Our community is in a crisis. The number of cases of COVID-19 that require admission to the hospital has exceeded our capacity to provide the high level of medical care that we depend on.

Kootenai Health was designed for 24 ICU beds, but with prudent foresight KH now has expanded to 46 by occupying most of the third floor of the hospital. We have had to use the surgery recovery room to keep critically ill patients while awaiting ICU beds. Because of the lack of physical beds in the hospital, we have had as many as 22 patients sitting in the emergency department waiting to get a bed in the hospital.

Nursing ranks are strained, resulting in nurses working double shifts to care for our patients.

Some nurses are caring for up to six patients assisted by teams of respiratory therapists, medical assistants and operating room technicians.

Physician assistants and nurse practitioners are stepping up to assist in patient care outside their specialty areas.

This dominant delta variant of COVID-19 is more contagious than the original alpha variant and it is more virulent: patients get sicker, get sicker faster and spread the virus more quickly.

Greater than 90% of COVID-19 patients at Kootenai health are unvaccinated.

As a result, Kootenai Health had to stop performing elective surgeries four weeks ago for lack of available beds and to deploy the OR staff to help care for COVID-19 patients.

It is likely that elective surgeries will be delayed for at least two more weeks.

By elective, I mean that we are doing only emergency surgeries that cannot wait more than 48 hours that threaten life or limb, such as brain bleeds, cardiac emergencies, abdominal trauma, acute traumatic bleeding, etc. Elective procedures may not be emergencies, but many are urgent. I have a patient who has spinal cord compression with progressing weakness that needs surgery, but must be delayed because of this crisis.

What concerns me as a practicing physician in Coeur d’Alene is that we are approaching the

point that we may have to triage who can be treated and who cannot based on our limited resources because of this COVID-19 surge. It is almost unthinkable that we may be forced to make these decisions because we are close to exhausting our resources.

Kootenai Health is continuing to adapt to this crisis in multiple ways by attempting to increase the number of ICU beds up to 68 patients, but dependent on adequate staffing. The hospital education building has been converted to three hospital wards, increasing bed capacity to accommodate patients. The crisis team had the foresight to apply for federal assistance one month ago and Kootenai Health has received some assistance from the Department of Defense and other federal staffing agencies to acquire more nurses and medical assistants.

This will help relieve the nursing workload, but it will not solve the problem.

We as the Coeur d’Alene community must act together to help solve this problem. We cannot expect that other hospitals can bail us out. All of the hospitals in the Pacific Northwest are dealing with similar stretched resources and are responsible primarily to their own communities.

Here is what we can do right now to prevent a health care disaster and further unnecessary loss of life:

Get vaccinated now.

COVID-19 is preventable.

There is no medical cure at this time.

The Pfizer, Moderna and the Johnson & Johnson vaccines all prevent serious illness and usually prevent hospitalization. All of these vaccines are effective against the delta variant of COVID-19, which accounts for the great majority of cases in Coeur d’Alene.

CDA Press

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