Idaho Hospitals Preparing to Enact Crisis Care Standards As COVID Overwhelms Facilities

Idaho hospitals overwhelmed by COVID cases are preparing to enact crisis standards of care, which call for allocating what scarce resources they have towards the patients most likely to survive.

This week, the state hit a record number of emergency room visits, hospitalizations and ICU patients. With one of the nation's lowest vaccination rates and a critical shortage of hospital beds and staff available for the influx of patients, Idaho could enact the crisis care standards in days, the Associated Press reported.

Dr. Bill Dittrich at St. Luke's Boise Medical Center said the standards would leave him with the excruciating task of deciding which patients will receive life-saving treatment.

"I don't think anybody will ever be ready to have the kinds of conversations and make the kinds of decisions that we're concerned we're going to have to be making in the next several weeks. I'm really terrified," Dittrich said.

For more reporting from the Associated Press, see below.

COVID hospitals
Hospitals across the U.S. are seeing a surge in COVID-19 cases, and Idaho may enact crisis care standards in days. A registered nurse tends to a COVID-19 patient inside the ICU at Adventist Health in Sonora, California on Aug. 27, 2021. Nic Coury/AFP via Getty Images

St. Luke's Boise Medical Center invited The Associated Press into its restricted ICUs this week in hopes that sharing the dire reality would prompt people to change their behavior.

"There is so much loss here, and so much of it is preventable. I'm not just talking about loss of life. Ultimately, it's like loss of hope," said Dr. Jim Souza, chief medical officer. "When the vaccines came out in December, those of us in health care were like, 'Oh, my God, it's like the cavalry coming over the hill. ... To see now what's playing out? It's all so needless."

Inside the ICUs, Kristen Connelly and fellow nurses frequently gather to turn over each patient, careful to avoid disconnecting the tangle of tubes and wires keeping them alive.

When Idaho's hospitals were nearly overwhelmed with coronavirus patients last winter, Connelly wasn't fazed, believing she could make a difference. Now, instead of focusing on one patient at a time, she cares for multiple. Many colleagues have quit, burned out by the relentless demands of the pandemic.

"At this point, I'm overwhelmed. I don't have much left," the 26-year ICU nursing veteran said Tuesday.

Connelly's own life is in triage mode as she tries to maintain her last reservoirs of energy. She doesn't eat at home anymore and has cut out all activities except for walking her dog. Her normally deep sense of compassion — which Connelly considers a critical job skill — has been shadowed by a seething anger she can't shake.

"We had a mother-daughter team in the hospital last week, and the mother died and the daughter was still here," Connelly said. "In that moment, I had a reprieve from the anger, because I got to be just overwhelmed with sadness."

"It's devastating," she said. "Where we are right now is avoidable — we didn't have to go here."

Most of the ICU patients fell prey to con artists before they fell ill with the virus, said Souza. He points to a patient who first tried the anti-parasite drug ivermectin. U.S. health officials have warned it should not be used to treat COVID-19. The man, in his 50s, refused standard medical treatments until he became so sick he needed to be hospitalized.

"What we're left with is organ supportive therapy. Misinformation is hurting people and killing people," Souza said.

What the science is clear on? Vaccines, he said. "We don't have any vaccinated patients here."

In deep-red Idaho, however, vaccinations, masks and nearly anything related to the coronavirus mark a de facto borderline between more traditional Republicans and the far-right.

Even families who have witnessed the trauma of COVID-19 firsthand are on opposite sides.

Lisa Owens' 48-year-old stepbrother, Jeff Owens, has been in the Boise hospital's ICU since early August.

"My kids call him the 'Candy Man' because he always brings candy when he comes," Lisa Owens said. "He really is this kind, loving, jovial person, and I wish with all my heart that he'd gotten vaccinated."

She's vaccinated, along with about half of her extended family. But Jeff, their aunt and uncle, Jeff's daughter and a few others are not. The aunt was hospitalized — she developed blood clots from the virus — but has since recovered.

If anything, those experiences entrenched other relatives in their anti-vaccination beliefs, Owens said.

"Sure, they see Jeff in the hospital, but they also see his aunt and uncle, and they're OK. The last update we had is even if he does recover, he's looking at eight months of rehab," she said. "If he pulls through, I'm going to march him into the nearest vaccine clinic myself."

Owens fears her stepbrother may be taken off life support if someone with a better chance of survival needs the bed.

"I don't even want to think about it. ... I mean, he's been in there for a month. If it comes to crisis standards of care, they're going to say he's not showing enough improvement, because he's not," she said, fighting back tears. "I hope he pulls through it."

Idaho Hospital
More than half of the patients in the ICU at an Idaho hospital are COVID-19 positive, none of which are vaccinated. A R.N. holds the hand of a COVID-19 patient in the Medical Intensive care unit (MICU) at St. Luke's Boise Medical Center in Boise, Idaho on Tuesday, Aug. 31, 2021. Kyle Green/AP Photo