A panel of Idaho health experts issued stern warnings on Tuesday about the critical health threat of an ongoing spike in COVID-19 cases and what one hospital administrator called a “humanitarian crisis.”
“This is a once-in-a-lifetime event,” said Dr. James Souza, vice president and chief medical officer for the St. Luke’s Health System.
Dr. Steven Nemerson, chief clinical officer for the Boise-based St. Alphonsus Health System, called it a “tragedy” that science-based responses to the coronavirus pandemic have become “a political and emotional issue.”
The comments came in an online informational meeting featuring a panel of doctors and health-system administrators from around the state, including Dr. Terry O’Connor, a St. Luke’s Wood River emergency physician and medical director of the Blaine County Ambulance District.
Souza issued a firm response to comments made earlier Tuesday during a meeting of the governing board of Southwest District Health, an agency that serves six counties in the southwest corner of Idaho, including well-populated Canyon County, west of Boise. Souza responded directly to the board’s decision to give extensive floor time to two Idaho doctors—Dr. Vicki Wooll and Dr. Michael Karlfeldt—who contradicted mainstream health professionals by discussing disproven COVID-19 treatments and debating the effectiveness of wearing masks to prevent the spread of the potentially deadly virus.
“As we speak right now, our citizens are suffering and dying in these buildings,” Souza said in front of an image of the main St. Luke’s hospital in Boise. “And, as we speak here right now, our fellow citizens are also doing everything they can inside of buildings and clinics like that to care for their fellow human beings, to ease their suffering, and to even ease their dying.
“These people are heroes,” he said of the doctors, nurses, and other health-care professionals on the frontlines of the pandemic. “Sadly, they’re doing this working the long shifts, and the extra shifts, holding the hands of people, toileting people, caring for their wounds, in the face of a toxic minority narrative that is actually denigrating the work they do.”
For nine months, Idaho health-care systems have been transparent in sharing COVID-19 data with the state and the public, Souza said, calling the controversial speakers at the Southwest District Health meeting stating otherwise—whom he did not mention by name—“conspiracy theorists.”
“At the end of the day, it’s not going to be OK to debate if the sky is blue or green,” he said, adding that he believes public agencies should “stop giving oxygen” to people who say the pandemic is “a hoax or no big deal.”
Souza said it is “complete BS” to say that “either we ignore the virus or we ruin our economy.”
“Our facilities are jammed to the gills. … The solutions are simple. They are not an invasion of freedom and at worst they are an inconvenience,” he said. “The morbidity is piling up and the mortality is piling up, and it is time for the quiet majority to take back this conversation.”
Nemerson said St. Alphonsus has been experiencing record highs in COVID-19 patient cases and positive test rates for the virus. Ada County—which includes Boise—has recorded “severe COVID prevalence,” he said, with more than 800 cases per 100,000 residents. St. Alphonsus has recently recorded positive test rates greater than 25 percent, he said; a positive test rate of more than 5 percent of the disease can be characterized as an “epidemic.”
The number of patients seeking care in St. Alphonsus emergency rooms is “exponentially increasing,” Nemerson said, with the number of people seeking COVID-19 testing doubling in the last two weeks. The number of COVID-19 in-patients at St. Alphonsus—at 60 on Tuesday—is at its highest level since July, he said, and some 80 staff members were in quarantine at the time because they contracted COVID-19 or were suspected to have contracted the disease. The staff is “exhausted,” he said.
“The numbers are very, very sobering,” he said.
In the health system’s modeling, Nemerson said, the number of COVID-19 patients needing to be hospitalized will double by Christmas and triple in the next two months.
The Idaho Department of Health and Welfare reported a running total of 86,435 COVID-19 cases in the state as of Wednesday, with 1,310 new cases that day. The coronavirus-related death toll in Idaho was 812 on Wednesday.
However, there is some cause for hope, Nemerson said. “Community behavior”—following coronavirus mitigation measures—can change the trajectory of the problem, and two good vaccine candidates could be approved and ready for distribution by the beginning of 2021, in a “best case” scenario, he said. Still, he noted, the people of Idaho need to “buckle down” until the virus is controlled, a process that could take numerous months. “Several hundred thousand” Idahoans will need the vaccine, he said, and health-care workers and other high-priority citizens will likely get the vaccine first.
O’Connor, who also serves as the emergency medical services director for Blaine County and the Sawtooth region, described the challenge and “misfortune” of the virus hitting the Wood River Valley suddenly last winter and spring, and said the community’s help is needed to slow the ongoing surge of cases.
“Ultimately, at the end of the day, it does take a village to see ourselves through this,” he said.
In March and April, O’Connor said, St. Luke’s Wood River Medical Center was effectively “engulfed” by the impacts of the virus, with nearly 30 percent of the staff lost to illness or quarantine measures.
“The inferno hit us out of the blue,” he said.
Now, O’Connor said, “There is smoke on the horizon,” and Idahoans need to “prevent the next firestorm from coming.”
On many days, O’Connor said, he is told he can’t admit patients to the hospital because of capacity concerns and the closest transfer site, St. Luke’s Magic Valley Medical Center in Twin Falls, “is also on total divert”—completely full.
The practice of having to divert patients because COVID-19 cases are stressing hospital capacities has some chilling effects, the doctor said. A person having a heart attack might get the appropriate initial care, he said, but eventually might not get the proper intervention to treat the crisis condition if transfer to a regional hospital is delayed. Or, O’Connor noted, if transfer services are delayed, a stroke victim might not get the proper care in a timely manner.
“In an alarming increasing frequency with each shift, my transfer ability continues to wean down, to be less and less and less.”
The number of patients in the St. Luke’s system’s intensive-care units is continuing to grow, O’Connor said, as is the number of employees getting sick.
“We do have another firestorm on the horizon,” O’Connor said. Yet, at the same time, “It seems like in some of our communities, we’re watching people continue to have bonfire parties in the backyard.”
In responding to a question about whether care is being rationed in Idaho, O’Connor said some choices about provisions of health care are being made.
He said St. Luke’s has to assess demand for in-patient services and is no longer scheduling “elective cases” that require an overnight stay and—at some health centers—some previously scheduled elective surgeries are being canceled.
In the end, Nemerson said Idaho is facing a “humanitarian crisis.”
Souza offered an equally somber assessment of the situation in Idaho.
“Never in my career did I think that we would even contemplate the rationing of care in the United States of America,” he said.
(This story was updated on Nov. 20 to correct the misattribution of two quotes.)