>> THIS PRESENTATION OF IDAHO REPORTS IS MADE POSSIBLE THROUGH THE GENEROUS SUPPORT OF THE LAURA MOORE CUNNINGHAM FOUNDATION, COMMITTED TO FULFILLING THE MOORE AND BETTIS FAMILY LEGACY OF BUILDING THE GREAT STATE OF IDAHO.

BY THE FRIENDS OF IDAHO PUBLIC TELEVISION, AND THE CORPORATION FOR PUBLIC BROADCASTING.

>> HELLO AND WELCOME TO THIS SPECIAL EPISODE OF IDAHO REPORTS.

I'M MELISSA DAVIS, AND TONIGHT WE ARE TAKING A LOOK AT THE RIPPLE EFFECTS OF HOSPITALS BEING OVERRUN WITH COVID POSITIVE PATIENTS, NEARLY ALL OF WHOM ARE UNVACCINATED.

TRAVIS MYKALBUST, CHIEF OF THE LEWISTON FIRE DEPARTMENT, SHARES HOW THIS SURGE IS AFFECTING EMERGENCY RESPONSE TIMES ACROSS THE STATE.

THEN PRODUCER RUTH BROWN TALKS TO SAM McCOMAS, ASSOCIATE DIRECTOR OF PATIENT CARE SERVICES, AND CHIEF NURSE EXECUTIVE AT MANN-GRANDSTAFF V.A.

MEDICAL CENTER IN SPOKANE ABOUT HOW VETERANS CARE HIS FACILITY IS AFFECTED BY NORTH IDAHO'S OVERWHELMED HOSPITALS.

FIRST ON WEDNESDAY MORNING, NEARLY A WEEK AFTER THE DEPARTMENT OF HEALTH AND WELFARE ACTIVATED CRISIS STANDARDS OF CARE STATEWIDE, SAINT ALPHONSUS IN BOISE INVITED IDAHO REPORTS TO TOUR ITS EMERGENCY DEPARTMENT, TRAUMA CENTER, AND LIFEFLIGHT COMMUNICATIONS CENTER TO SEE HOW COVID IS AFFECTING THE HOSPITAL'S ABILITY TO DELIVER HIGH QUALITY CARE TO EVERYONE WHO NEEDS IT.

WE ALSO GOT A LOOK AT THE ICU, WHERE WE SAW ROOM AFTER ROOM OF SEDATED, VENTILATED, COVID PATIENTS, NOT ALL OF WHOM WOULD BE GOING HOME.

THESE ARE PLACED ON THE WINDOW SILL OF A PHYSICAL THERAPY ROOM AT SAINT ALPHONSUS IN BOISE.

THE GYM HAS BEEN CONVERTED TO PATIENT CARE SPACES DURING THIS COVID-19 SURGE.

THE ROOM ISN'T OUTFITTED WITH CALL BUTTONS.

BELLS ARE THERE TO HELP THE PATIENT PATIENTS FROM THE NURSE WHERE IS THEY NEED HELP.

IN MID SEPTEMBER, IDAHO ACTIVATED CRISIS STANDARDS OF CARE STATEWIDE WHICH ALLOWS HIGHER NURSE TO PATIENT RATIOS AND GIVES HEALTH CARE PROVIDERS A FRAMEWORK ON HOW TO USE LIMITED RESOURCE LIKE BEDS OR VENTILATORS, IN EXTREME EMERGENCIES.

IN THIS CASE, THAT EXTREME EMERGENCY IS COVID-19.

AND UNVACCINATED PATIENTS FILL HOSPITALS ACROSS THE STATE.

BUT THE CRISIS STANDARDS OF CARE DOESN'T MEAN THAT PEOPLE WON'T GET NEEDED CARE.

>> CRISIS STANDARDS OF CARE ALLOWS HOSPITALS TO BE MORE CREATIVE, TO BE -- TO PUT INTO PLACE THE PROCESSES THAT DIDN'T EXIST BEFORE, TO MEET THE EXTRA DEMAND.

IT HAS NOTHING TO DO WITH THE UNIVERSAL DNR OR ANYTHING LIKE THAT.

>> WHEN IDAHO REPORTS VISITED THE CENTER ON WEDNESDAY MORNING, THE EMERGENCY DEPARTMENT WAS QUIET.

THAT CAN CHANGE RAPIDLY, SET DR. FILLMORE, THE MEDICAL CENTER DIRECTOR.

>> WHEN IT IS NOT QUIET, YOU WILL SEE A PATIENT IN EVERY ROOM, AND EVERY BED, AND EVERY HALLWAY.

IT'S HARDER TO GET AROUND, TRYING TO GET AROUND PEOPLE, AT LEAST THREE OR FOUR PEOPLE GO IN DIFFERENT DIRECTION, AND YOU WILL SEE THE NURSES REALLY HUSTLING.

THEY ARE WORKING DOUBLE TIME, NOT ONLY THE HOURS, BUT JUST HOW FAST THINGS ARE HAPPENING IN THE EMERGENCY ROOM.

IT MAY TAKE LONGER TO BE SEEN BY, YOU KNOW, YOUR DOCTOR, AND THEY TAKE LONGER FOR THAT NURSE TO COME BACK AND TO CHECK ON YOUR PAIN LEVEL, CHECK ON THE RESPONSE TO ANY TREATMENT THAT'S RECEIVED.

IT MAY TAKE LONGER TO GET IMAGING AND MAY TAKE LONGER TO GET IMAGING RESULTS BACK, SO THERE IS A BIT OF A STRETCH IN TERMS OF WHEN THINGS HAPPEN.

>> HOURS AFTER DECLARING CRISIS STANDARDS OF CARE STATEWIDE, THE IDAHO DEPARTMENT OF HEALTH AND WELFARE DIRECTOR DAVE JEPSON EXPERIENCED THAT REALITY FOR HIMSELF.

>> MY MOM HAD A STROKE THURSDAY MORNING, A FEW HOURS AFTER THE CRISIS CARE WAS ACTIVATED STATEWIDE.

IT WAS STRESSFUL.

MY MOM HAD A STROKE.

I WAS WORRIED, AND ABOUT THE AVAILABILITY OF THE HEALTH CARE WHEN SHE WENT TO THE E.R..

THERE WERE OTHER PATIENTS RECEIVING CARE IN THE WAITING ROOM.

THERE WAS A CONCERN THAT SHE HAD BROKEN BONES.

THE X-RAYS WERE DONE IN A NON-ADDITIONAL X-RAY AREA, WITH A LONGER WAIT THAN USUAL.

FORTUNATELY, SHE DID NOT BREAK ANY BONES.

NORMALLY, THE PERSON IN HER CONDITION WOULD BE HELD FOR OBSERVATION.

BECAUSE OF THE CRISIS STANDARD OF CARE, AFTER SHE WAS STABLE, SHE WAS DISCHARGED FROM THE E.R.

>> WHEN YOU COME TO THE EMERGENCY ROOM, YOU HAVE A WIDE VARIETY OF PATIENTS.

YOU HAVE THE PATIENTS WHO COME WITH CHRONIC PROBLEMS.

YOU HAVE PATIENTS WHO COME WITH EMERGENCIES THAT NEED IMMEDIATE ACTION.

YOU ARE NOT WAITING FOR THAT TO TAKE PLACE.

>> SAINTS ALPHONSUS IS A LEVEL TWO CENTER.

IF YOU GET INTO A CAR ACCIDENT, THERE IS A CHANCES THAT YOU WILL END UP HERE.

RIGHT NOW, YOU WILL GET A HIGH LEVEL OF CARE.

>> FROM A TRAUMA PERSPECTIVE, THINGS REALLY HAVEN'T CHANGED TOO MUCH FOR US.

WE ARE STILL SEEING THE SAME TYPE OF PATIENTS WE SAW BEFORE AT ABOUT THE SAME VOLUME AS BEFORE, SO FROM A LOGISTICS, OPERATIONAL STANDPOINT, TRAUMA HASN'T CHANGED DRASTICALLY.

>> WHEN WE TALK ABOUT CRISIS STANDARD OF CARE WE GET IN THE MINDSET THAT WE ARE MAKING THE DOOR SMALLER.

IT IS HARDER TO GET CARE.

THAT'S NOT WHAT YOU ARE GOING TO SEE.

WE ARE MAKING THE ROOM BIGGER.

>> OR CONVERTING ROOMS.

THIS IS A FORMER STORAGE ROOM THAT HAS BEEN SET UP FOR TRANSFUSIONS AT SAINT ALPHONSUS.

THE ITEMS STORED HERE HAVE BEEN MOVED TO A CONFERENCE ROOM ACROSS THE HALL.

THIS IS AN OPERATING THEATER THAT NOW HAS NEWLY SET UP ICU BEDS.

NOW THAT NON-EMERGENCY SURGERIES HAVE BEEN SUSPENDED, THIS SPACE CAN BE USED TO TREAT COVID AND% OTHER PATIENTS.

>> MY MENTOR WOULD ALWAYS SAY, CRITICAL CARE IS NOT JUST A PHYSICAL LOCATION, IT'S A STATE OF MIND.

SO WE CAN DELIVER THAT CRITICAL CARE IN THE EMERGECY ROOM.

WE CAN DELIVER THAT CRITICAL CARE IN AN OPERATING ROOM, IN A RECOVERY ROOM.

WE DON'T HAVE TO BIG TIED TO ANY PHYSICAL LOCATION.

>> THAT'S GOOD NEWS FOR PATIENTS WITH EMERGENCIES AND INJURIES.

THEY WILL GET CARE.

BUT THE CONVERSION OF OPERATING THEATERS AND PHYSICAL THERAPY ROOMS TO COVID UNITS COMES AT A COST TO OTHER PATIENTS WHO ARE WAITING FOR SURGERIES TO REMOVE TUMORS, OR ARE IN PAIN WHILE THEIR HIP REPLACEMENTS ARE DELAYED INDEFINITELY.

UPSTAIRS THE INTENSIVE CARE UNITS AND CARDIAC INCENTIVE CARE UNIT ARE FILLED WITH COVID POSITIVE PATIENTS.

THERE WERE 26 COVID PATIENTS ON WEDNESDAY MORNING, BUT THAT'S A NUMBER THAT FLUCTUATES OFTEN AS PATIENTS ARE ADMITTED, DISCHARGED, OR DIE.

DURING OUR VISIT, THE NURSES WERE PREPARING TO END LIFE-SAVING TREATMENT FOR ONE PATIENT AFTER CONSULTING WITH THEIR FAMILIES.

OTHER HEALTH CARE WORKERS HAD JUST FINISHED SHIFTING PATIENTS INTO PRONE POSITIONS.

THE ICU WAS SILENT, WITH MOST PATIENTS SEDATED AND ON VENTILATION.

EARLIER IN THE WEEK, DR. JIM SOUZA OF SAINT LUKES HEALTH SYSTEM SAID I SEE PATIENTS HIS FACILIY HAVE A HIGHER MORTALITY RATE THAN PREVIOUS SURGES.

>> THE MORTALITY IS AROUND 28%.

FOR THOSE WHO GO TO THE ICU AND SURVIVE, THEY WILL BE TERRIBLE FOR A PERIOD OF TIME, WE ARE TALKING MONTHS.

>> NOT ALL IDAHO HOSPITALS HAVE THE ABILITY TO CARE FOR CRITICALLY ILL COVID PATIENTS, AND INCREASINGLY, CRITICAL ACCESS FACILITIES ARE RELYING ON LIFEFLIGHT TO TRANSFER THOSE PATIENTS TO REGIONAL HOSPITALS.

AND AT THE SAINTS ALPHONSUS CAMPUS, LIFEFLIGHT OPERATES A COMMAND CENTER THAT COORDINATES PATIENT TRANSPORTATION FROM THE WASHINGTON AND THE OREGON COASTS TO MONTANA, WITH 26 BASIS CURRENTLY IN OPERATION.

OFTEN, THAT MEANS GETTING PATIENTS FROM SMALLER, CRITICAL ACCESS LIKE THOSE IN BLACK FOOT OR SALMON, TO THE NEAREST TRAUMA CENTER OR REGIONAL CARE CENTER, WHETHER THAT'S IN PORTLAND OR IDAHO FALLS OR BOZEMAN.

AND LATELY, THOSE CALLS ARE MORE FREQUENT, AND SOME PATIENTS ARE TRAVELING LONGER DISTANCES FOR BEDS, LIKE FROM COEUR D' ALENE TO TWIN FALLS.

MOST OF THE TIME TRANSPORTATION HOME IS THE PATIENT'S RESPONSIBILITY, AND THOSE BILLS CAN BE THOUSANDS OF DOLLARS.

>> I HEARD A VERY, YOU KNOW, A SAD STORY RECENTLY ABOUT A CRITICAL ACCESS HOSPITAL, REALLY STRUGGLING TO FIND A PLACE TO TRANSFER TH -- THEIR PATIENTS.

A PATIENT WHO WAS BLEEDING AND NEEDED A HIGH LEVEL OF CARE.

THEY MENTIONED THEY CALLED 30 OR 40 DIFFERENT FACILITIES, AND ALL OF THEM SAID, WE ARE FULL.

>> THE DOCTOR FILLMORE EMPHASIZED THOSE CARE GIVE USER WILL KEEP CALLING UNTIL THEY FIND A BED.

>> I THINK THAT IS A SIGN OF A ROBUST HEALTH SYSTEM, RIGHT.

THAT WE CAN COORDINATE CARE, NO MATTER WHERE YOU ARE, RIGHT, THAT WE CAN USE OUR RESOURCES TO THE M MAXIMUM.

>> EVEN IF THOSE INCLUDE BELLS IN LIEU OF CALL BUTTONS.

DR. FILLMORE SAID THAT IN ADDITION TO GETTING VACCINATED, IDAHOANS CAN HELP TO EASE THE STRAIN ON THE HEALTH CARE SYSTEM BY TAKING CARE OF THEMSELVES AND AVOIDING DANGEROUS SITUATIONS THAT MIGHT LAND THEM IN THE EMERGENCY ROOM.

OUR THANKS TO SAINT ALPHONSUS AND LIFEFLIGHT FORGIVING US ACCESS.

FOR SOME PATIENTS, IN EMERGENCY SITUATIONS THEIR FIRST ENCOUNTER WITH THE HEALTH CARE SYSTEM IS EMS, AFTER A 9-1-1 CALL.

ON FRIDAY, I SPOKE TO TRAVIS, THE CHIEF OF THE LEWISTON FIREARM AND PRESIDENT OF THE IDAHO FIRE CHIEFS ASSOCIATION ABOUT HOW THE INCREASE IN EMERGENCY CALLS RELATED TO COVID IS AFFECTING THE RESPONSE TIMES AND THE PATIENT TRANSPORT SERVICES.

>> HOW IS THE RECENT SURGE IN COVID CASES AFFECTE YOUR ABILITY TO RESPOND IN A TIMELY MANNER?

>> WELL, YOU KNOW, THE COVID CALLS DEFINITELY HAD AN UPTICK OVER THE LAST FEW WEEKS, AND THEY ADD THAT TO THE ALREADY CURRENTS CALL VOLUME.

IT HAS BEEN A BUSY SUMMER ALONE, AND YOU ADD THE COVID TO IT.

IT'S BEEN REALLY HARD.

WE, ACTUALLY, LAST MONTH, WAS THE LARGEST NUMBER ON RECORD IN OUR DEPARTMENT'S HISTORY FOR THE NUMBER OF EMS CALLS, AND IN A MONTH, AND AS WE ARE FINISHING UP THIS MONTH, WE ANTICIPATE THAT WE WILL BREAK AN ALL-TIME DEPARTMENT RECORD FOR THE NUMBER OF EMS CALLS.

>> HOW DOES THAT AFFECT YOUR RESPONSE TIMES?

>> YOU KNOW, IT THROWS A CHALLENGE, AND IT IS REQUIRING US TO LOOK SAT PRIORITIZING IT, AND I SEE THAT IT HASN'T IMPACTED US AS MUCH, AND THAT'S BECAUSE OF MY STAFF.

I HAVE -- WE CALL THEM THE TURN AND BURN.

THEY GO ON A CALL, THEY GET TO THE HOSPITAL, DROP THE PATIENT OFF AND AS SOON AS THEY CAN GET THE GURNEY AND SUPPLIES, THEY ARE GOING TO THE NEXT CALL, WHICH THEN CREATES A BIG DEFICIT ON OUR REPORT RIDING.

BUT YOU KNOW, WE ARE HAVING TO PRIORITIZE WHETHER WE ARE SENDING AN INJURED COMPANY TO A CALL OR A CHIEF OFFICER OR A MEDIC CREW UTILIZING MUTUAL AID.

WE GO TO ALL CALLS, SO IF WE ARE TIED UP ON EMS, AND WHAT WE ARE SEEING IS WE ARE SEEING WHAT WE CALL, CALL CONCURRENCY.

WHEN WE GET ONE CALL, WE ARE SEEING THREE OR FOUR CALLS IN THE NEXT TEN MINUTES.

SO WE ARE CALLING AN OFF-DUTY PERSONNEL, AND IT BECOMES A VERY BIG CHALLENGE.

>> YOU ARE PRESIDENT OF THE IDAHO FIRE CHIEFS ASSOCIATION.

WHAT ARE YOU HEARING FROM OTHER FIRST RESPONDERS AROUND THE STATE?

>> I JUST HAD A BOARD MEETING WITH THE BOARD OF DIRECTORS WITH -- FROM THE BOARD OF DIRECTORS, AND THE MESSAGE IS SIMPLE, EVERY DEPARTMENT IS SEEING A SIRGD AMOUNT OF CALL VOLUME, WHICH IS TAXING THEIR SYSTEM, AND MORE IMPORTANTLY, IT'S TAXING OUR EMPLOYEES.

WE'VE BEEN DEALING WITH COVID FOR 18 MONTHS, AND NOW WITH THIS LAST DELTA VARIANT SURGE, THEY ARE WARN DOWN, AND COMING OFF OF A WILDFIRE SEASON OF ONE WE HAVE NEVER HAD BEFORE, AND IT IS TRULY -- WE ARE REALLY WORRIED ABOUT THEM BEING WARN OUT.

THAT'S THE MESSAGE ACROSS THE STATE IS THAT OUR -- WE ARE GOING ON A LOT OF CALLS, AND EVERYBODY IS HAVING TO PRIORITIZE THE RESPONSES.

WHAT WE DON'T WANT TO DO IS, YOU KNOW, HAVE TO DELAY RESPONSES, BUT BECAUSE OF PRIORITY DISPATCHING, WE MAY TAKE AN ACUITY CALL AND WAIT TEN MINUTES BEFORE WE CAN GET SOMEONE HEADING THAT WAY.

>> YOU MENTIONED YOUR EMPLOYEES A COUPLE TIMES, AND YOU MENTIONED THAT THEY TURN AND BURN.

THEY TURN AROUND AND THEY GO RIGHT TO THE NEXT CALL.

AND HAVE THEY ALSO HAD TO DEAL WITH THEMSELVES BEING OUT AND HAVING TO ISOLATE OR BE IN QUARANTINE BECAUSE OF THEIR OWN EXPOSURE?

>> YOU KNOW, HERE IN LEWISTON, WE HAVE DONE WELL WITH -- WE HAVE STANDARDS OF HOW WE LIVE IN THE FIRE STATIONS, AND HOW WE GO ON CALLS AND TAKING OUT PROTECTIVE MEANS THAT WE CAN, BUT YEAH, IT HAS AN IMPACT, AND THE BIGGER IMPACT IS THOSE THAT ARE OFF IN QUARANTINE, SOMEBODY, WE HAVE TO KEEP THE STAFFING LEVELS UP, SO EVEN THIS MORNING, I HAD A MEETING WITH ONE OF MY ITALIAN CHIEFS.

WE HAD TO MANDATORILY REQUIRE AN EMPLOYEE -- THAT'S HAVING TO WORK 16 HOURS OF OVERTIME TODAY BECAUSE WE ARE SHORT STAFFED, AND WE HAVE TO KEEP THE STAFFING AND WE HAVE HAD RECORD NUMBERS OF OVERTIME THIS YEAR DUE TO WILDFIRES AND CALLS, AND SO NOW, THEY JUST FINISHED THE 20-HOUR SHIFT, WE ARE MANDATORILY MAKING THEM WORK 16 HOURS, THEY ARE GOING TO GET AN EIGHT HOUR BREAK AND COME BACK TOMORROW AND FINISH ANOTHER 24-HOUR SHIFT.

WITH THE CALL VOLUME, WE USUALLY AVERAGE 20-23 CALLS A DAY.

WE WERE POPPING 46-50 CALLS A DAY RIGHT NOW WITH THE SAME STAFFING LEVEL, AND THAT'S WHAT WE WORRY ABOUT, AND THAT'S WHAT I AM HEARING ACROSS THE BOARD WITH EMS AGENCIES AND FIRE DEPARTMENTS IN IDAHO.

>> WE KNOW THAT A NUMBER OF PATIENTS IN RURAL IDAHO HAVE TO BE TRANSPORTED TO LARGER HOSPITALS FROM CRITICAL ACCESS HOSPITALS.

WHAT'S YOUR ROLE IN THAT AND WHAT ARE YOU SEEING?

>> SO, OUR ROLE IS WE TRY TO SUPPORT S -- OUR RURAL HOSPITALS AND STAFF.

WE STRUGGLED BECAUSE WE USE OUR OFF-DUTY FIRE AND EMS PERSONNEL TO TAKE THE TRANSPORTS, SO WE KEEP OUR ON-DUTY CREWS FOR THE 9-1-1 CALLS, AND BECAUSE OF THE WORKLOAD AND THE CALL VOLUME IS, IF THEY GET EIGHT HOURS OFF, THEY ARE NOT ANSWERING THEIR PHONE.

THEY ARE NOT COMING IN, SO THAT IS HAVING AN IMPACT TO WHERE WE ARE HAVING TO SAY NO MORE THAN WE EVER HAD BEFORE FOR THESE DISTANCE TRANSPORTS OF BRINGING PATIENTS FROM THE RURAL ACCESS HOSPITALS IN, OR BRINGING SOME OF OUR PATIENTS BECAUSE THE HOSPITALS ARE -- MAYBE THE RURAL ACCESS HOSPITAL IS THE ONLY HOSPITAL WITH A BED THAT WE CAN GET A PATIENT INTO, AND SO WE ARE -- WE ARE HAVING TO SAY NO MORE THAN WE EVER HAVE BEFORE.

AND I DON'T HOLD THAT AGAINST MY PERSONNEL.

THEY HAVE TO REST.

WE ARE ALL WORN OUT.

WHAT WE ARE FACING.

>> WHEN A PATIENT NEEDS A BED, AND YOU AREN'T AIRCRAFT TRANSPORT THEM, WHAT HAPPENS TO THAT PATIENT?

>> YOU KNOW, IT'S AN INTERESTING DEAL BECAUSE THAT BED, IF THE MEDICAL FACILITY, IT'S LIKE A LOTTERY, YOU GET THE BED, AND IF THEY CANNOT GET THE PATIENT TRANSPORTED OR EN ROUTE WITHIN A PERIOD OF TIME, THEY MAY LOSE THAT BED COMPLETELY, WHICH THEN NOW THAT TAKES THE MEDICAL FACILITY HAVING TO GO BACK THROUGH THE PROCESS OF CALLING AND TRYING TO FINDS ANOTHER PLACE, AND SO THAT IS ONE OF THE IMPACTS THAT WE ARE SEEING, AND MAYBE THAT PATIENT IS STUCK IN THE EMERGENCY ROOM, WHICH NOW IS, IF WE TRANSPORT AN EMERGENCY CALL IN, YOU KNOW, THEY MAY HAVE TO WAIT IN THE WAITING ROOM FOR A FEW HOURS BECAUS, YOU KNOW, OUR EMERGENCY ROOMS MAYBE HAVE 20 BEDS, WELL, IF THEY ARE HOLDING THE PATIENTS BECAUSE THERE IS NO PLACE IN THEIR FACILITY OR ANOTHER, MAYBE NOW WE ARE DOWN TO A 12-BED E.R.

INSTEAD OF 20, AND THAT'S AN IMPACT WHERE THE MOTOR VEHICLE ACCIDENTS, WE ARE SEEING A LOT OF SITUATIONS IN MOTORCYCLE AND MOTORCYCLE VEHICLE AND ILLNESSES NOT COVID RELATED, AND SO ALL THIS JUST KIND OF CREATES THE PERFECT STORM TO WHERE WE SEE THESE CRITICAL PATIENTS OF ARE WE GOING TO BE ABLE TO GET THEM THE CARE THAT THEY NEED AND THE TIME FRAME THAT THEY NEED.

>> HOW ABOUT PATIENTS WHO NEED TO MOVE TO HOSPITALS THAT ARE EVEN FARTHER AWAY.

WHAT'S LIFEFLIGHT'S RULE IN THAT?

>> YEAH.

SO USUALLY, IF THEY ARE A FARTHER DISTANCE, THEY ARE BRINGING IN THEIR FIXED WING PLANES, AND THAT CREATES ANOTHER IMPACTS ON US BECAUSE WE HAVE TO GET THE FLIGHT CREW TO THE HOSPITAL, AND THE PATIENT AND THE FLIGHT CREW BACK TO THE AIRPORT, AND THOSE CALLS CAN TAKE 45 MINUTES TO AN HOUR, AND THAT TAKES ONE OF OUR PRIMARY 9-1-1 AMBULANCES SERVICE, SO WE ARE WORKING WITH OUR MUTUAL AID PARTNERS TO SEE OKAY, WHO HAS AN AVAILABLE RESOURCE?

CAN WE GET THEM THERE?

AND YOU KNOW, UNDER THE CRISIS CARE STANDARDS, IT ALLOWS US TO SEND A SINGLE PROVIDER ON THE VEHICLE BECAUSE THE LIFEFLIGHT CREWS ARE PROVIDING THE PATIENT CARE, BUT WE ARE GETTING CREATIVE AND DOING THINGS THAT I HAVE NEVER SEEN BEFORE, AND TALK ABOUT -- I ALWAYS SAY, I AM THINKING OUT OF THE BOX, IN THE LAST 18 MONTHS I HAVE NEVER THOUGHT MORE OUT OF THE BOX THAN WE HAVE JUST TO MAKE SURE THAT WE ARE CONTINUING TO PROVIDE THE SERVICES THAT OUR COMMUNITIES DESERVE.

>> WHAT CAN PEOPLE DO RIGHT NOW TO EASE THE STRAIN ON RESOURCES THAT FIRST RESPONDERS ARE EXPERIENCING?

>> WEAR YOUR SEAT BELT, YOUR HELMET.

THE WEATHER THIS WEEKEND WILL BE WARM.

PEOPLE WILL BE IN THE WATER, WE SEE DROWNINGS.

THE FISHING SEASON -- DOING THOSE PREVENTATIVE MEASURES THAT WE CAN DO FOR THE EMERGENCIES THAT ARE GOING TO CONTINUE TO HAPPEN WHETHER WE ARE IN A PANDEMIC OR NOT, AND REALIZING, YOU KNOW, IF YOU NEED AN EMERGENCY, IF YOU ARE TRULY HAVING AN EMERGENCY, PLEASE CALL US.

THE OTHER IS DON'T PUT OFF YOUR HEALTH CARE.

THAT'S ONE OF THE THINGS THAT WE ARE SEEING IS PEOPLE ARE SICKER BECAUSE THEY HAVE BEEN PUTTING OFF JUST GOING TO THE DOCTOR, AND YES, WE ARE IN A PANDEMIC, BUT THAT HAS A BIG IMPACT THAT THEN TRICKLES DOWN, AND NOW WE ARE PUTTING A BIGGER LOAD ON THE 9-1-1 SERVICES AND DELAYING RESPONSES.

SO IF WE CAN PREVENT THAT, I THINK THAT'S THE MOST IMPORTANT THING THAT WE CAN DO IS JUST PROBLEM ACTIVE AND FOLLOW THE PREVENTATIVE MEASURES THAT WE'VE BEEN TALKING ABOUT.

>> ALL RIGHT.

LEWISTON FIRE DEPARTMENT CHIEF, TRAVIS MYKALBURST.

THANK YOU VERY MUCH FOR JOINING US TODAY.

>> THANK YOU FOR HAVING ME ON.

>> YOU CAN WATCH MY FULL INTERVIEW WITH THE CHIEF ON-LINE, VISIT YOUTUBE.COM/IDAHOREPORTS.

IDAHO'S HOSPITALS ARE NOT THE ONLY ONES AFFECTED BY THE STATE'S RECENT SURGE.

ON FRIDAY, PRODUCER RUTH BROWN SPOKE TO SAM McCOMAS, ASSOCIATE DIRECTOR OF PATIENT CARE SERVICES AND CHIEF NURSE EXECUTIVE AT MANN-GRANDSTAFF V.A.

MEDICAL CENTER IN SPOKANE ABOUT HOW THE INFLUX OF COVID PATIENTS HAS AFFECTED CARE FOR VETERANS AT HIS FACILITY.

SAM, I APPRECIATE YOU BEING HERE WITH ME TODAY.

CAN YOU WALK ME THROUGH A BIT OF HOW HAS THE LATEST SURGE IN IDAHO IMPACTED THE V.A.

IN SPOKANE?

>> YEAH.

THERE'S BEEN A LOT.

OUR FACILITY IS ONLY ABOUT 20-30 MINUTES FROM THE STATE LINE, AND JUST A LITTLE FARTHER TO THE MEDICAL CENTER IN COEUR D' ALENE, IDAHO, AND THAT COVERS THIS AREA.

OUR AREA IS INCLUDED IN THAT, AND WE HAVE BEEN IN CLOSE COLLABORATION WITH THE KUEHNE MEDICAL CENTER SPECIFICALLY ABOUT WHAT WE CAN DO TO HELP THEM ASSIST CARE FOR PATIENTS, BOTH VETERAN AND NON-VETERAN PATIENTS ALIKE, AND THAT IS INCLUDED.

WE HAVE BEEN ABLE TO ADMIT PATIENTS FROM THE MEDICAL CENTER AND TRANSFER THEM TO OUR FACILITY, AND SOME OF THOSE ARE VETERAN PATIENTS.

SOME OF THOSE ARE NON-VETERAN PATIENTS.

HOWEVER, WHEN WE COME FROM THE V.A., WE CALL IT A MISSION OR A HUMANITARIAN MISSION.

WE WANT TO DO WHAT WE CAN TO HELP OUT, AND ANY PATIENT THAT WE CAN ADMIT TO OUR HOSPITAL HERE IN SPOKANE OPENS UP IS A BED FOR THE MEDICAL CENTER TO HAVE MORE CAPACITY TO CARE FOR A PATIENT IN THEIR FACILITY.

SO WE FEEL LIKE IT'S A COMMUNITY EFFORT, AND WE ARE HAPPY TO BE PART OF THAT.

>> THE PANDEMIC HAS PUT AN UNUSUAL STRAIN ON ALL HEALTH CARE FACILITIES.

HOW UNPRECEDENTED IS IT FOR A V.A.

MEDICAL, EXCUSE ME, A V.A.

MEDICAL CENTER TO ACCEPT CIVILIAN PATIENTS?

>> YEAH, THIS IS A UNIQUE -- THIS IS SOMETHING WE DID DURING THE COVID PANDEMIC DURING THE FIRST PEAK AND SOMETHING WE ARE DOING NOW.

ISSUE THAT OTHER V.A.

MEDICAL CENTERS ARE IN COLLABORATION WITH THEIR COMMUNITY PARTNERS, AND BUT, IT IS SORT OF THE FIRST TIME DURING THIS COVID PANDEMIC, THE FIRST TIME THAT WE HAVE DONE IT.

WE TALKED ABOUT IT, AND WE MADE COMMUNICATION, AND WE MADE PARTNERSHIPS WITH OUR COMMUNITY PARTNERS AND THE HOSPITAL COMMUNITY PARTNERS, BUT THIS IS THE FIRST TIME THAT WE HAVE DONE IT, AND WE FEEL LIKE IT'S A GREAT HONOR AND A GREAT OPPORTUNITY.

SOME OF THE DATA, IF I CAN JUST TAKE A SECOND TO SHARE, YOU KNOW, UP TO THIS POINT, DURING THE LAST COUPLE OF WEEKS, ABOUT THREE WEEKS OR SO, WE HAVE ADMITTED A TOTAL OF EIGHT PATIENTS FROM THE MEDICAL CENTER.

TWO OF THOSE WERE NON-V.A.

PATIENTS.

SIX OF THOSE WERE VETERAN PATIENTS.

ONE OF THE DAUGHTERS OF ONE OF THOSE HUMANITARIAN PATIENTS THAT WE ADMITTED, HER MOTHER WAS ADMITTED HERE, AND WE CARED FOR HER HERE FOR A FEW WEEKS.

UPON TRIAGE AND EVALUATION IN THE EMERGENCY ROOM, HER MOTHER WAS PRELIMINARILY TOLD THAT WE MAINTENANCE BE ABLE TO ADMIT YOU EVEN THOUGH YOU MAY OR MAY NOT MEET CRITERIA, JUST BECAUSE WE ARE SO TIGHT.

AND THEN WE WERE ABLE TO, IN COLLABORATION WITH OUR PARTNERS THERE, TO OFFER THE PATIENT AN ADMISSION HERE, AND THE DAUGHTER WAS THANKFUL THAT WE WERE ABLE TO OFFER ADMISSION TO THAT PATIENTS HERE, AND SHE WAS VERY COMPLIMENTARY TO THE CARE THAT WE WERE ABLE TO PROVIDE HERE.

SHE IS ALSO A HEALTH CARE PROFESSIONAL, THE DAUGHTER IS, AND WE WERE ABLE TO GET SOME INFORMATION FROM HER PERFECTLY ABOUT THE TOP LEVEL OF CARE THAT HER MOTHER WAS ABLE TO RECEIVE HERE, AND WE FEEL LIKE THAT'S ONE EXAMPLE OF THE GREAT WORK THAT WE CAN DO AS COMMUNITY PARTNERS, TOGETHER WITH OUR PARTNERS IN IDAHO.

>> YOUR MEDICAL CENTER IS ABOUT 30 MILES AWAY FROM KOOTENAI HEALTH, BUT I WANTED TO RUN BY YOU, HAS THE V.A.

BEEN ACCEPTNG ANY WASHINGTON COVID PATIENTS?

OR IS IT MOSTLY IDAHO COVID PATIENTS THAT YOU SEE?

>> YEAH.

OF COURSE, IT'S A COMBINATION.

SPECIFICALLY, OF COURSE, WE HAVE AN IEWRNLTSES -- AN URGENT CARER HERE.

WE HAVE SEEN AN OVERALL INCREASE IN THE DEMAND FROM BOTH WASHINGTON, IDAHO, MONTANA, AND ALL THESE AREAS.

THERE IS AN INCREASE IN THE DEMAND.

ONE OF THE OTHER PARTNERS THAT WE PARTNERED UP WITH HERE IN WASHINGTON IS OUR STATE VETERAN HOME SO THIS IS NOT A V.A.

IT'S THE WASHINGTON STATE DEPARTMENT OF VETERAN AFFAIRS.

THEY HAVE A LONG-TERM CARE FACILITY FACILITY HERE IN OUR COMMUNITY, AND WE BUILT A GREAT RELATIONSHIP WITH THEM, AND WE HAVE ALSO ADMITTED SOME OF THEIR PATIENTS HERE SO THAT THEY CAN RECEIVE A HIGH LEVEL OF CARE.

ALL THIS IS RELATED TO COVID AND COVID-LIKE ILLNESSES.

>> OUTSIDE OF THE PANDEMIC, THE V.A., OF COURSE, OFFERS A VARIETY OF SERVICES TO VETERANS.

HAVE YOU HAD TO REDUCE ANY SERVICES THAT, PERHAPS, WOULD NORMALLY BE PROVIDED TO THE CITIZENS IN WASHINGTON?

>> A GREAT QUESTION.

THIS IS A BALANCE -- THIS IS A FINE LINE THAT WE WALK EVERY DAY.

OF COURSE, IT COMES DOWN TO DOING WHAT WE CAN TO OFFER THE MOST CARE THAT WE CAN TO AS MANY PATIENTS AS WE CAN.

SOME OF THOSE OUTPATIENT, NON-EMERGENT SERVICES HAVE BEEN IMPACTED.

WE HAVE HAD TO DIVERT RESOURCES, MOSTLY STAFF MEMBERS, TO HEALTH CARE FOR OUR PATIENTS.

THAT MEANS THAT SOMETIMES, THAT AMBULATORY OUTPATIENT EVERY YEAR SORT OF ANNUAL CHECKUP TYPE OF APPOINTMENTS, SOME OF THOSE HAVE HAD TO BE DELAYED OR RESCHEDULED.

WE ARE DOING EVERYTHING THAT WE CAN TO CONVERT THOSE TO VIRTUAL APPOINTMENTS.

WE DO WHAT WE CAN AS A MAKEUP, BUT WE OFFERED A LOT OF OVERTIME AND EXTRA HOURS TO OUR STAFF MEMBERS, TO DO THAT WORK, BUT STILL, YES, THERE ARE IMPACTS TO SOME OF THOSE OUTPATIENT SERVICES.

>> HAS THAT RESULTED IN ANY ADVERSE OUTCOMES FOR PATIENTS WHO, PERHAPS, WOULD HAVE GOTTEN THAT CARE HAD IT NOT BEEN A PANDEMIC?

>> YEAH.

THAT'S A GREAT QUESTION.

THAT'S SOMETHING THAT WE WRESTLE WITH ALL THE TIME.

WHAT IF THAT PATIENT WHO IS WAITING HAS SOMETHING BAD HAPPEN TO THEM?

SO THAT'S WHY WE HAVE DONE -- AND ESPECIALLY I AM PROUD OF OUR HOME TELE-HEALTH TEAM.

THIS IS A TEAM OF NURSES WHO CONTACT PATIENCE BY -- THEY CONTACT PATIENTS BY PHONE, AND ESPECIALLY FOR THOSE PATIENTS WHO TESTED POSITIVE BUT NOT ADMITTED.

BUT IF THEY TESTED POSITIVE FOR COVID, WE HAVE A TEAM 6 NURSES REACHING OUT TO THOSE PATIENTS ON A REGULAR BASIS TO SEE HOW THEY ARE DOING.

YOU ARE YOUR SYMPTOMS GETTING WORSE?

ARE YOU ABLE TO GET THINGS DONE THAT YOU NEED TO GET DONE?

DO YOU HAVE THE SUPPORT THAT YOU NEED AT HOME?

THAT'S ONE OF THE MEASURES THAT WE ARE DOING TO -- BECAUSE OF THAT VERY CONCERN, WE ARE DOING WHAT WE CAN TO REACH OUT TO THOSE PATIENTS IN A PROACTIVE WAY, MOST OF IT VIRTUALLY, TO CONNECT WITH THEM TO SEE HOW THINGS ARE GOING.

>> EARLIER WE TALKED ABOUT EQUIPMENT.

IT'S MY UNDERSTANDING THAT THE V.A.

HAS SHARED EQUIPMENT WITH OTHER HOSPITALS.

CAN YOU WALK ME THROUGH HOW THOSE RESOURCES HAVE BEEN DIVIDED?

>> YEAH.

THANKS FOR THE QUESTION, SO EARLIER DURING FIRST COVID SURGE, WE HAD THE OPPORTUNITY WHERE WE WERE ABLE TO, FOR OUR FACILITY, AND ALSO AS A COMMUNITY PARTNER, TO INCREASE SOME OF OUR EQUIPMENT, SUCH AS THINGS LIKE VENTILATORS, AND THE EQUIPMENT ASSOCIATED WITH VENTILATORS, SO ONE OF THE THINGS THAT WE'VE BEEN ABLE TO DO DURING THIS MOST RECENT COVID SURGE IS WE HAVE LENT FOUR VENTILATORS TO OUR FRIENDS -- TO THE MEDICAL CENTER, AND ALSO, FOUR ADDITIONAL VENTILATORS TO OUR PARTNERS, IN NORTH IDAHO, ADVANCED CARE HOSPITAL, IN THE FALLS AREA, WE WERE ABLE TO LEND THAT EQUIPMENT TO THEM, AND FROM OUR PERSPECTIVE, THEY CAN USE IT ON WHATEVER KIND OF PATIENT THAT THEY NEED TO, AND IT'S A GREAT OPPORTUNITY FOR US TO -- ESPECIALLY IF THE PATIENT, OR THE VENTILATOR IS HERE IN STORAGE OR GETTING MAINTENANCE.

WE CAN SENDS THAT VENTILATOR OUT, AND THAT'S ANOTHER PATIENT WHO CAN BE ON A VENTILATOR.

IT KILLS US TO KNOW THAT WE HAVE COLLEAGUES WHO MAY BE IN THAT CRISIS OF A STANDARDS OF CARE WHERE THEY HAVE TO DECIDE -- AS AN EXAMPLE, THERE ARE TWO PATIENTS THAT NEED A VENTILATOR, BUT I ONLY HAVE ONE.

WE SAID HOLD ON, WE CAN HELP.

SO THAT'S ONE OF THE WAYS THAT WE ARE TRYING TO REACH OUT.

>> SAM McCOMAS, I REALLY APPRECIATE YOUR TIME TODAY.

I HOPE YOU ARE DOING WELL.

>> ABSOLUTELY.

MY PLEASURE.

THANK YOU.

>> FOR OUR FULL INTERVIEWS, GO TO THE IDAHO REPORTS YOUTUBE CHAN--GO TO OUR YOUTUBE CHANNELT YOUTUBE/IDAHOREPORTS.

YOU CAN FINDS OUR REPORTING ON THE IDAHO REPORTS BLOG, YOUTUBE CHANNEL AND IDAHO REPORTS WEEKLY PODCAST.

YOU CAN ALSO GET A ROUNDUP OF ALL OUR REPORTING WITH OUR WEEKLY NEWSLETTER DELIVERED TO YOUR INBOX EACH FRIDAY.

YOU WILL FIND THE LINKS TO ALL THOSE AT IDAHOPT.ORG/IDAHOREPORTS, AND FOLLOW US ON FACEBOOK AND TWITTER.

THANKS FOR WATCHING.

PLEASE STAY SAFE.

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