Idaho enacts ‘crisis standards of care’ as hospitals overwhelmed by Covid patients

Republican governor says rationing of care is ‘an unprecedented and unwanted point in the history of our state’

Gustaf Kilander
Washington, DC
Tuesday 07 September 2021 21:27
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Public health officials in Idaho have instituted “crisis standards of care” for the hospitals in the northern part of the state because there are more Covid-19 patients than they can care for.

The state’s department of health put the change in care standards into motion on Monday and announced the move on Tuesday, saying that patients may not get the health care they would under normal circumstances if they end up in hospital.

About 39.5 per cent of Idaho residents are fully immunised, one of the lowest vaccination rates in the US.

On 5 July, the seven-day average of new daily cases in the state was 50. On 4 September, it was 1,092.

The state’s health department said they were suffering from “a severe shortage of staffing and available beds in the northern area of the state caused by a massive increase in patients with Covid-19 who require hospitalization”.

The average number of hospitalisations in Idaho was 534 on 6 September, an increase of 28 per cent over the last 14 days, according to data from the US Department of Health.

The change in care standards is taking place across ten hospitals in northern Idaho, which shares a border with Canada in the northwest.

The state’s health department said the goal with the change in standards is meant to ensure that as many as possible get care and to save the maximum number of lives.

The change means that the hospitals can now give an ICU bed to a patient with the highest chance of survival.

While others will still get care, they could be placed in a hospital’s class- or conference rooms and may not be granted access to some medical equipment.

Other states are looking at similar actions in the face of mounting case numbers.

Hawaii Governor David Ige signed an order last week that removed the possibility that hospitals and workers could be held liable if they were forced to ration care.

According to experts, if current trends continue, Idaho could see as many as 30,000 new cases a week by the middle of this month.

“Crisis standards of care is a last resort. It means we have exhausted our resources to the point that our healthcare systems are unable to provide the treatment and care we expect,” Idaho Department of Health and Welfare Director Dave Jeppesen said in a statement.

“This is a decision I was fervently hoping to avoid. The best tools we have to turn this around is for more people to get vaccinated and to wear masks indoors and in outdoor crowded public places,” he added. “Please choose to get vaccinated as soon as possible – it is your very best protection against being hospitalized from Covid-19.”

The updated care standards will stay in place until enough resources exist to provide a normal level of care to all patients.

Hospitals in Idaho have struggled to find workers to fill empty jobs, partly because some have left after suffering from burnout from working during the pandemic. Others have been forced into quarantine after being exposed to the virus.

Idaho’s Republican Governor Brad Little said the new limits on health care was “an unprecedented and unwanted point in the history of our state” and pushed for residents to get vaccinated.

The governor ordered a partial shutdown of the state at the start of the pandemic in 2020, trying to avoid what has now become a reality.

Last winter, the state got close to being forced to lower care standards but only just avoided having to do so.

After lifting restrictions, Mr Little has chosen not to put limits on gatherings again and businesses in the state are for the most part operating as they would normally.

The guidelines for how to ration care are complicated, and hospitals have received both medical and ethical guidelines for how to navigate the limiting of care.

Patients will receive priority scores based on how likely it is that they will survive and those who are considered to be in most need of care and who are also most likely to improve from that care will be put on priority lists for ICU beds, which are in short supply.

Others who may also really need intensive care but who are less likely to survive will be given “comfort care” to make their recovery or passing free of pain.

Patients with medical issues that aren’t directly life-threatening will experience delays in their care until the resources needed once again become available.

The Associated Press contributed to this report

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