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Idaho hospitals on course for 'likely' return to crisis standards of care

Leaders at Saint Alphonsus and St. Luke's say their hospitals will soon be overwhelmed if the COVID case surge continues at its current pace.

BOISE, Idaho — As coronavirus cases continue to surge, Idaho hospitals could be on a course to go back under crisis standards of care in the near future. 

Medical leaders from Saint Alphonsus and St. Luke's say the chances of making the move to crisis standards of care are high if the COVID-19 case surge fueled by the omicron variant continues at its current pace. Under crisis standards, it is possible that non-urgent or less-urgent care may not be provided in order to ensure timely response to the most severe life-or-death emergencies.

Both case and hospitalization numbers have been rising rapidly. 

This week, Idaho set records for the most COVID-19 cases reported in a single day, with 2,821 new cases on Wednesday. That beat the single-day high set just the day before. Both were higher than the previous single-day record set way back on December 9 of 2020.

Idaho was previously placed under statewide crisis standards of care on Sept. 6, 2021 as COVID-19 cases overwhelmed hospitals. Crisis standards were lifted Nov. 22 as the case rate lessened.

Now, Idaho hospitals are once again under stress. Saint Alphonsus announced it will temporarily close three urgent care clinics on weekends because of employees being sick with COVID or isolating because of possible exposure.

Leaders at both Saint Alphonsus and St. Luke's Health Systems say the number of staff who are out because of COVID has risen sharply in the last two to three weeks. 

Saint Alphonsus Chief Clinical Officer Dr. Steven Nemerson says three weeks ago, 20 Saint Al's employees were on leave because of COVID. On Thursday, that number hit 157. 

St. Luke's went from ten people out three weeks ago to 250 employees out this Thursday, according to Chief Medical Officer Dr. Jim Souza. 

As of Jan. 10, 346 patients were hospitalized with a confirmed or suspected case of COVID-19. Ninety-three were in intensive care units.

"There's no evidence that we're coming close to a peak, and so on that basis, we expect to see increasing numbers of patients on an ongoing basis, and at some point we'll require a move back into crisis standards of care, most likely," Dr. Nemerson said. "Of course, God willing, we will get lucky and see a peak and a plateau, but right now that's not predicted."

As of Friday morning, 81 Saint Alphonsus patients are COVID positive out of a total of 448 patients. 

St. Luke's Medical Center facilities had 116 COVID patients, with 96 of those in isolation for COVID because they are infectious. Another 20 had a positive COVID test during their hospital stay, but are no longer in isolation because they are no longer infectious or they have a non-COVID-related diagnosis

A spokesperson for the Idaho Department of Health and Welfare says the state only counts a patient as a COVID hospitalization if that person is there because of the virus. If someone went into the hospital for another reason, such as childbirth or a broken bone, and then tested positive, Idaho does not count that as a COVID hospitalization.

Nemerson and Souza say current indications point to the "likely" need to reinstate crisis standards of care before long. They're preparing for the worst and hoping for the best.

"If you ask me to do an over/under on it, I'd say the odds are more probable than not," Souza said. "Because of our learned experience so far, we know in every wave there's been a spike in cases, two weeks later hospitalizations, two weeks later deaths."

Because of the increasing number of COVID patients and staffing issues, Nemerson says Saint Alphonsus has begun limiting some non-emergency surgeries and procedures on a selective basis. St. Luke's has not gotten to that point yet, but they're getting prepared, Souza added.

This Sunday morning on Viewpoint, they also discuss the severity of illness for those infected with the omicron variant compared to earlier ones. Viewpoint airs Sunday morning at 9 a.m. on KTVB NewsChannel 7.

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