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Doctors Decry the ‘Toxic Minority’
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Wednesday, November 18, 2020
 

STORY AND PHOTO BY KAREN BOSSICK

COVID GRAPH BY PAUL RIES

Doctors painted a chilling forecast of Christmas Future if Idahoans continue to disregard admonitions to wear masks, distance themselves and stop gathering in groups without following precautions.

If coronavirus cases continue to balloon, hospitals will be forced to ration healthcare, with care going to the youngest, healthiest and those most likely to survive, Dr. Jim Souza said. And those who have a stroke or fall on the ice and break an arm may not be able to get the help they need.

As COVID patients fill the hospitals, more and more surgeries and screenings will be cancelled and  “curable conditions that can be found early will become incurable ones that they find late,” he added.

All this is totally preventable, he said. We just need to act.

Unfortunately, Sousa said, the community’s response to COVID is like watching a train come down the track and refusing to get out of the way. Healthcare providers have been telling people to wear a mask and socially distance since April, he said, “But I’m getting to wonder if anyone is listening.”

Souza and other doctors spent Tuesday morning sounding alarms--first at a video conference with Boise Mayor Lauren McLean and then in a virtual press conference arranged by several Idaho health care organizations.

It came on the anniversary of the day a new novel coronavirus was announced in China. It came as Idaho recorded 1,781 new cases--its worst ever--for a total of 85,125 since the pandemic was found in Idaho in mid-March. The state recorded a single-day record 35 new deaths for a total of 798. One of those was a person between the ages of 18 and 29. Blaine County now has 1,117 cases after 12 new cases on Tuesday.

The state has an unsustainable positivity rate of 42 percent and nearly 1,000 new cases reported for every 100,000 residents in the past two weeks, according to Johns Hopkins University.

Souza said the situation has become dire at St. Luke’s Health System.

The first week of October, a daily average of 35 adult COVID patients were in St. Luke’s Health System. It’s grown exponentially until St. Luke’s now has 135 COVID patients. The number in intensive care has gone from single digits to 24.

St. Luke’s has 197 clinical staff out sick—and 133 of those have confirmed COVID.

St. Luke’s Magic Valley alone has not had fewer than 50 COVID patients of late. It’s seen 700 patients with COVID during the past two weeks, after having seen 75 patients a week in August.

St. Luke’s has done a variety of things to make room for COVID patients. The Twin Falls hospital closed its pediatric unit and is sending patients to Boise and Meridian. All of St. Luke’s hospitals have stopped scheduling non-emergent procedures until Christmas, and many of those hospitals have cancelled surgeries already on the book.

St. Luke’s opened two units during the past two weeks, filling them immediately. And clinic doctors are now being put into hospital rotations.

“Never in my career did I think we would even contemplate the idea of rationing care in the United States of America. Never,” said Souza. “In October we began realizing (rationing) might be needed. Now, more probably than not…”

“We will have to tell people, ‘Sorry, there’s nothing we can do,’” added Dr. William Vetter of Valor Health in Emmett. “It kind of sucks. It's, 'I'm sorry, the line is full, you don't get it.' Whatever lifesaving thing you need, whether a life-saving treatment you need, whether it's delivering a baby via C-section or a heart attack, ventilator, whatever--you’re not going to get it.”

 Dr. Terry O’Connor, St. Luke’s Wood River emergency physician, recounted how COVID hit the Wood River Valley “like an inferno” in March and April, forcing St. Luke’s Wood River to close down surgeries and admissions and become a stand-alone ER transferring patients to regional hospitals.

Now, he is watching new cases of virus reach rates the valley experienced last March when Blaine County was one of the world’s hot spots. He can no longer admit patients to his hospital, nor can he transfer patients to Twin Falls. And he has to again assume that anyone he encounters has COVID.

More and more hospital employees are getting sick with COVID, which is hampering the hospital’s ability to care for patients, he said. Needing to don personal protective equipment leads to delays in dealing with those with cardiac arrests. And, he said, he might have to perform a stopgap procedure to open a blood vessel if he can’t get patients to specialists in timely fashion.

“We’re brainstorming everything we can, including virtual monitoring at home, home health tests, increased capacity for testing,” he said. “But, at the end of the day, it’s clear to me there’s another firestorm on the horizon. The smoke is blowing in, the air quality suffering. And it’s frustrating seeing people have what might be likened to bonfire parties in their yard.”

Doctors and nurses are exhausted, working longer shifts than they normally would in a continuing marathon. Watching patients die of COVID or leave the hospital debilitated is taking its toll. And the heroes of spring are now receiving pushback from the community.

“I feel kind of scared if I say what I feel,” Vetter said as he described a vocal contingent in his community trying to stifle the truth about the pandemic.

Souza called out what he called the “toxic minority”—those tweeting, retweeting and spreading conspiracy theories.

“At the end of the day, it’s not going to be okay to have a debate about whether the sky is blue or green. When so many people are sickened by this is our community and so many people are dying from this in our buildings, to allow conspiracy theorists to spread their non-patriotic narrative is unbelievable.”

Souza added that he would like to know when they’re going to stop giving oxygen to those who say COVID is a hoax, to those who say that there’s an effort to take away their freedom, to those who say there is an either/or choice….either we ignore our virus or ignore our economy.

“I never dreamed this would become so political. The morbidity is piling up and the mortality is piling up. The solutions are simple. They're not an invasion of freedom and at worse they're an inconvenience. It’s time for the quiet majority to take back this conversation,” he added.

St. Luke’s is not alone in being “jammed to the gills,” as Souza says.

Dr. Steven Nemerson, chief clinical officer of Saint Alphonsus, noted that Ada County has more than 800 active cases per 100,000 population and Canyon County more than 900. Any number over 100 is considered to be “severe prevalence.”

Primary Health Medical Group in Southern Idaho is doing between 500 and 600 tests a day and has a positivity rate of nearly 28 percent, when more than 5 percent is considered out of control.

There are few counties or states in the country that have a positivity rate that high. Once you get that rate, contract tracing to stem further spread is pointless, said Dr. David Peterman, CEO of Primary Health

Peterman said staff shortages have forced six clinic closures, which means some people can’t be treated. As many as 45 staff are out daily due to COVID and they’re getting 3,000 phone calls a day, which means they can’t get to them all.

Saltzer Health likewise is performing 1,600 tests a day compared with a few hundred a day earlier. The test positivity is 30.16 percent.

“And coming upon a holiday season, that only has the potential to get worse, said Dr. John Kaiser, chief medical officer of Saltzer.

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