'Tremendous amount of stress': COVID surge engulfs Idaho health care systems once more

Jan. 12—Cases are surging, the positivity rate has doubled and hundreds of health care workers are out sick. The coronavirus omicron wave that has beset the nation has arrived in Idaho in full force, and public health officials are worried about how the system will stay afloat.

As case numbers rise precipitously and the demand for testing balloons, resources at health facilities are shrinking, with many medical professionals and caregivers among those ill with COVID-19.

"Health care capacity is decreasing while demand for health care services is increasing," said the director of the Department of Health and Welfare, Dave Jeppesen, during a Tuesday media briefing. "Health care systems are under a tremendous amount of stress right now, and we expect that to get worse before it gets better."

Multiple health care systems in the Treasure Valley have had to close or curtail the hours of their urgent care clinics because of a lack of adequate staffing. On Monday, 85 out of 600 employees at Primary Care Medical Group were unable to work either because they have tested positive or are showing symptoms or awaiting a test result, according to the group's CEO, Dr. David Peterman.

At Saint Alphonsus Health System, which has 6,000 employees in Idaho and Oregon, 128 employees were off work due to illness or possible COVID exposure, according to a spokesperson, Mark Snider.

In December, the Centers for Disease Control and Prevention updated its isolation and quarantine guidance for health care workers, allowing asymptomatic or lightly symptomatic workers to return to work sooner — even without a negative test — if hospitals are stretched beyond capacity.

Elke Shaw-Tulloch, the administrator for the Division of Public Health, said on Tuesday that some hospitals are currently operating under contingency standards, which is one level below crisis standards, and so they are allowing workers to return to work five days after testing positive, or since symptom onset. For hospitals operating at "conventional" standards, workers should wait 10 days, or only seven if they test negative.

But even those loosened restrictions are not sufficient for the current situation, officials said.

"We know that it's not enough," said Dr. Christine Hahn, state epidemiologist, on Tuesday. "That even using these new protocols, the staffing is really getting very, very tight."

Cases 'up significantly' in a matter of days

During the delta variant surge in the fall, most hospitals in the Treasure Valley stopped conducting elective and nonemergent procedures to deal with the influx of COVID-19 patients. This month, those limits may be reinstated.

"Things really went up significantly (over the weekend), both in cases going to the hospital as well as staffing challenges," Jeppesen said. "I don't know of any hospitals that have officially made that decision to start to curtail less critical procedures, but I can tell you that those conversations are actively happening, and I would expect that to be the case shortly."

He added that "it would not surprise me" if Idaho hospitals return to crisis standards of care, which allows for facilities to ration health care when available resources cannot meet the demand.

"It's probably going to be driven by staffing, in addition to increases in hospital patients," he said.

Currently, the number of COVID-19 patients at Idaho hospitals is not near what it was during the peak last fall.

Multiple studies have shown that omicron likely causes less severe illness than the delta variant, but its much higher rate of transmissibility could make it equally or even more dangerous in a community health setting.

Even if a larger proportion of people don't get seriously ill, some will, and Turner noted that the surge could mean Idaho goes "right back where we were last fall, with the same pressure on our health care system that sent us into crisis standards of care. And these case rates are not something that is reflecting positively on that possibility."

Idaho reported nearly 7,700 new cases the week of Jan. 3, which was more than four times the number reported the week of Dec. 20. But even those large numbers are not fully representative of the current spike, health officials say, because of a backlog in the reported data.

On Monday, DHW reported 1,882 new cases, but the state also announced a backlog of more than 13,000 cases yet to be processed. On Tuesday, Health and Welfare reported 2,319 cases, and the backlog was listed at 14,800 cases.

Based on the published data from the dashboard, the state's seven-day incidence rate — meaning the number of new cases per 100,000 residents — was 48.24 as of Jan. 10, said Dr. Kathryn Turner, deputy state epidemiologist. But accounting for positive lab results that have not been processed, the estimated rate could be as high as 135.51.

"This would represent one of the highest seven-day average incidence rates we have seen over the course of the pandemic," Turner said. "Clearly, the increase in cases over the last 10 days has been significant."

After rising to 8.6% the week of Dec. 19, the state's test positivity rate doubled to 17.1% for the week of Dec. 26, the most recent date available. During last fall's case surge, the positivity rate peaked at 17.3%.

Plus, testing positivity rates at some Treasure Valley health systems are even higher. As of Monday, Saint Alphonsus reported that its 14-day average for patients testing positive was 29.5%. At St. Luke's, it was 21%. The seven-day average at Primary Health, as of Monday, was 34%.

"We expect testing positivity to continue to increase and stay well above the goal of 5%," Jeppesen said.

Testing availability in Boise and Treasure Valley

At Tuesday's briefing, public health officials emphasized the importance of testing while acknowledging the limited availability.

"Currently, the manufacturing of rapid tests is not keeping up with demand," said Shaw-Tulloch. She suggested Idaho residents purchase rapid tests online, in advance of needing them, so that they'll be handy when they're required.

Shaw-Tulloch said 100,000 PCR tests, which are more accurate than rapid tests but take longer to process, were distributed through the Idaho Care Line, but only about 10% of those tests have been used.

"We are trying our level best to make sure that we have as much capacity as we can and we are raising the flag to our federal partners repeatedly about, 'You've got to do something about this supply,'" she said. "So we hope to see that turn around in the near future."

The administration of President Joe Biden announced last month that it will make 500 million free rapid tests available to the public through a website in the coming days.

For Idahoans who suspect they may have COVID-19 but are waiting for test results, Shaw-Tulloch urged them to stay home. If you must venture out, she said it's "very important" to wear a mask.

While "any mask is better than no mask," she said that higher-quality masks — like N95, KN95 or surgical masks — are more effective at protecting people.

'A decision that the people make'

On Tuesday, Idaho health officials again emphasized the safety and importance of vaccination, masking and social distancing in slowing the spread of the coronavirus.

Jeppesen said a vaccine booster shot helps protect Idahoans not only against severe illness, but also infection.

Less than 47% of Idaho's population is fully vaccinated — the lowest rate in the nation, according to the CDC. Of those who are fully vaccinated, only around 38% have chosen to get a booster dose. And a bulk of state residents have fought against health safety measures.

The decision by many residents not to follow public health guidance will affect the state's health care systems, economy and schools, Jeppesen said.

"That's a decision that the people will make, and we will continue to broadcast the message that we know is accurate and what will work best to help people avoid those (negative health) outcomes," he said. "But ultimately, it's what the people will choose to decide, and there will be consequences for those choices."

This story was originally published January 11, 20227:08 PM.

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