On Thursday, Idaho leaders of public health increased their healthcare rationing across the state, indicating the gravity of the delta variant spread. This was replicated across the U.S. and in some Alaska and Montana hospitals due to a spike in hospitalizations among unvaccinated Covid-19 patients.
In several Western states where there is some skepticism related to vaccinations, this crisis care rationing was marked as an escalation in the Covid-19 situation.
One of the lowest vaccination rates in the U.S. is for Idaho and it only has a 40% full vaccination rate for its adults. This decision was made after Idaho’s largest hospital network; St. Luke’s Health System appealed, after which the Idaho Department of Health and Welfare announced the directive for health care rationing.
These care standards for crisis mean that resources such as ICU beds will be given to patients with greater chances of survival. Patients with lower chances of survival, in extreme cases, will be offered pain relief, palliative care, or under better situations less effective methods of care.
Officials on Thursday said that maximum capacity for critical care resources at St. Peter’s Health Hospital had been reached. A hospital in Helena, in the state of Montana, also had to implement this standard as a result of a spike in Covid-19 patients, while the Providence Alaska Medical Center, the largest hospital in Alaska, had also started managing resources in the same way.
This development came after state officials had started allowing health care rationing in the northern hospitals of Idaho.
“The situation is dire — we don’t have enough resources to adequately treat the patients in our hospitals, whether you are there for COVID-19 or a heart attack or because of a car accident,” Idaho Department of Welfare Director Dave Jeppesen stated. He further urged the population to opt for the Covid-19 vaccination, and wear masks both indoors and in outdoor settings that are crowded.
St. Luke’s Health System’s patients are currently manually ventilated by nurses or doctors, even for multiple hours, until a bed with a mechanical ventilator becomes available. This was provided in a statement by Dr. Jim Souza, the chief medical officer at the hospital. He further informed that some patients were undergoing treatment in rooms with high-flow oxygen, without monitoring systems. This means that a doctor or nurse might not hear an alarm if a medical emergency were to take place. Some patients with sepsis- a serious infection with potentially life-threatening consequences, are being treated in waiting rooms of emergency departments.
A net is provided to the hospital staff through such standards of care and allows them to “carry out the high wire acts that we do every day, like open-heart surgery and bone marrow transplants and neuro-interventional stroke care,” Dr. Souza said.
The largely rural state of Idaho is ranked at 12th in the U.S. for new Covid-19 confirmed cases per capita with 1 in every 201 residents testing positive for the virus in the last week, as found by a tally by John Hopkins University.
Hospitalizations have soared and most recently, the data had indicated 678 hospitalizations across the state.
An indication exists that the state has reached its threshold limit for its ability to treat patients in ICUs, with the number of Covid-19 patients in the ICU staying at a constant number of 170 for the past two weeks.
Public officials said that the entire state’s hospitals can ration health care resources if needed but not all may need to opt for this option. The individual hospital may decide the crisis standards of care at its discretion.
Reports on Wednesday found that almost 92% of Covid-19 patients at St. Luke’s hospitals consisted of unvaccinated individuals and a total of 61 occupants of the 78 available ICU beds were housing Covid-19 patients. The staff at St. Luke’s had routinely urged the population to get themselves vaccinated and slow the spread of the virus with the warning that the hospital was running out of available beds.
The crisis is not limited to hospitals alone but primary care physicians and suppliers of medical equipment are also unable to meet the covid-19 induced demand.
Norcos Medical is one of these suppliers and stated that an increase in the demand for oxygen tanks and such equipment meant that it was forced to provide patients with less than the cylinders that would be provided under normal circumstances. Equipment, such as high-flow oxygen, which was normally used in hospice care or a hospital was now routinely being requested for at-home patients. This information was provided by the President of the company Elias Margonis and he further stated that an increase in customers was seen for oxygen equipment with the flow rates 8, 12, or 20 liters a minute instead of the usual standard at 4 or 5 liters a minute.
Idaho’s largest primary care urgent care system is Primary Health Medical Group and it had to shorten its operating hours because so many patients were packed into the waiting rooms that the staff had to stay past hours to assist them all. Furthermore, the number of staff out sick due to the coronavirus was higher than normal due to their exposure.
The CEO Dr. David Peterman said that it is likely that patients released from hospitals early, or patients looking to avoid emergency rooms would be sicker and require a higher level of care.
