Idaho COVID crisis: Hospitals overflowing with sicker, younger patients

September 22, 2021 by No Comments

Enlarge / A coronavirus preparedness tent setup outside a hospital emergency room entrance at Gritman Medical Center in the northern Idaho city of Moscow in March 2020.

Health officials in Idaho are reporting dire circumstances as hospitals around the state continue to crumble under the delta-fueled surge of COVID-19 cases.

“We continue to set record highs,” Dave Jeppesen, director of the Idaho Department of Health and Welfare, said in a press briefing Tuesday. With the latest data through September 18, the state saw a new record high of 686 hospitalized COVID-19 patients, a record high of 180 COVID-19 patients in intensive care units, and a record high of 112 COVID-19 patients on ventilators. The number of ventilated COVID-19 patients is nearly double what was seen in the last surge of COVID-19 cases in December.

“These numbers continue to increase, and we expect them to continue to increase,” Jeppesen added.

Currently, the daily average of new cases is around 1,200, an increase of 25 percent in the past two weeks, according to data tracking by The New York Times. Hospitalizations are up 34 percent, and the current average of deaths each day is 22, an increase of 223 percent.

Last Thursday, the health department expanded the use of crisis standards of care to cover the entire state. The health department had previously only activated the standards—which allow for suboptimal care and rationing of resources, like ventilators—for 10 hospitals in the hard-hit northern region of the Gem State. Now, hospitals statewide are facing a crush of patients, staff shortages, and a lack of beds.

“Bottom line: Our in-patient facilities are progressively becoming COVID hospitals and that’s the same story for the rest of the state,” said James P. Souza, chief physician executive for St. Luke’s Health System.

Lost time

Dr. Souza gave a grim rundown of what health care providers are now facing in Idaho’s hospitals. In the St. Luke system—which includes several hospitals across the state—COVID-19 patients accounted for just 8 percent of adult hospitalizations in July, but they now account for 67 percent. “That’s an unprecedented event in modern medicine,” he said. In the system’s intensive care units, the percentage of COVID-19 patients went from 17 percent to a current high of 70 percent.

As for the patients themselves, they’re skewing younger and sicker than those seen in the previous surge, Souza said. Of 51 COVID-19 patients in system’s ICUs, 36 are under the age of 55 and 13 are under the age of 40. The hospital system is also using more invasive treatments than before. Souza attributed this to the younger ages of the patients, who are attempting to use every method possible to try to survive their infections. “If we’re honest about it, 40-year-olds have not contemplated death before,” he said.

The system is also seeing more complications for severe COVID-19 infections, including clotting disorders and kidney damage. The average length of stay in the ICU has also increased from about six days to eight. Souza estimated that 30 percent of patients will have long-term recoveries.

Patients are also dying more. In previous surges, the mortality rate among COVID-19 patients in the ICU was about 28 percent, Souza said. But in the current surge, it’s 43 percent. There have been 80 COVID-19 deaths in the system since the beginning of September—four every day—with 35 in the last week. Calculating the estimated years of life lost from the people who died just in September—assuming they would have had average life spans otherwise—it amounts to more than 1,100 life years lost.

Crisis care

“For the people who say ‘we all die sometime:’ Yes we do,” Souza said. “But these people didn’t need to die now, and they didn’t need to die like this.”

Of the patients hospitalized with COVID-19, 90 percent are unvaccinated, as are 98 percent of ICU patients. Of the sliver of COVID-19 patients who are vaccinated, many have compromised immune systems, such as organ-transplant patients and people who are actively being treated for cancers.

The unvaccinated are far from the only ones suffering in this crushing surge. Health department director Jeppesen noted in an emotional appeal that his mother suffered a stroke and a fall on Thursday, just as crisis standards went into effect statewide. His mother went to an emergency department, where she saw people being treated in the waiting room. She had to wait longer than normal for care and was treated in a “nontraditional” area of the hospital. Though the hospital would have normally kept his mother overnight for observation, she was instead discharged the same day. Though he reported that his mother appears to be recovering well, the stroke was more stressful than it would have normally been.

“We are so lucky to have such talented health care professionals in Idaho,” Jeppesen said, his voice cracking with emotion. “And those same health care professionals need our help. They need the unvaccinated to please consider getting vaccinated.”

Source link