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Idaho Enters Crisis Standards Of Care, Region Struggles Against COVID-19 Surge

Hospital workers wearing masks and scrubs move quickly.
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Idaho entered crisis standards of care Thursday, becoming the first state in the region to do so. Those standards tell hospital workers how to ration care now that they're running low on resources and beds because of a surge in largely unvaccinated people getting COVID-19.

But Idaho isn't the only state in the Mountain West getting overwhelmed. Several providers across the region are preparing to move into crisis standards of care, while others did weeks ago.

Billings Clinic, Montana's largest healthcare system, said on Wednesday it was preparing to make that move.

"Although not yet in place at Billings Clinic, implementation of these measures may be needed as early as this week if COVID-19 volumes don’t slow down," the provider said in a press release.

Intermountain Healthcare is the largest healthcare provider in the region, serving Utah, Idaho, and Nevada. It has also been overburdened with COVID-19 cases and is postponing non-urgent surgeries and procedures "to support ICUs and acute care units and staffing needs."

Ben Smalley is one of its hospital administrators in southern Idaho.

"We anticipate this getting worse before it gets better. And so I think it’s absolutely a possibility that other states may need to move to crisis standards of care as well," he said.

He described one potential scenario specific to COVID-19 that hospitals may face.

"If there's multiple people who need a ventilator, crisis standards of care may say, 'Well, we're at a point where there's so many people who need a ventilator, and there are only so many ventilators available,' then you're now making those difficult decisions about who gets the ventilator and who doesn't."

Earlier this month, Cody Regional Hospital in Wyoming also had to initiate crisis standards of care. Kim Deti, the public information officer for the Wyoming Department of Health, said it makes the most sense for a facility to decide to enter crisis standards of care or not, since the situation can be very fluid—the availability of beds and other resources can change on a day to day basis.

"If the hospital in one town is really under the gun, the hospital in the other part of the state might not be feeling the same pressure at the same time," she said.

At the same time, Deti said Wyoming will feel the impacts of strained hospitals in neighboring states, like Idaho. For example, there are no pediatric ICU beds in Wyoming.

"So if the level of illnesses have increased so much that the places that do have the pediatric ICU beds, for example, in another state, they can't accept the transfer, then that affects the carer, and affects people in our state too," she said.

She also added it's not just about bed availability or physical space, it's "about having staff to care for the patients too."

Like many public health officials, Deti said one way to combat overwhelmed hospitals is to increase vaccination rates.

"They're free. They're safe. They're effective," she said.

Meanwhile, public health officials in New Mexico say they have come very close to making the activation, but remain cautiously optimistic.

This story was produced by the Mountain West News Bureau, a collaboration between Nevada Public Radio, Wyoming Public Media, Boise State Public Radio in Idaho, KUNR in Nevada, the O'Connor Center for the Rocky Mountain West in Montana, KUNC in Colorado, KUNM in New Mexico, with support from affiliate stations across the region. Funding for the Mountain West News Bureau is provided in part by the Corporation for Public Broadcasting.

Maggie Mullen is Wyoming Public Radio's regional reporter with the Mountain West News Bureau. Her work has aired on NPR, Marketplace, Science Friday, and Here and Now. She was awarded a 2019 regional Edward R. Murrow Award for her story on the Black 14.
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