BY DR. JIM SOUZA

PHOTO BY KAREN BOSSICK

COVID GRAPH BY PAUL RIES

Editor’s Note: Eye on Sun Valley received a copy of this letter on Saturday from a friend of The Eye. It offers a heartfelt look at the mounting crisis Idaho finds itself in from the head of St. Luke’s Health System. And it offers his thoughts as he prepares to receive training in how to address appeals from families whose loved one’s care may be restricted because of increasingly scarce resources.

Jim Souza, chief medical officer of St. Luke’s Health System, gave permission for the letter to be shared:

“Dear …

“Thanks for checking in. I appreciate your interest and your concern for our team. To be candid, the current situation with COVID-19 in our community has me very worried. In the past 4 weeks at St. Luke’s, we’ve gone from a challenging, but manageable, situation to one that is threatening our ability to provide adequate care to the community. First, the infection rates in our communities began to soar about 30 days ago. Here at St. Luke’s, our test positivity rate is now exceeding 30%.

“We have gone from about 30 adult COVID hospitalizations on any day to 135 today. It’s like watching a speeding freight train coming down the tracks. The ICU COVID admissions have more than doubled. This is on top of all of our other ICU care. 

“We’ve also had increasing numbers of our clinical staff out with confirmed COVID, almost 100% of it acquired in the community where this pandemic fire is out of control. Today, we had more than 140 clinical staff out with confirmed COVID, up from about 120 last week and less than 100 the week before.

“We have begun to shift nursing ratios and we have pulled clinic physicians from office settings to the hospital to staff our admissions. Because of this surge in activity, we have closed our pediatric unit in Twin Falls to make more adult beds, have stopped scheduling elective surgeries until Christmas and are actively canceling other elective care. In addition, we’ve been diverting patients from several of our smaller hospitals to downtown Boise. We’ve already opened at least a couple of additional units and filled them.

“The current out-of-control spread will cause one of two things to happen: We manage it by turning our facilities into COVID hospitals and ICUs. But this will come at an enormous cost to public health issues like cancer, heart disease, and stroke.

“The other possibility is that our surge planning also becomes overwhelmed, and the Governor needs to declare crisis standards. This would mean that we have to make terrible decisions on which patients get access to certain types of care, like ICU care. We will always provide care, but the full spectrum of care will not be available to everyone if we are resource-constrained. I am profoundly saddened, especially as I prepare to do my orientation next week to serve on the committee that will govern the appeals from families around these decisions. 

“This is something we have never done in healthcare in this country. And it is entirely preventable.

“Best prevention efforts are being hampered by the false narrative that we let COVID run rampant and save our economy or we shutter our economy and control COVID. This is nonsense. If we consistently apply the simple things, we will protect healthcare capacity AND we will protect jobs and the economy. We’re already doing this successfully in healthcare, by taking care of our employee and patient safety, while simultaneously keeping the lights on. We are proof you can achieve both.

“With Thanksgiving coming next week, I worry that many will let their guard down and decide to connect with friends and family. It’s hard. I get it. I want to be with my family, too. The idea of just one dinner is tempting. But this year, it just isn’t safe.

“You asked me what you could do to help. It’s simple, really. Wear a mask, wash your hands and avoid gatherings. These simple actions make a meaningful difference – if everyone in the community did them consistently, we’d be able to get the virus back under control.

“I know you have connections with a large network of women. Our community needs their help. Please ask them to follow these prevention steps, model them for others and plan a safe Thanksgiving by not gathering with others outside their immediate household. If we can work together, we can end the year in a better place.

“Thank you, Jim”

Editor’s Note: St. Luke’s and other health care providers are doing everything they can to avoid the worst-case scenario. And they hope they can do so, WITH the community’s help. Those needing care for anything, from heart issues to broken legs, are encouraged to seek help as they would normally.