St. Luke’s ‘cautiously optimistic’ as COVID-19 surge abates, crisis standards near end

With COVID-19 cases on the decline, Idaho’s largest health care system is seeing promising signs of improvement after eight weeks under crisis standards of care.

St. Luke’s, the first local hospital system to request the crisis standards activation from the state in September, has seen marked signs of improvement in the past week, administrators said. As the number of new patients declines, the system has been able to close down overflow units and restart some of the thousands of nonemergency surgeries and procedures that hospitals had to put on hold.

The health system admitted 295 new COVID-19 patients on Sept. 23, according to the hospital dashboard. On Nov. 11, that number was just 66.

After needing to open more than a dozen overflow units to house patients in nontraditional settings, the hospital is now down to only two overflow units at its four main hospitals, according to Sandee Gehrke, senior vice president and chief operating officer of the health system. Staff are being assigned back to areas of hospitals where they normally work, and patients are not having to be cared for in irregular areas.

“We’ve backed off on almost all of that,” Gehrke said of the reassignments, which saw more than 300 staff members moved to nontraditional areas. That number is down to 36, she said, and nurse-to-patient ratios have mostly returned to normal.

“We are closer and closer to contingency care as it relates to where we’re providing care for our patients,” Gehrke said.

Crisis standards of care are activated when hospitals are overwhelmed with patients to the point that they are unable to provide the usual levels of care, and might have to ration care. Contingency care is one level below that.

St. Luke’s also is catching up on an estimated 5,000 medically necessary procedures and surgeries that had to be put on hold during the crisis standards. Hospitals have continued doing emergency surgeries, a category filled with more severe cases.

Dr. Frank Johnson, chief medical officer for the health system’s hospitals in Boise, Elmore and McCall, said it could take up to six months for the hospital system to catch up in the “medically necessary” category, which includes orthopedic surgeries, some abdominal surgeries and pediatric operations.

Employee vaccination requirements

On Thursday, Gehrke also announced that 99% of the hospital’s employees are in compliance with the system’s COVID-19 vaccination requirements.

The health system first announced a vaccine requirement in July, but enforcement of that was paused in September when the latest surge became a crisis, with St. Luke’s needing all hands on deck.

For employees who do not want to get vaccinated, St. Luke’s and Saint Alphonsus both offer religious or medical exemptions, which are reviewed by each hospital on an individual basis. St. Luke’s did not say how many of its employees have received an exemption.

For the roughly 100 employees who remain noncompliant, out of about 17,000, Gehrke said they will need to be fully vaccinated or have received an exemption by Jan. 4, as is required by the federal government.

The Biden administration has mandated vaccines for health care workers at facilities that receive Medicare or Medicaid funding. On Wednesday, 10 states sued over that requirement.

Though Idaho was not one of those 10, Gov. Brad Little has joined other states in suing the federal government over vaccine mandates for employees of large companies and for federal contractors.

Will there be another surge?

Though some hospital and state prediction models had expected infections to surge through November, cases and hospitalizations have been declining in Idaho. Johnson said the quicker-than-expected drop in Idaho’s fourth COVID-19 surge might be attributable to increased masking in some parts of the state, a vaccination rate that continues to inch up and overall immunity in the population.

He said he doesn’t know whether another surge can be expected this winter.

“I don’t want to suggest that the mission is accomplished,” he said. “Be thoughtful over how we are interacting with groups and how we’re working to protect our neighbors through the next couple of months.”

Johnson also said that even though the virus still will be present in Idaho’s communities, he’s “cautiously optimistic” that “we won’t see this dramatic surge again like what we saw this time.”