On Sept. 16, the day Idaho’s Department of Health and Welfare began allowing crisis standards of care at hospital systems across the whole state, the department director’s mother had a stroke. When she went to a St. Luke’s Health System emergency room, the care she received was not what you’d expect.
Other patients were receiving treatment in the emergency facility waiting room, she had to wait longer than usual, and X-rays she received to assess whether she had broken any bones were taken in a “nontraditional” area, said Dave Jeppesen, director of Health and Welfare, at a press briefing on Tuesday.
Instead of being admitted to the hospital for observation overnight, she was discharged the same day.
“The ER team at St. Luke’s was amazing,” Jeppesen said. But “those same dedicated health care professionals across the state need our help.”
Crisis standards allow hospitals to ration care in response to an emergency, and they were activated statewide at the request of St. Luke’s last week. Since then, the number of COVID-19 patients is still rising and the strain on available care for all patients continues to mount.
Though hospital leaders continue to encourage those experiencing medical emergencies to go to a hospital, health care facilities are teetering.
“We’re not providing the same level of care,” Jim Souza, the chief physician executive at St. Luke’s, said at Tuesday’s briefing.
Breast cancer patients have had their surgeries postponed, he said, and some COVID-19 patients who should be transferred to an intensive care unit are instead being treated in less-equipped facilities.
“Everybody is going with a little bit less,” Souza said.
In Twin Falls, doctors at St. Luke’s on Saturday were nearly forced to ration care when the condition of six hospitalized patients went south rapidly, and the facility had no available ICU beds, he said. Other facilities were able to make room for the patients, but Souza said a similar problem is almost certain to recur.
“This happens every day,” Souza said. “And yet, when it happened on Saturday, we were really pressed to find a solution.”
The crux of the problem is the overwhelming number of COVID-19 patients in a state where barely 50% of eligible people are vaccinated.
Eighty people have died of COVID-19 at St. Luke’s facilities this month, stretching from the Treasure Valley to Twin Falls to Ketchum, and 35 of them have died in the past week, Souza said. Three of the deaths were individuals younger than 30, and six were younger than 40.
“For the people who say ‘we all die sometime,’ yes, we do,” said Souza. “But these people didn’t need to die now, and they didn’t need to die like this.”
Seventy percent of the hospital system’s ICU beds are filled with COVID-19 patients, as are 67% of its hospital beds in general, which Souza called an “unprecedented event in modern medicine.” Of those in the hospital beds, 90% are unvaccinated; of those in ICU, 98% are unvaccinated, he said.
The ICU hospital mortality rate has grown markedly, from around 28% last winter to 43% today. The patients at St. Luke’s facilities are sicker and younger, too, down from a two-week average of 72 years old for hospitalized patients in December to 58 years old now.
Statewide, there are nearly twice as many ICU patients as there were during last year’s COVID-19 peak, according to Health and Welfare data. The high point last December was 60 in ICU, and that figure was 112 on Saturday.