Idaho health-care officials deactivated crisis standards of care for most of the state on Monday, stating that conditions at hospitals and clinics had improved but that the COVID-19 pandemic is not over.

Idaho Department of Health and Welfare Director Dave Jeppesen stated in an online media briefing that health-care facilities would move out of crisis standards in all of the state except in the Panhandle Health District in northern Idaho. Most health-care systems will now operate under “contingency operations,” a lower-level alert status between crisis standards and normal operations, Jeppesen said.

The decision is an indication that hospitalization numbers “are heading in the right direction” but many hospitals are still stressed by high numbers of patients, Jeppesen said.

“It will be some time before health-care systems return to full, normal operations,” he said. “It also will take time for the health-care systems to work through the many delayed surgeries and other medical treatments.”

With Idaho hospitals and health-care clinics overwhelmed by soaring numbers of patients, the state implemented crisis standards of care across Idaho in mid-September. The crisis status allows health-care providers to use below-normal standards of care, permitting them to indefinitely delay care for some people and provide reduced care for others, and to add beds in unconventional spaces, such as emergency departments or conference areas.

The crisis standards were implemented as the number of COVID-19 cases surged in Idaho.

Dr. Jim Souza, chief physician executive of the St. Luke’s Health System, said the challenges caused by the fall surge of COVID-19 patients and other patients had improved but still exist.

“It’s not mission accomplished,” he said.

Souza said St. Luke’s has closed all its “surge units” added to accommodate overflow patients, has some empty beds in intensive-care units and has been able to do some nonemergent surgeries, which had been delayed. Ratios of staff to patients had returned to normal, he said, and St. Luke’s has been encouraging some hard-worked staff members to take time off.

Nonetheless, St. Luke’s is still treating many COVID-19 patients, Souza said. About 21% of adult patients admitted into St. Luke’s facilities are COVID-19 patients, with the number climbing to 40% in its ICUs, he said.

“We are very busy,” he said.

On Tuesday, St. Luke’s had 565 patients admitted to its facilities, with 48 in ICUs. St. Luke’s normally maintains about 600 beds in the facilities in its system.

St. Luke’s is now starting to work through 7,000 to 8,000 surgeries or medical procedures that were delayed, Souza said, a process that will take numerous months. Under normal conditions, the St. Luke’s Health System performs about 50,000 surgeries a year.

During the implementation of crisis standards, Souza said, St. Luke’s did not have to deny urgent care to any patients, such as choosing which of two patients would get only one available ventilator to aid in breathing.

Souza praised and expressed gratitude to Idaho health-care workers who navigated the crisis and encountered “a lot of suffering and dying” but “saved thousands of lives.”

He said there are lessons to be learned from the pandemic and latest surge, which should be heeded so communities do “not do what we did before and expect a different outcome.”

To help continue to maintain public health and keep hospitalization numbers down, Jeppesen encouraged Idahoans who have not been vaccinated against COVID-19 to get vaccinated.

Blaine County’s COVID-19 risk goes down

Meanwhile, the South Central Public Health District lowered Blaine County’s COVID-19 risk level from “high” to “moderate” on Thursday, Nov. 18, when it updated its biweekly risk assessments for the eight counties it serves.

Two weeks earlier, the Health District lowered Blaine County’s risk level from “critical” to “high.”

The district has four risk levels in its model: minimal, moderate, high and critical.

The Health District reported that the county’s 14-day average of new daily cases per 10,000 residents was 2.27, in the “moderate” risk category.

The rate of positive test results in the county was 5.34%, also in the “moderate” category.

The highest number of new cases in the two-week span ending Nov. 18 was in the 50-59 age category, at 13. New cases were recorded in all age groups in Blaine County, including eight in the 0-10 age group and six in the 11-13 age group.

The district was monitoring 79 confirmed and 27 probable COVID-19 cases in Blaine County on Monday. It stated that case investigations have continued to be delayed by the surge in new cases this fall.

The Health District determined that the risk level in neighboring Camas County was “minimal” and in Lincoln County was “moderate.”

By Tuesday, 3,146 COVID-19 cases and 27 COVID-related deaths had been recorded in Blaine County, the Idaho Department of Health and Welfare reported.

The county’s daily seven-day moving average of new cases per hypothetical 100,000 residents was 21.7 on Monday, trending upward since it dropped to 11.8 on Nov. 15, Health and Welfare data shows. This year, it peaked at 81.9 in late January. It dropped to zero in early June.

Statewide, the seven-day average of new daily cases per 100,000 residents has been trending downward since mid-September, when it reached 84.5. It was 23.8 on Monday.

The state recorded 632 new COVID-19 cases in Idaho on Monday, bringing the total during the pandemic to 303,928. The state has recorded 3,862 deaths attributed to COVID-19.

Nationally, COVID-19 cases are trending upward, after steadily dropping in September and October. On Sunday, the federal Centers for Disease Control and Prevention recorded 29,286 new cases, with the seven-day moving average of new cases at about 91,000. The CDC recorded more than 105,000 new cases last Wednesday. The number of new daily cases had dropped below 15,000 in late June.

The CDC has approved COVID-19 vaccines for people 5 and older. Last week, it approved COVID-19 vaccine booster shots for people 18 and older, to be received six months after their first vaccine shots. 

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