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Hospitals in Crisis Mode; Care Being Rationed Throughout Region

Associated Press

A growing number of hospitals in the West are facing an unprecedented surge of COVID-19 patients. Most of them are unvaccinated. That’s prompting some hospitals to begin rationing care for everyone, regardless of their diagnosis. 

A couple of weeks ago Ed Crosby was talking with his brother-in-law over the phone. As they were setting up dinner plans, Crosby recalls hearing this: 

“I just had a bad fall this morning, I hit my head, and I’m kind of bleeding.”

Crosby’s elderly relative was showing stroke-like symptoms.  He was eventually airlifted to North Idaho’s biggest hospital… Kootenai Health in Coeur D’Alene. He needed intensive care. But when he got there... 

“There were no beds available in the ICU.  It was totally filled with COVID patients, certainly almost all unvaccinated.”

Crosby says his brother-in-law had to wait in the emergency room for two days before an ICU bed opened up. He survived but overcrowding is a problem in a growing number of hospitals across the West. 

ICU beds from Albuquerque to Las Vegas to Salt Lake City are jammed with COVID-19 patients. 

That means everyone else is waiting longer to get the care they need. Hospitals in Utah and North Idaho, for example, have cancelled most surgeries. 

And… Health officials are warning everyone to avoid risky activities that might land them in the emergency room because… bottom line… beds are full and resources are strapped. 

“There’s no question about it the system is incredibly stressed.” 

That’s John Hick. He’s the medical director for emergency preparedness at Hennepin Healthcare in Minneapolis. He’s also an expert in crisis standards of care. 

These are guidelines that hospitals or public health agencies activate when they are overwhelmed like this. 

“It’s really about using the resources we have in the best way possible to maintain as close to usual standards of care as we can.”

Hick says this doesn’t mean doctors are going around deciding who lives and who dies in a COVID ward:

“Like who gets a ventilator and who doesn’t.”

Instead he says it’s about rationing the existing staff and equipment you have.

“So that might mean that a person instead of getting four hours of dialysis winds up getting two hours, because that's just enough to keep them safe. And then two hours for another patient on that machine, because that's just enough to keep them safe.”

Idaho state health officials have activated crisis standards of care for hospitals there. Other nearby states and hospitals are considering doing the same. 

Hick says the biggest problem right now is a shortage of critical care beds.. The issue is especially acute in the Mountain West and the Great Plains because we don’t have as many large hospitals as they do back East.

“The number of ICU beds for the population is just not adequate at baseline. And you threw in additional trauma, you throw in COVID. And you're talking about a real crisis.”

It’s a crisis that 30-year-old Emily Farness faces every day. 

“It's been so physically tough. It's been emotionally tough, and, and just draining on so many levels.”

She’s an ICU nurse at Kootenai Health’s 330-bed hospital in Coeur D’Alene. Right now, their COVID unit is full of people suffering from the Delta variant. The hospital estimates 97 percent are unvaccinated. 

“Almost all of them, tell me, I had no idea it was like this. And I, if I had only known, I would have gotten vaccinated, if I had only known I would have been, I would have taken this so much more seriously. For them it’s already happened. They can’t go back and change their decision.” 

That’s why she wishes the unvaccinated could just get a glimpse of what she and other nurses see every day. The fear. The pain. 

The Delta variant is putting more young, seemingly healthy people into the hospital. Farness says it breaks their bodies down. 

“Their breathing is so labored that they can't take breaks off of their oxygen mask long enough to really eat a solid meal and they're scarfing, a few bites and then just giving up.” 

Farness says they can spend a month or two in the hospital. And when they do eventually get out… they often have long-term lung damage. Or brain fogginess.

“Their prior quality of life might not be attainable, the job that they held before that was maybe fairly physical or fairly mentally taxing, might not they might not be capable of returning to. And I personally as someone who is young and healthy To me, that's almost scarier than dying.”

Vaccination rates have either remained stagnant or decreased over the past week across much of the Mountain West. Public health officials expect the surge of Covid patients to get worse in the coming weeks. 

Nate is UM School of Journalism reporter. He reads the news on Montana Public Radio three nights a week.