U.S. military aid Idaho hospital amid COVID-19 surge

Amid the Idaho coronavirus surge that prompted officials to authorize hospitals to ration health care, U.S. Army personnel sent to one hospital have traded their fatigues for personal protective equipment to help treat a flood of infected patients. The U.S. Department of Defense said 14 nurses, four physicians and two respiratory therapists arrived over the weekend at Kootenai Health hospital in Coeur d'Alene.

Jeremy Evans, COVID-19 incident commander for Kootenai Health, said the hospital has 115 COVID-19 patients, of which 40 are in critical care and 20 on ventilators. "This help couldn't have come at a better time. Our staff was stretched to the limit of how many patients we could care for as physicians and also nurses," said Dr. Roberts Scoggins, Kootenai Health ICU medical director.

The conference center at Kootenai Health hospital in the city Coeur d’Alene has been converted into a field hospital of sorts - with some of its classrooms filled with hospital beds where patients receive oxygen or get monoclonal antibody treatment, hospital officials said.

At the nearby main hospital building in the city of about 50,000, some emergency room patients receive care in a converted lobby and others get it in hallways. Urgent surgeries have been put on hold and some patients in critical condition are facing long waits for intensive care beds.

The hospital is licensed for 200 regular medical beds - not including the ones designed for children, women giving birth and people experiencing a mental health crisis - and on Wednesday had 218 “med surge” patients, said Jeremy Evans, the hospital's COVID-19 incident commander.

Meanwhile, about 500 of its roughly 3,600 clinical and staff positions are empty, he said, forcing managers to ask administrative staffers and others to take on additional work like cleaning hospital rooms. The overwhelmed hospital is at the epicenter of a coronavirus crisis for the northern part of the state - and where state officials this week authorized “crisis standards of care” status.

That allowed Kootenai Health, where an entire floor has been turned into a makeshift COVID-19 unit, and other hospitals in the region to ration health care during the surge. Public health officials are warning the health care rationing could soon spread statewide, forcing already  traumatized doctors and nurses  to make gut-wrenching decisions about who will get life-saving care.

Newly confirmed coronavirus infection cases in Idaho are surging and the state is now averaging more than 950 new cases every day, according Johns Hopkins University - an increase of more than 41% over the past two weeks. Idaho is also last among U.S. states with only about 45% of residents having received at least one dose of COVID-19 vaccine, according to the Centers for Disease Control. Just under 40% of residents are fully vaccinated, making Idaho 48th the nation compared to other states and Washington, D.C.

Kootenai Health recently installed a larger oxygen tank in an effort to treat all the patients. While many of northern Idaho's smaller, rural hospitals have not been forced to ration health care, they frequently have no place to send their critically ill patients who would normally be transferred to Kootenai Health.

Hospitals in neighboring Washington state would normally help with the overflow, but they are also full of patients, Jeppesen said. The Idaho Department of Health and Welfare moved northern and north-central Idaho into the crisis designation Monday evening, giving hospitals a legal and ethical template to use while rationing care.

The designation will remain in effect until there are enough resources - including staffing, hospital beds and equipment or a drop in the number of patients - to provide normal levels of treatment to all patients. Under the guidelines, patients are given priority scores based on a number of factors that impact their likelihood of surviving a health crisis.

Those deemed in most in need of care and most likely to benefit from it are put on priority lists for scarce resources like ICU beds. Others in dire need but with lower chances of surviving will be given “comfort care” to help keep them pain-free whether they succumb to their illnesses or recover. Other patients with serious but not life-threatening medical problems will face delays in receiving care until resources are available.