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Idaho health leaders reflect on the early days of COVID in the Gem State

This Friday marks two-years since Governor Little announced a stay-home order, a serious turn in tone early in the pandemic.

BOISE, Idaho — This week marks the second anniversary of Governor Little's 2020 COVID-19 stay-home order. At the time, the community knew very little about the "novel coronavirus" and the implications of a global pandemic playing out in real time. To be frank, it was a scary and trying time for a lot of people.

Two years later, the medical community is reflecting on the early days of COVID, the changes in community perception, and the treatment of frontline healthcare workers.

KTVB sat down to reflect with Dr. Jim Souza, Chief Physician Executive for St. Luke's Health System; Saint Alphonsus Chief Clinical Officer Dr. Steven Nemerson; and Elke Shaw-Tulloch, Administrator of Public Health for Idaho Health and Welfare.

The trio reflected on the days leading up to Gov. Little's tone-setting stay-home order, which was in effect from March 25 to May 1, 2020.

“I remember the first meetings we had standing up our incident command. We brought our experts together and we started preparing and we were scared,” Dr. Nemerson said. “We didn't know exactly what we were dealing with. We didn't have anything in terms of treatment other than symptomatic, supportive patients. And all the data showed that we were going to run out of beds and we were going to be taking care of people in the hallway. And so we rapidly prepared for that. We mobilized equipment and then we just stood ready and took our first patient. And fortunately, as I said earlier at the beginning, we were able to accommodate the numbers of patients that were coming in because of the fact that people were sheltering in place.”

Dr. Souza detailed his memory of the emotion of the early days of COVID.

“The emotions, that are just palpable as I think back on them, they were fear and uncertainty. But there was also this amazing energy, sort of pragmatic optimism. Like, if we keep our heads down and keep working together we're going to come through this. Oh, my goodness -- long, long days, scraping for any information that might be helpful, any resource that might be helpful because there was so much we didn't know, making up policies and changing them maybe later the same week because some new, little snippet of information came in,” Dr. Souza said.

The public messaging during the early days of COVID could be complicated -- telling the public the truth while also not causing a panic. Shaw-Tulloch explains the mindset in early 2020.

“We were all very thirsty for information, and I feel incredibly fortunate. I think Idaho is incredibly fortunate that we have a really, really strong team of scientists here and in Health and Welfare. They're sitting on national committees. For example, we have Dr. Hahn sitting on some of these front-row seats to what's happening regarding immunizations. They're bringing information back. They're challenging some of the assumptions that are being talked about at the national level. So, we're trying to bring that information back into it, still, and package in a way that makes sense to people. Some of my peers across the nation didn't have that same experience. It was very isolated. They had hospitals warring still, partners that weren't really aligned. And I feel like we tend to, in Idaho, do a really great job of in these times of crisis coming together and really sharing the experience and sharing it and advancing our efforts well,” Shaw-Tulloch said.

Reflecting on early 2020 also brings memories of outstanding support for frontline healthcare workers. Support that would wane as COVID went on.

“We had the community coming together to deliver food. We had health care workers who were working shifts that were really unfathomable because of the demands that were being placed on them. And the community bonded together to support those individuals to cheer them when they were coming in. We had a drive-by parade in front of the hospital that was COVID-safe. It was just wonderful to see and it kept people going,” Nemerson said.

Colleagues agree: That support made a huge difference.

“It was that community togetherness that put the gas in the tank on that," Souza said. "And then we lost that."

Heading into the end of 2020, the promise of an effective vaccine brought hope. Ironically, the vaccine rollout marked a change in how the medical community was treated.

“And then in late December, the vaccines hit. And I cannot describe the feeling of hope and joy. but it was it was shortly after that that the 'us-and-them' started. The purveyors of misinformation on vaccines started to spin their stories, and that created this divide and that's how we went into the Delta surge, which was really unfortunate for us with that sort of divided populace,” Souza said.

It took a toll on already exhausted healthcare workers.

“That's when our caregivers started experiencing this trauma, this moral trauma to watch unnecessary deaths and to, at the time of intubation -- I remember hearing this story -- having a patient say, 'I don't have COVID. You're lying to me. Leave me alone,' while the team is trying to save a life. So, compounding the fact that public support began to wane was the fact that our caregivers were experiencing this incredible moral trauma,” Nemerson said.

The Idaho Department of Health and Welfare worked through harassment and conspiracy claims while powering valuable data and crucial public health messaging.

“I think in our core, we all feel very good about what we've done. And so we did kind of had to take that approach a bit of just head down. Keep pushing through. Don't let that affect us. I mean, we weren't frontline facing the patient, but certainly I think know our staff have gone through and at the local level as well, certainly have gone through a lot of that same sort of trauma,” Shaw-Tulloch said. “Like, why? Why don't people believe us? How do we get people to really understand that we are here with good intentions where I would never do anything to deliberately mislead anyone? I think those were the biggest things that we're grappling with, but really staying true to ourselves as well, that, you know, we're here doing the right thing.”

COVID is still very much with us two years later, but community leaders say they’ve learned a lot in that time.

“There's a lesson from within health care that I think might be good for all of us, but a lot of our providers experienced it in the Delta surge with that hostility. Doctor Nemerson, we talked about when we still knew we had a mission, a guiding mission, to save that patient's life, and we approach that patient with curiosity: Why do you feel that way? Tell me what you want. If we can do that more between us, among us, we're going to be successful. We're going to have more of those conversations where we get curious and seek to understand one another. But it's 'united we stand' for me,” Souza said.

The pandemic highlights the advancements in medical technology and the perseverance of community spirit.

“We're blessed by incredible science and technology, and the fact that new therapies could be mobilized so quickly that the vaccine could come through at a speed that was literally lightning. And we were able to use those tools so quickly to literally saved so many lives. This pandemic isn't just about the lives that are lost. It's about the millions of lives that have been saved,” Nemerson said.

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