• Revamping information graphics and public service announcements to show new measurements, including how many hospital patients are vaccinated and unvaccinated

• Setting up an additional field hospital

Sheriff Bob Norris requested the meeting in response to North Idaho health facilities activating Crisis Standards of Care on Tuesday. According to the Idaho Department of Health and Welfare, Crisis Standards of Care are guidelines that health care providers use to determine the best treatment for patients in a disaster or emergency. 

On Thursday, Kootenai Health reported 109 COVID-19 hospitalizations, 37 critical care patients and 20 required ventilators.

Before this surge, Kootenai Health Chief Regional Operations Officer Jeremy Evans said the highest peak hospitalization count was 91.

Since the pandemic began in 2020, several waves of COVID-19 have rocked the state. However, Evans said the surge currently flooding North Idaho is “faster and more aggressive than anything we’ve seen before.”

“The Delta Variant is more contagious, and it results in a much sicker patient population,” Evans said. 

Panhandle Health District Public Health Services Administrator Don Duffy said approximately 95% of COVID-19 hospitalizations in Idaho are unvaccinated. Since Aug. 1, Duffy said 36 of the 46 COVID-19 deaths in the Panhandle were unvaccinated persons.

The activation in North Idaho results from staffing shortages, increased hospitalizations and stretched resources, IDHW said. 

“We have reached our limit,” Evans said. “We have 3,600 employees in the health system and about 550 openings today.”

Evans said Kootenai Health plans to receive a 20-member medical response team and approximately 100 additional staffers through state and federal programs. Still, that is not half the amount they need, Evans said. 

Due to slim resources Kootenai Health, a regional center for outlying hospitals, cannot accept patients typically admitted for treatment. Over the last three months, Evans said the number of outside requests for care has escalated from maybe 20 to 392.

Kootenai Health operates 26 critical care beds. Some days, Evans said there could be 50 or more patients needing critical care. On top of this, the oxygen supply for ventilators is wearing thin. 

Evans fears the situation will worsen following Labor Day weekend, the North Idaho State Fair, and the start of the 2021 school year. PHD Public Health Preparedness Coordinator Nick Mechikoff said officials anticipate the current surge to peak in October. 

“They’re saying by mid-October there will be 30,000 cases a week and about 5.8% of those hospitalized,” Duffy said. “That’s for the state. It’s much higher than where we were back in November.”

To mitigate facility capacity limitations, Kootenai Health recently converted a classroom to care for up to 22 patients. Other departments on the medical campus have also doubled the number of beds to accommodate increased patient loads. 

“We are already deploying nurses in a thinner ratio. We are already putting patients in conference rooms. That is not standard of care,” Evans said.

Through a partnership with Heritage Health and Northwest Specialty Hospital, the state authorized a monoclonal antibody treatment center to open next week at the Kootenai County Fairgrounds. On Thursday, officials discussed the possibility of reopening a field hospital at the fairgrounds and partnership efforts with Northwest Specialty Hospital. 

Officials emphasized the need for vaccinations, masking and social distancing.

“For many people in our system, even doctors, that trust with the public has been lost,” Duffy said. “The public isn’t listening to them any longer. In fact, that decision to not be vaccinated has become a kind of identity at this point.”