Idaho Allows Overwhelmed Hospitals to Ration Care If Needed

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U.S.|Idaho allows overwhelmed hospitals across the state to ration care if necessary.

https://www.nytimes.com/2021/09/16/us/idaho-covid-hospitalizations.html

Attending to a Covid-19 patient at St. Luke’s Boise Medical Center in Boise, Idaho, last month.
Credit...Kyle Green/Associated Press

Mike Baker

  • Sept. 16, 2021, 12:40 p.m. ET

With its hospitals struggling to cope with a flood of patient, Idaho officials activated “crisis standards of care” across the state on Thursday, allowing overwhelmed facilities to ration treatment if needed.

“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,” Dave Jeppesen, the director of the Idaho Department of Health and Welfare, said in a statement.

Crisis standards of care lay out guidelines for hospitals to follow when they cannot meet demand and must ration services. Idaho officials noted that patients may find themselves being treated in repurposed rooms, or that needed equipment is not available. Some patients may have to wait for beds to become available.

Though states around the country have prepared plans for how to allocate critical resources in a crisis during the pandemic, few have formally implemented such plans even when hospitalizations have soared. Alaska’s largest hospital said this week that it was operating under crisis standards, and that some emergency-room patients were having to wait in their vehicles for hours to be seen by a physician.

Nationwide, new coronavirus cases and hospitalizations have declined slightly in recent weeks, but much of the progress seen in hard-hit Southern states is being offset by growing outbreaks in the Upper Midwest and Mountain West, including Idaho.

One in four hospitals across the country reports that more than 95 percent of its intensive care beds were occupied as of the week ending Sept. 9, up from one in five hospitals last month. Experts say hospitals may have difficulty maintaining standards of care for the sickest patients when all or nearly all I.C.U. beds are occupied.

Idaho adopted crisis standards for hospitals in the northern part of the state earlier this month. Nurses there are caring for higher patient loads than usual and are authorized not to check vital signs as often as they otherwise would. If the situation worsens, rationing could get more drastic, with hospitals having to decide which patients will get priority for limited supplies of oxygen or ventilators.

Hospitalizations for Covid-19 have continued to surge across Idaho, and are now running nearly 40 percent above the previous peak of the pandemic, according to federal data. The state health department said that St. Luke’s Health System, which has a network of hospitals across the state, requested that the crisis standards be expanded statewide.

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About this data Source: U.S. Department of Health and Human Services. The seven-day average is the average of a day and the previous six days of data. Currently hospitalized is the most recent number of patients with Covid-19 reported by hospitals in the state for the four days prior. Dips and spikes could be due to inconsistent reporting by hospitals. Hospitalization numbers early in the pandemic are undercounts due to incomplete reporting by hospitals to the federal government.

Despite the spreading crisis, Gov. Brad Little has resisted imposing new coronavirus restrictions or mandating mask-wearing and vaccinations. That has led to growing frustration in neighboring Washington State, which has an indoor mask mandate and other safety protocols, and where hospitals have been strained by numerous patient transfers from Idaho.

Idaho has one of the lowest vaccination rates in the country. Mr. Jeppesen said the best way to end the use of crisis standards of care is for more people to get vaccinated.

“Our hospitals and health care systems need our help,” he said.

Mitch Smith and Charlie Smart contributed reporting.

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