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Kootenai Health prepares for 'crisis standards of care' as COVID-19 patients hit record high

Hospital leaders made the decision to convert its Health Resource Center into a patient care unit last week.

COEUR D'ALENE, Idaho — North Idaho's largest hospital is converting an office building into a patient care unit as leaders report a record number of COVID-19 patients being hospitalized.

Kootenai Health leaders made the decision to convert its Health Resource Center into a makeshift COVID wing last week. They plan to use the space to care for low-acuity COVID-19 patients, meaning patients with more severe cases will remain in the actual hospital. 

Teams have been working around the clock to make sure the space meets all the necessary standards for patient and staff safety as well as infection prevention. Carpets were ripped up, rental beds were brought in, and portable hand washing stations were purchased because there aren’t enough sinks in the actual facility. The space can accommodate up to 22 patients.

Separate rooms in the Health Resource Center have been converted to provide monoclonal antibody therapy to COVID-19 patients who are not hospitalized.

This is the second step of a possible three step process. The first step was doubling up patients in the existing COVID units, which have taken up the entire third floor of the main hospital. The next step would be to open a field hospital, a contingency leaders say they've been actively preparing.

With 96 coronavirus patients at Kootenai Health on Wednesday, and 34 in critical care, the previous pandemic record of 91 was broken. That previous wave took more than two months to peak; this record has been reached in just about three weeks, with no end in sight.

The low capacity problems are being exacerbated by low staff levels, overwhelming local hospitals.

"We have many patients that need services for things like car accidents, other types of infections, other health issues," Kootenai Health Chief Physician Executive Dr. Karen Cabell said. "And we’re really struggling to find capacity for them, because at this point half of our baseline bed capacity is being devoted to COVID.”  

As of Wednesday afternoon, there are no patients in the new wing. That will only happen when it becomes absolutely necessary. Daily new admissions are far exceeding discharges, so that may be the case sooner rather than later.

The changes to the space mean the hospital would transition to crisis standards of care but only the state has the authority to issue a crisis standard of care declaration.

“Crisis standards of care are guidelines that help health care providers decide how to deliver the best care possible under extraordinary circumstances,” Kootenai Health wrote in a press release. “These can include disasters or public health emergencies when health care systems are so overwhelmed by patients, or resources are so scarce, it is no longer possible to provide all patients the level of care they would receive under normal circumstances. The goal of crisis standards of care is to extend care to as many patients as possible and save as many lives as possible.”

In the last 36 hours, Kootenai Health said four COVID-19 patients died, three of whom were under the age of 45. Kootenai Health also installed a new, higher capacity oxygen tank because COVID-19 patients have a much greater need for oxygen. Hospital leaders are also looking to seek additional clinical staff to care for the growing number of patients.

Nearly all of the COVID patients are unvaccinated, according to Cabell, and most of the patients who are vaccinated had immune system issues that weakened the vaccine's efficacy for them.

Only about 53% of those eligible for the vaccine in Idaho have gotten a shot. According to the state's dashboard, 803,695 people have received a vaccine and 720,700 people have been fully vaccinated. The total number of doses administered in Idaho now stands at 1,464,258.



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