Idaho Hospitals Move to Crisis Protocol Amid Shortage of Beds, Staff Due to COVID

Hospitals in northern Idaho entered "crisis standards of care" as the influx of COVID-19 patients surpassed what the institutions can handle, the Associated Press reported. The Idaho Department of Health and Welfare enacted the measure Monday and released a statement to the public announcing the measure on Tuesday.

The statement cautioned that residents of the state may not be able to access the same level of medical treatment that they would usually get when hospitalized, referencing "a severe shortage of staffing and available beds in the northern area of the state caused by a massive increase in patients with COVID-19 who require hospitalization."

Under the "crisis standards of care" designation, hospitals are permitted to dole out resources, like intensive care unit beds, to patients with the highest chance of survival. The move comes amid surging infection rates in the state in the past few weeks, coupled with one of the lowest vaccination rates in the country, the AP reported.

For more reporting from the Associated Press, see below.

Idaho COVID Crisis
Idaho public health leaders have activated "crisis standards of care" for the state's northern hospitals because there are more coronavirus patients than the institutions can handle. Ann Enderle R.N. checks on a COVID-19 patient in the Medical Intensive care unit (MICU) at St. Luke's Boise Medical Center in Boise, Idaho, on August 31, 2021. Kyle Green/AP Photo

The designation included 10 hospitals and healthcare systems in the Idaho panhandle and in north-central Idaho. The agency said its goal is to extend care to as many patients as possible and to save as many lives as possible.

Other patients will still receive care, but they may be placed in hospital classrooms or conference rooms rather than traditional hospital rooms or go without some life-saving medical equipment.

Other states are preparing to take similar measures if needed. Hawaii Governor David Ige quietly signed an order last week releasing hospitals and health care workers from liability if they have to ration health care.

It's a scene that Idaho's health care providers have anticipated with dread. Medical experts have said that Idaho could have as many as 30,000 new coronavirus cases a week by mid-September if the current rate of infections lasts.

"Crisis standards of care is a last resort. It means we have exhausted our resources to the point that our healthcare systems are unable to provide the treatment and care we expect," Idaho Department of Health and Welfare Director Dave Jeppesen said in a statement.

He added: "This is a decision I was fervently hoping to avoid. The best tools we have to turn this around is for more people to get vaccinated and to wear masks indoors and in outdoor crowded public places. Please choose to get vaccinated as soon as possible – it is your very best protection against being hospitalized from COVID-19."

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.

More than 500 people were hospitalized statewide with COVID-19 on September 1 — the most recent data available on the Department of Health and Welfare's website — and more than a third of them were in intensive care unit beds.

Idaho's hospitals have struggled to fill empty nursing, housekeeping and other health care positions, in part because some staffers have left because they are burned out by the strain of the pandemic and because others have been quarantined because they were exposed to COVID-19.

Idaho Governor Brad Little called the move to limit care "an unprecedented and unwanted point in the history of our state" and urged residents to get vaccinated against coronavirus.

Data from the U.S. Centers for Disease Control and Prevention shows that full vaccination with any of the currently available coronavirus vaccines dramatically reduces the risk of requiring hospitalization for a coronavirus infection.

"More Idahoans need to choose to receive the vaccine so we can minimize the spread of the disease and reduce the number of COVID-19 hospitalizations, many of which involve younger Idahoans and are preventable with safe and effective vaccines," said Little, who is a Republican.

When the pandemic first came to Idaho at the start of 2020, Little ordered a partial shutdown of the state — ordering some businesses to temporarily close or shift to take-out style services, banning some large gatherings and asking residents to stay home as much as possible.

The move was aimed at ensuring that hospitals wouldn't become overwhelmed by patients. Idaho was on the verge of enacting crisis standards of care during a major coronavirus surge last winter, but narrowly avoided doing so — making this the first time the state has taken the drastic measure.

Little reopened the state in stages over a period of several months and has not reimposed restrictions limiting gatherings. Businesses are mostly operating as normal.

The state's crisis guidelines are complex, and give hospitals a legal and ethical template to use while rationing care.

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 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.

Idaho Hospitals Overrun
An influx of COVID-19 hospitalizations in northern Idaho caused the state to enact "crisis standards of care," which permits hospitals to provide treatment resources to patients most likely to survive. Jack Kingsley R.N. attends to a COVID-19 patient in the Medical Intensive care unit (MICU) at St. Luke's Boise Medical Center in Boise, Idaho on August 31, 2021. Kyle Green/AP Photo