Department of Defense medical personnel arrive at Kootenai Health

COEUR d’ALENE — The cavalry has arrived to support staff at Kootenai Health, where surging COVID-19 cases have pushed the hospital to crisis standards of care.

But the aid of military medical personnel may not be enough if COVID-19 cases continue to climb.

For at least 30 days, a team of 20 from the Department of Defense will be on site at Kootenai Health, comprised of 14 nurses, four physicians and two respiratory therapists.

The hospital also expects to receive clinical support this week from ACI Federal Labor, a government-contracted agency.

“This help could not come at a better time,” said Dr. Robert Scoggins, chief of staff and medical director of Critical Care at Kootenai Health. “Our staff is stretched to the limit.”

The Idaho Department of Health and Welfare announced Tuesday that the Panhandle Health District and the Idaho North Central District entered into crisis standards of are because of “a massive increase in patients with COVID-19 who require hospitalization.”

Crisis standards of care are guidelines that health care providers follow in order to decide how to best treat patients in a disaster or emergency.

Initially, crisis standards can mean patients are receiving care in a place where they wouldn’t otherwise, such as the Kootenai Health classroom that has been converted to a care room for up to 22 patients.

The makeshift unit is already filling with COVID-19 patients.

Nurses may provide care to more patients than they would normally or monitor vital signs less frequently.

In extreme instances, hospital care teams have to choose how to ration resources.

“We have not had to limit ventilators,” Scoggins said. “We could get there.”

Kootenai Health requested federal aid in early August, when 69 patients were hospitalized due to COVID-19.

Those numbers have only climbed — 115 people were hospitalized Wednesday, with 40 in critical care.

Of those, 20 were on ventilators.

The scarcest resource right now is staff.

Kootenai Health employs more than 3,600 people and has about 550 open positions at present, including about 240 clinical caregiver positions.

“The resources we’re bringing in now puts a dent in that, but we’re still short,” said Jeremy Evans, Kootenai Health’s COVID incident commander.

Capacity poses another major challenge as COVID cases continue to rise.

Kootenai Health normally has 330 beds and operates at around 80% capacity.

Of those beds, 77 are for behavioral health patients and 53 are allocated for labor and delivery, pediatrics and similar, making them unsuitable for COVID-19 care. A total of 200 beds remain.

Yesterday, 218 beds were filled at the hospital — more than half of them occupied by COVID-19 patients.

“We’re well above our capacity,” Evans said.

Meanwhile, local nurses are working 12-hour shifts in full PPE and coming in to work on their days off.

They’re sometimes faced with treating people they know personally, whose bodies are ravaged by COVID-19.

As the highly contagious delta variant spreads, patients are getting younger. Many have few or no underlying health conditions.

“That emotional trauma the nurses see every day wears on them,” Scoggins said. “I’ve never seen anything like this. Coronavirus is different.”

Since the beginning of the most recent surge, 97% of patients hospitalized for COVID-19 at Kootenai Health are unvaccinated.

Data from IDHW shows the overwhelming majority of people who are dying from COVID-19 are unvaccinated.

Infections among vaccinated people, called breakthrough infections, are rare.

Vaccinated people who contract COVID-19 are likely to experience a much milder case.

Many community members find it hard to conceptualize what’s happening inside the hospital, Scoggins said, because they can’t see it.

But that doesn’t mean it isn’t real.

Most people who contract COVID-19 recover, he said. About 10% of those who catch the virus are hospitalized. Of those, about 3% land in the ICU.

At that point, the mortality rate rises dramatically.

“Patients in the ICU regret not taking this seriously,” Scoggins said.