AND DR. DARIN LEE, A VICE PRESIDENT OF MEDICAL AFFAIRS FOR SAINT VON EHLINGER IN NAMPA.

AN THURSDAY THE PRESIDENT ANNOUNCED A MULTI-FACETTED APPROACH TO REDUCING COVID-19, REQUIRING TESTS FROM FEDERAL EMPLOYEES HEALTH CARE WORKERS AT FACILITIES THAT TAKE MEDICARE OR MEDICAID, WHICH IS MOST OF THEM.

AND EMPLOYEES OF PRIVATE BUSINESSES, WITH MORE THAN 100 EMPLOYEES.

ACCORDING TO THE IDAHO DEPARTMENT OF LABOR THERE ARE 781 PRIVATE EMPLOYERS WITH MORE THAN 100 EMPLOYEES IN IDAHO, WHICH EMPLOY A COMBINED TOTAL OF 203,000 PEOPLE.

THAT DOESN'T INCLUDE THE FEDERAL EMPLOYEES AFFECTED BY THE MANDATE.

WE WILL DISCUSS THAT MORE LATER IN THE SHOW BUT FIRST, EARLIER THIS WEEK, THE IDAHO DEPARTMENT OF HEALTH AND WEATHER ANNOUNCED CRISIS STANDARDS OF WEAR FOR HOSPITALS.

IN DISTRICTS 1 AND 2, IN OTHER WORDS, HEALTH CARE FOOTS FROM GRANGEVILLE TO THE CANADIAN BORDER.

THAT DECISION AFFECTS 10 HOSPITALS.

DIRECTOR JEPPESEN, THANKS SO MUCH FOR JOINING US.

FOR PEOPLE WHO AREN'T FAMILIAR, WHAT IS CRISIS STANDARDS OF CARE?

>> THANKS, MELISSA.

THAT'S A GREAT QUESTION.

CRISIS STANDARDS OF CARE MEANS ALL THE RESOURCES AVAILABLE, THE DEMAND FOR RESOURCES AT A MEDICAL FACILITY ARE BEING OVERRUN OR OVERTAXED.

SAID DIFFERENTLY IN NORTH IDAHO WE ARE SEEING SUNCH A LARGE NUMBER OF COVID-19 PATIENTS IT'S EXCEEDING THE CAPACITY OF THE HEALTH CARE SYSTEM THERE.

>> SO FROM A LOGISTICAL STANDPOINT AT A HOSPITAL IF YOU WERE GOING TO SEEK CARE FOR A HEART ATTACK OR CAR ACCIDENT, WHAT MIGHT YOU ENCOUNTER IF YOU GO TO A HOSPITAL THAT'S UNDER THE CRISIS STANDARDS OF CARE DESIGNATION?

>> GREAT QUESTION AND I AM SURE THAT'S ONE MANY PEOPLE ARE WONDERING ABOUT.

I WANT TO BE SURE TO EMPHASIZE YOU WILL STILL GET SEEN.

WE ARE NOT AT A PLACE WHERE WE ARE TURNING PEOPLE AWAY.

WHAT MAY HAPPEN YOU MAY SHOW UP AND THE ER MIGHT BE DIFFERENT.

YOUR TRIAGE MIGHT BE OUTSIDE IN A TIPPED OR THE LOBBY AS YOU GO INTO THE HOSPITAL.

IT MAY TAKE LONGER TO GET SEEN DEPENDING ON THE SEVERITY OF WHAT'S HAPPENING WITH YOU OR YOUR LOVED ONE.

IT MIGHT BE THE CASE YOU ARE SEEN IN A NONTRADITIONAL LOCATION SUCH AS A HALLWAY OR CONFERENCE ROOM.

IT MAYING THE CASE THE NURSES ARE NOT COMING BY QUITE AS OFTEN.

>> PATIENTS AREN'T BEING TURN AUDIT WAY NECESSARILY BUT ARE THERE CASES WHERE MAYBE MILDLY OR MODERATELY ILL PEOPLE WHO WOULD OTHERWISE PERHAPS BE ADMITTED FOR OBSERVATION ARE BEING SENT HOME?

>> YOU KNOW, GENERALLY, THEY'RE FINDING SOME PLACE TO HOUSE THOSE PATIENTS AT THE HOSPITAL.

AGAIN, MAYBE A NONTRADITIONAL LOCATION, AND IT MAY BE IN THE ER UNTIL THEY ARE READY TO GOES.

AND THEN THE HOSPITALS ARE LEVERAGING QUITE HEAVILY IN TELEHEALTH AND MONITOR AT HOME FOR PATIENTS AT LOWER ACUITY.

>> WHAT HAS THE STATE DONE TO HELP THESE HOSPITALS?

>> THECHERY REACHED OUT FOR HELP SOME WEEKS AGO, AND WE HAVE DONE A NUMBER OF THINGS.

WE HAVE RELEASED ADDITIONAL FUNDS TO HELP THEM WITH ONE OF THEIR CRITICAL SHORTAGES IS STAFFING.

THAT'S REALLY THE, THEIR STAFFING SUPPLIES AND SPACE AND STAFFING IS REALLY WHERE THE SHORTAGE IS.

WE HAVE UNDER THE GOVERNOR'S ORDER WE HAVE RELEASD MONEY TO HELP THEM WITH STAFFING.

WE HAVE WORKED WITH THE NATIONAL GUARD, THE NATIONAL GUARD HAS BEEN ACTIVATED AND WE WILL BE DEPLOYING THEM OUT.

WE WORK WITH OUR FEDERAL PARTNERS UP IN KOOTENAI, ACTUALLY, THE DEPARTMENT OF DEFENSE HAS DEPLOYED 100 OF THEIR MEDICAL TEAMS.

WE ARE FORTUNATE TO HAVE ONE OF THOSE.

WE HAVE WORKED WITH FEMA TO FIND A CONTRACTOR WHO IS BRINGING IN ADDITIONAL RESOURCES TO HELP THEM OUT.

>> TWO WEEKS AGO THE GOVERNOR ANNOUNCED HE WAS RELEASING FUNDS TO SET UP THREE MONOCLONAL ANTIBODY TREATMENT CENTERS RAFNED THE STATE INCLUDING ONE IN COEUR D'ALENE.

BUT KOOTENAI HEALTH.

WHAT'S THE STATUS ON THAT?

>> THAT ONE IS COMING TOGETHER WELL.

IT'S ACTUALLY BEING PUT TOGETHER THROUGH A PARTNERSHIP WITH THREE PROVIDERS UP THERE.

AND THEY'RE ON TRACK TO BE OPEN NEXT WEEK.

SO WE'RE QUITE EXCITED ABOUT THAT.

AND I WANT TO EMPHASIZE THAT MONOCLONAL IS NOT A REPLACEMENT FOR VACCINATION BUT IF SOMEBODY IS TESTED POSITIVE IN EARLY IN THAT, EARLY IN THEIR COAST OF THEIR COVID DISEASE IT'S A GOOD TREATMENT.

>> NOT AS EARLY AS A VACCINATION.

>> EVACUATE NATION IS MUCH BETTER.

VACCINATION IS LIKE A SEAT BELT.

MONOCLONAL IS LIKE AN AIR BAG.

>> BACK TO THE CONVERSATION ABOUT CRISIS STANDARDS OF CARE, DID THE COMMITTEE, DID THE DEPARTMENT CONSIDER DECLARING CRISIS STANDARDS OF CARE STATEWIDE?

>> YES, THAT WAS AN ACTIVE CONVERSATION.

WE HAD A REQUEST FROM KOOTENAI HEALTH TO ACTIVATE AND WE HAD A LENGTHY DEBATE ABOUT SHOULD THAT BE REGION OOL DECLARATION OR STATEWIDE DECLARATION.

THERE WAS LOTS OF CONVERSATION.

ULTIMATELY WITH THE DATA WE HAD IN FRONT OF US AND THE INPUT OF THOSE THAT OPERATE THOSE HEALTH CARE FACILITIES INCLUDING ONE OF OUR GUESTS TONIGHT IT WAS DECIDED THAT AT THE MOMENT, IT REALLY WAS APPROPRIATE FOR NORTH IDAHO AND ALTHOUGH WE ARE VERY STRESSED IN THE REST OF THE STATE, WE WEREN'T QUITE TO CRISIS STANDARDS OF CARE.

>> YOU SAY WE ARE VERY STRESSED IN THE REST OF THE STATE.

HOW CLOSE ARE WE TO SEEING CRISIS STANDARDS OF CARE IN SOUTHERN IDAHO, IN SOUTHEAST IDAHO?

>> YOU KNOW, I THINK WELL, THE PHRASE I'VE BEEN USING IS DANGEROUSLY CLOSE.

IF YOU LOOK ON THE KAT THAT WE TRACK DAILY ON OUR WEBSITE, THE NUMBER OF HOSPITALIZATIONS AND THE NUMBER OF PEOPLE ICU CONTINUES TO GO UP.

THE HOSPITALS EXPAND AND CONCERT OTHER AREAS 2349 HOSPITAL TO BE AN YUE FOR PATIENTS THAT NEED TO BE SEEN THERE.

BUT IT'S DANGEROUSLY CLOSE.

>> ONE OF THE BIGGEST ISSUES IS THE STAFFING SHORT ONLY.

THIS HAS EXISTED LONG BEFORE COVID BUT WITH MORE PATIENTS IT'S EXEXACERBATED.

THE STATE HAS ASKED CIVIL I DON'T KNOW TO VOLUNTEER.

WHAT'S THE STATUS ON THAT AND HAVE ANY BEEN CALLED UP TO SERVE?

>> THAT'S A GREAT QUESTION.

IF YOU ARE INTERESTED IN VOLUNTEERING GO TO VOLUNTEER.COM OR IDAHO.GOV.

IT'S RUN, THE ACTUAL MECHANICS OF IT'S RUN BY THE PUBLIC HEALTH DISTRICTS.

BUT WE HAVE ACTUALLY SEEN AN INCREASE IN THE NUMBER OF PEOPLE VOLUNTEERING ON THAT WEBSITE.

AND THE PUBLIC HEALTH DISTRICTS ARE WORKING WITH THE HOSPITALS TO GET THOSE VOLUNTEERS PLACED WHERE THEY'RE NEEDED.

>> CAN YOU GIVE US AN UPDATE ON THE STATEWIDE PICTURE FOR CASE RATES AND INFECTIONS RIGHT NOW?

>> SURE.

OUR CASE RATES ARE INCREASING AT THE MOST RAPID RATE WE HAVE EVER SEEN THROUGH THE PANDEMIC.

WE HAVEN'T HIT THE HIGHEST NUMBER OF CASES PER DAY WE SAW BACK IN THE WINTER.

BUT THE RATE OF INCREASE IS INCREASING PRETTY DRAMATICALLY.

OF PARTICULAR CONCERN US TO IS THE HIGHEST INCREASE IN CASES IS OCCURRING AMONG CHILDREN, ACTUALLY.

WE'RE NOT SEEING AN INCREASE IN HOSPITALIZATION IN CHILDREN BUT WE ARE SEEING A LOT MORE CASES.

THEN IN THE HOSPITALS, WE ARE SEEING A DRAMATIC INCREASE IN THE NUMBER OF 4079IZATIONS, MUCH FASTER THAN WE SAW LAST WINTER.

AND WE ARE AT RECORD HESSELL HIGHS FOR HOSPITALIZATIONS, ICU AND VENTILATION USAGE ACROSS THE STATE.

>> YOU MENTIONED THAT CHILDREN REPRESENT A SIGNIFICANT PROPORTION OF THE NEW CASES THAT ARE BEING RECORDED EVERY SINGLE DAY BUT AS YOU SAID NOT A LOT OF THEM ARE BEING HOSPITALIZED.

AND WE HAVE BEEN VERY FORTUNATE IN THAT IDAHO HAS RECORDED NO JUVENILE DEATHS THROUGHOUT THE PANDEMIC.

HOW CONCERNED SHOULD THE STATE BE WHEN CHILDREN AREN'T ENDING UP IN THE HOSPITAL EN MASSE?

>> WELL, I THINK IT'S PRETTY IMPORTANT FOR A COUPLE REASONS.

BECAUSE THIS IS STILL A PRETTY SEVERE DISEASE.

AND CAN HAVE LONG LASTING EFFECTS EVEN FOR CHILDREN.

BUT THE OTHER REASON IS THAT KIDS, WE DON'T HAVE A VACCINE FOR KIDS THAT ARE UNDER 12 THAT'S APPROVED SO THEY HAVE NO PROTECTION.

SO IT HAS A RISK OF SPREADING VERY QUICK LIE AMONG THEM.

AND THEY BRING IT HOME.

IT'S THOUGH VULNERABLE PEOPLE, WE ARE SEEING YOUNGER AND YOUNG YOU ARE ADULTS GOING TO THE HOSPITAL AND THAT'S THE OTHER RISK IS THEY INFECT THOSE IN THEIR FAMILY OR THEIR LOVED ONES.

>> THE DEPARTMENT HAS A GREAT DATA DASH WORRIED ON HOSPITALIZATIONS AND CASE RATES AND DEATHS AND HOSPITALIZATIONS.

I'VE BEEN KEEPING A CLOSE EYE ON THAT DURING THE PANDEMIC AND WE ARE SEEING MORE DEATHS AND HOSPITALIZATIONS IN PEOPLE IN THEIR 30s AND 40s AND 50s, EVEN IN THEIR 20s.

THE MAJORITY ARE STILL IN PEOPLE OLDER THAN 60 BUT WHY ARE WE SEEING YOUNGER PEOPLE WITH KELL THAT BE HOSPITALIZED AT A HIGHER RATE THAN BEFORE?

>> I DON'T KNOW THAT WE KNOW THE PRECISE SCIENCE ANSWER BUT IT'S DEFINITELY WHAT WE ABSENTEE.

AS I TALK TO MY COLLEAGUES THAT ARE PHYSICIANS AT THESE HOSPITALS, THEY ARE NOTING THAT THIS YOUNGER AND YOUNGER PEOPLE THAT ARE LANDING THERE.

AND OFTEN WITH VERY SEVERE DISEASE.

SO WE DON'T KNOW EXACTLY WHY THE DELTA VARIANT IS DRIVING THAT BUT IT'S HAPPENING.

VERY HEART BREAKING TO SEE THAT, ACTUALLY.

VERY HEART BREAK.

>> DR. GOOD, I WANT TO BRING YOU INTO THE CONVERSATION.

YOU ARE AT BONNER GENERAL HEALTH RIGHT NOW.

CAN YOU GIVE US A SNAPSHOT?

HOW ARE THINGS AT YOUR FACILITY?

>> SO THANKS FOR HAVING ME.

I'M ALSO ONE OF THE ER DOCS THERE.

IT'S PRETTY DIFFICULT RIGHT NOW.

WE'VE BEEN IN THE STATE KIND OF THAT KOOTENAI HAS BEEN IN BUT A LITTLE DIFFERENTLY.

KOOTENAI IS HAVING TONS OF PATIENTS RIGHT NOW.

WITH COVID.

WE HAVE A LOT AS WELL BUT THE DIFFERENCE IS, WE DON'T HAVE SPECIALTY CARE.

SO WE ARE A RURAL 25-BED HOSPITAL, 21 OF THOSE BEDS ARE USABLE.

THE OTHER ONES ARE FOR -- AND WE HAVE FOUR ICU BEDS.

WE HAVE ONE HOSPITALIST WHO RUNS ALL THE BEDS, WHICH INCLUDE THE FOUR ICU BEDS.

AND WE DON'T HAVE CARDIOLOGY AS SPECIALTY CARE OR NEUROSURGERY.

WE DON'T HAVE TRAUMA SURGERY.

SO FOR US, WE'RE ABLE TO MANAGE RIGHT NOW OUR IN PATIENT COVID STATUS CENSUS.

BUT WHAT WE ARE NOT ABLE TO MANAGE IS GETTING PEOPLE SPECIALTY CARE THEY NEED.

SPECIFICALLY OUR BIGGEST ONE WE ARE HAVING ISSUE WITH IS DIALYSIS.

WE CAN'T DO DIALYSIS IN PATIENT.

SO OUR NUMBER ONE TRANSFER CENTER WAS KOOTENAI.

SECONDLY WAS SACRED HEART AND WE ARE UNABLE TO TRANSFER.

SO THAT PROCESS AND TAKING CARE OF PATIENTS THAT ARE COMPLEX AND NEED SPECIALT CARE IS OUR NUMBER ONE CHALLENGE RIGHT NOW.

>> SO NORMALLY, IF YOU HAD A PATIENT WHO LIVED IN, SAY, LACLEDE AND THEY NEEDED DIALYSIS OR OTHER HIGHER CARE, YOU WOULD NORMALLY TRANSFER THEM TO SACRED HEART OR KOOTENAI.

WHERE ARE THEY GOING NOW?

>> IT'S A LONG PROCESS.

WE END UP CALLING, WE CALLED UP TO SIX STATES.

AND 30 TO 40 HOSPITALS TO TRY TO FIND A BED FOR PATIENTS.

AND THEY'VE GONE AS FAR AS WYOMING.

FOR A WHILE WE WERE ABLE TO TRANSFER PATIENTS TO KALISPEL IN MONTANA.

WHAT ENDS UP HAPPENING IS WE PUT THEM ON WAIT LISTS EVERYWHERE.

AND EVENTUALLY THEY GET A BED, EVENTUALLY WE GET A CALL AND WE JUST CONTINUE CALLING AND MANAGING THEM IN THE ER.

SOMETIMES GETTING OUR HOSPITALIST ON BOARD BUT THEY STAY WITH US UNTIL WE GET THEM IN SOMEWHERE.

AND BASICALLY IF THERE'S A WAIT LIST IN EVERY HOSPITAL AND YOU JUST GET THEM ON A WAIT LIST AND THEY SLOWLY MOVE UP.

>> WHEN WE ARE TALKING ABOUT THAT WAIT LIST, HAVE YOU SEEN ANY ADVERSE EFFECTS FROM PATIENTS HAVING TO WAIT ON THAT WAIT LIST FOR CARE?

ARE YOU SEEING WORSE OUTCOMES?

HAVE YOU SEEN PATIENTS EVEN DIE BECAUSE THEY WEREN'T ABLE TO GET IMMEDIATE CARE?

>> YES.

>> HOW OFTEN IS THAT HAPPENING NOW?

>> RELATIVELY FREQUENTLY.

>> WE KNOW THAT KOOTENAI HAS RECEIVED ADDITIONAL MEDICAL STAFF FROM THE DEPARTMENT OF DEFENSE, FROM THE STATE.

HAVE YOU SEEN ANY RELIEF RIPPLE EFFECTS FROM THAT ADDITIONAL SUPPORT?

>> NOT QUITE YET.

KOOTENAI JUST, IT JUST WAS INSTITUTED ON MONDAY.

WE HAVEN'T -- WE'RE AT A POINT WHERE WE ARE NOT AT THE CRISIS LEVEL THAT THEY ARE AT.

SO WE HAVE NOT -- WE HAVEN'T REALLY SEEN ANY EFFECTS AS FAR AS, MOST OF WHAT WE GET FROM KOOTENAI IS CONSULTS AND TRANSFER CARE.

AND WE HAVEN'T BEEN ABLE TO DO THAT YET.

BUT I ANTICIPATE HOPEFULLY WE WILL.

>> WE ARE STILL SEEING CASES RISE, AS YOU KNOW.

WE'RE NOT SEEING HOSPITALIZATIONS GO DOWN.

AS YOU LOOK OUT FOR THE NEXT FOUR OR FIVE WEEKS, WHAT IS YOUR STAFF DOING TO PREPARE FOR WHAT MOST PEOPLE ARE ANTICIPATING IS GOING TO BE A CONTINUED ONSLAUGHT OF PATIENTS NEEDING CARE?

>> THAT'S A GOOD QUESTION AND I KIND OF WANT TO BACK UP BY SAYING THAT WE WOULD BE WHERE COOT MY IS AT RIGHT NOW -- KOOTENAI FROM A CRITICAL ACCESS HOSPITAL STANDPOINT, NOT FROM EVERYTHING THEY ARE DOING DIFFERENT.

BUT WE PUT PROACTIVE MEASURES IN PLACE EARLY.

WE HAD INCIDENT COMMAND WHAT HAS BEEN MEETING FOR OVER A YEAR.

WEEKLY TO MONTHLY.

AND EARLY ON, FROM AN ER STANDPOINT, WE CONTACTED THE MEDICAL SPECIALTY -- AND SPOKE TO THE OWNERS AND WERE ABLE TO ACCESS OXYGEN EARLY.

SO WE HAVE BEEN ABLE TO SEND PATIENTS HOME A LOT EARLIER ON OXYGEN THAT NORMAL LIEU WOULD HAVE TO BE ADMITTED.

IF WE HADN'T DONE SPECIFICALLY THAT ONE PIECE OF CARE, WE WOULD BE OVERBURDENED RIGHT NOW WITH PATIENTS.

WITH COVID.

AND SO OUR BIGGEST ISSUE RIGHT NOW IS SUPPLY OF OXYGEN.

BECAUSE WE CAN'T SEND PATIENTS HOME ON OXYGEN, THEY HAVE TO COME IN IF WE DON'T HAVE BEDS, WHAT DO WE DO?

OUR SECOND BIGGEST ISSUE IS STAFFING.

WE'RE A CRITICAL ACCESS HOSPITAL.

WE'RE ALWAYS A LITTLE BIT UNDERSTAFFED EVEN IN THE BEST OF TIMES.

AND THEN YOU ADD A PANDEMIC, AND YOU ADD BURNOUT AND PEOPLE GETTING SICK, AMONG OTHER THINGS, AND WE ARE JUST UNDERSTAFFED ON EVERY LEVEL.

>> AND TO BE CLEAR, A LOT OF PEOPLE ONLINE IN COMMENTS HAVE BEEN ASKING, WHY DO HOSPITALS HAVE A VACCINATION MANDATE IF IT'S GOING TO EXACERBATE STAFFING CONCERNS?

AS OF NOW, BONNER GENERAL HEALTH DOESN'T HAVE A VACCINE MANDATE.

CORRECT?

>> CORRECT.

>> HOW'S YOUR STAFF HOLDING UP?

>> THEY'RE TIRED.

THEY'RE BURNED OUT.

THEY'RE FATIGUED.

THEY'RE OVERWHELMED.

WE HAVE A LOT OF STAFF THAT ARE VERY LOYAL TO OUR COMMUNITY AND TO OUR HOSPITAL.

AND EVERYBODY'S FEELING IT.

AND IT'S BECAUSE, WHERE'S THE END?

AND HOW LONG CAN YOU GO?

AND UNFORTUNATELY, WHEN OUR STAFF AREN'T TREATED WELL, YOU ARE DOING THINGS AND NOBODY IS LISTENING.

AND SO THE STAFF IS STRUGGLING.

>> THANK YOU SO MUCH, DR. GOOD.

DR. LEE, I WANT TO BRING YOU INTO THE CONVERSATION.

YOU ARE AT SAINT VON EHLINGER IN NAMPA.

WHAT'S -- >> IT'S ROUGH.

OUR HOSPITAL IS A LITTLE BIGGER AND HAS MORE RESOURCES THANKFULLY.

BUT IN THE EMERGENCY DEPARTMENT, WE ARE FULL ALL THE TIME.

WE ARE HOLDING PATIENTS IN THE EMERGENCY DEPARTMENT THAT DON'T HAVE A BED AND AGAIN WE HAVE SYSTEM RESOURCES THAT GO ACROSS SAINT ALPHONSUS.

BUT DESPITE THAT WE ARE NOT ABLE TO TRANSFER EVEN WITHIN OUR OWN SYSTEM WHEN WE GET PAIRKSED A MITTED TO THE CIA OR THE FLOORS BECAUSE WE JUST DON'T HAVE BEDS.

RIGHT NOW, ABOUT A THIRD OF OUR BEDS ARE TAKEN UP BY COVID PATIENTS IN THE HOSPITAL.

BUT 70% OF OUR ICU IS COVID PATIENTS.

THOSE ARE THE CRITICALLY ILL PATIENTS THAT ARE TAKING MOST OF THE BEDS IN THE ICU.

SO THAT RESOURCE RIGHT THERE IS PROBABLY THE MOST SOUGHT AFTER AND MOST DIFFICULT TO FIND AT THIS POINT IN TIME.

SO THOSE PATIENTS END UP STAYING IN THE EMERGENCY DEPARTMENT AND BEING CARED FOR IN THE EMERGENCY DEPARTMENT, WHICH IS NOT THE BEST CARE FOR THEM AT THE TIME.

THERE'S A LOT OF OTHER PEOPLE COMING IN AND OUT.

THE NURSES ARE NOT AT THE SAME RATIO.

SO IT'S DIFFICULT AND IT DOES NOT LOOK LIKE IT WILL GET ANY BETTER.

>> NORMALLY SAINT ALPHONSUS WOULD BE ONE OF THE PLACES WHERE SMALLER HOSPITALS WOULD TRANSFER THEIR PATIENTS IF THEY WERE IN NEED OF HIGH ARE LEVELS OF CARE.

WHERE ARE THEY SENDING PATIENTS NOW?

>> THAT'S A GOOD QUESTION.

I DON'T KNOW WHERE EVERYBODY IS SENDING PATIENTS NOW.

WE GET REQUESTS ALL THE TIME AT SAINT ALPHONSUS TO ACCEPT PATIENTS.

SOMETIMES WE ARE ABLE TO ACCOMMODATE THOSE.

WE HAVE THREE HOSPITAL WAS OUR SYSTEM, ACTUALLY FOUR WITH ICU BEDS.

AND THAT INCLUDES ONTARIO.

AND SO SOMETIMES WE ARE ABLE TO MANAGE THOSE RESOURCES.

BUT A LOT OF TIMES WE JUST DO NOT HAVE THE ABILITY TO ACCEPT PATIENTS FROM OUTSIDE.

AND YOU HAVE TO REMEMBER THAT AS OUR MAIN HOSPITAL IN BOISE AS A TRAUMA CENTER, AND THE ONLY LEVEL 2 TRAUMA CENTER IN THE AREA, WE HAVE TO REMAIN OPEN FOR THAT AS WELL.

THERE'S NO OTHER PLACE FOR TRAUMA CARE TO GO.

THAT'S SPECIFICALLY TAKES UP A LOT OF ICU BEDS IN THAT CRITICAL CARE RESOURCE.

RIGHT NOW, WE DO NOT HAVE A CAPACITY TO TAKE A LOT OF PATIENTS FROM OTHER PARTS OF THE STATE.

ALTHOUGH WE DO GET REQUESTS DAILY.

>> YOU KNOW, I'M CURIOUS ABOUT THE COST OF TREATING CRITICALLY ILL PATIENTS.

WE KNOW THAT THE VACCINE IS WIDELY AVAILABLE.

IT IS FREE.

YOU CAN WALK TO MOST PHARMACIES AND GET IT.

IF SOMEBODY NEEDS A HIGH LEVEL OF CARE IN THE ICU AND WE KNOW THAT SOME ICU PATIENTS ARE THERE FOR WEEKS WITH COVID.

WHAT KIND OF COST IS THAT TO THE PATIENT AND TO THE HOSPITAL AND TO THE SYSTEM?

>> I DON'T KNOW THE EXACT NUMBER TO THAT.

BUT I THINK ANYBODY WHO IS WATCHING CAN UNDERSTAND THAT A THREE-WEE STAY IN THE ICU IN RAE HOSPITAL, NO MATTER WHERE YOU ARE AT, IS VERY EXPENSIVE.

IT IS VERY EXPENSIVE.

IT'S ALSO VERY LABOR INTENSIVE.

MOST OF THOSE PATIENTS END UP IN THE ICU ARE ON VENTILATORS.

THEY REQUIRE A SINGLE NURSE TO TAKE CARE OF THAT PATIENT AT ALL TIMES.

AND SO YOU ARE USING A LOT OF RESOURCES TO TAKE CARE OF THAT PATIENT.

IN TERMS OF MONITOR COSTS IT'S MONETARY COST, IT'S ASTRONOMICAL.

I THINK WE CAN ALL GUEST THREE WEEKS IN AN INTENSIVE CARE YIEWBT IS VERY EXPENSIVE.

THAT'S THE OTHER PART IS THE VACCINE IS FREE.

AND THE VACCINE KEEPS YOU OUT OF THE ICU.

THERE ARE STILL PEOPLE WHO GET BREAK THROUGH INFECTIONS.

WE KNOW THAT.

AND THAT WILL HAPPEN.

BUT THOSE PATIENTS ARE NOT GOING TO THE ICU.

THEY ARE NOT GETTING PUT ON VENTILATORS.

THEY ARE NOT STAYING IN THE HOSPITAL FOR THREE WEEKS.

THEY ARE YOU ARELY THERE FOR A FEW DAYS.

MOST CAN GO HOME IF THEY HAVE THE VACCINE.

AND SO THE DIFFERENCE BETWEEN THIS HAS BECOME QUITE CLEAR IN THE EMERGENCY DEPARTMENT WHEN YOU SEE PATIENTS.

AND IT DOESN'T MATTER IF THEY'RE AN ELDERLY PATIENT WITH MAYBE A BAD LUNG DISEASE.

YEAH, THEY MAY NEED A LITTLE OXYGEN IF THEY'RE VACCINATED.

IF THEY WERE THAT SAME PATIENT WITHOUT THE VACCINE, THEY'RE GOING TO BE SPENDING THREE WEEKS IN THE ICU, AND MOST LIKELY NEVER LEAVE.

>> THANK YOU SO MUCH, DR. LEE.

JORDAN, I KNOW THAT EASTERN IDAHO HASN'T SEEN THE SAME SURGE LATELY AS NORTH IDAHO AND THE TREASURE VALLEY RIGHT NOW.

BUT WHAT ARE YOU DOING TO PREPARE FOR A POTENTIAL SURGE ON THIS LEVEL?

>> THANKS FOR HAVING ME, MELISSA.

AND I JUST WANT TO START AND ECHO WHAT DR. GOOD AND DR. LEE AND SAID ABOUT OUR HEALTH CARE WORKERS ACROSS THE STATE.

THEY'VE SHOWED UP HEROICALLY ON A DAILY BASIS 24/7 TO BE THERE WHEN WE ALL NEED HEALTH CARE.

AND SO WE JUST WANT TO RECOGNIZE THE PHYSICIANS, THE STAFF, AND EVERYONE WHO HAS SHOWN UP UNDER THESE TRYING CIRCUMSTANCES.

WE'RE IN A LITTLE BIT BETTER SHAPE AS YOU MENTIONED.

SOUTHEAST SIDE OF THE STATE.

WE ARE ALWAYS MONITORING IT AND PREPARING FOR POTENTIAL SURGE.

AND WE ARE DOING A LOT OF THINGS DIRECTOR JEPPESEN SAID AND THE OTHER FACILITIES, WE MIGHT PLAN FOR AN ALTERNATE CARE SPACE.

OR WE MIGHT PLAN, WE ARE DEFINITELY STAFFING UP.

WE ARE TRYING TO GET AS MANY RESOURCES THAT WE CAN AS POSSIBLE.

AND SO WE ARE CONSTANTLY MONITORING THE SITUATION.

I THINK ONE OF THE THINGS THAT'S BEEN INCREDIBLY HELPFUL, WHICH I WANT TO RECOGNIZE DIRECT JEPPESEN AND HIS TEAM FOR, WE HAVE A DAILY PHONE CALL WITH ALL THE HOSPITALS ACROSS THE STATE.

SO WE'RE AWARE OF WHAT CAPACITY AND TRANSFER CAPABILITIES ARE OUT THERE.

I THINK THAT'S BEEN EXTREMELY HELPFUL.

>> ARE YOU WORRIED ABOUT HITTING CRISIS STANDARDS OF CARE IN YOUR PART OF THE STATE SOON?

AND HOW CLOSE MIGHT THAT BE?

>> GOOD QUESTION.

I THINK WHERE WE STAND TODAY, WE HAPPEN TO HAVE 27 COVID PATIENTS IN THE HOSPITAL.

WE ARE 20 A-LICENSED BED FACILITY.

THAT'S ABOUT WHERE WE ARE AT THE HEIGHT OF THE PANDEMIC, MAYBE A LITTLE BIT LESS BUT SO IF TRENDS CONTINUE WHERE WE ARE I DON'T ANTICIPATE WE WILL REQUEST CRISIS STANDARDS OF CARE.

BUT UNLESS SOMETHING DRAMATIC HAPPENS.

BUT WE'RE CONSTANTLY MONITORING THAT.

>> ARE YOU ACCEPTING TRANSFERS FROM OTHER PARTS OF THE STATE THAT ARE HIT HARDER THAN YOU ARE?

>> YES, ABSOLUTELY.

THAT DAILY CALL IS KIND OF THE GATEWAY FOR THAT.

BUT WE HAVE ACCEPTED PATIENTS FROM AS FAR AS COOT NIGHT HEALTH.

-- KOOTENAI HEALTH.

WE HAVE 12 REGIONAL ACCESS HOSPITALS IN SOUTHEAST IDAHO.

BUT WE HAVE HELPED OUT AND VICE VERSA.

HOSPITALS ACROSS THE STATE HAVE HELPED US AS WELL.

>> DIRECTOR JEPPESEN, EARLIER IN THE SHOW, WE TALKED ABOUT THE MANDATES THAT WERE ANNOUNCED TODAY FROM THE BIDEN ADMINISTRATION.

THEY'RE NOT IN PLACE YET.

IT SOUNDS LIKE THEY ARE STILL BEING CRAFTED AND THERE'S GOING TO BE SOME TIME AFTER THEY GET INTO PLACE FOR WORKERS TO DECIDE WHETHER OR NOT THEY ARE GOING TO GET VACCINATED.

HAS THE STATE RECEIVED ANY GUIDANCE ON THIS?

OR DID YOU GET A HEADS UP THIS WAS COMING?

>> GREAT QUESTION, MELISSA.

WE BASICALLY FOUND OUT AT EVERYONE ELSE IN THE COUNTRY.

I THINK WE HAD AN HOUR'S HEADS UP.

WE DON'T HAVE ANYTHING SPECIFIC FROM EITHER THE AGENCIES OR EVEN AN EXECUTIVE ORDER THAT WE CAN LOOK AT TO SEE WHAT'S IMPLIED IN THAT.

THERE'S QUITE A BIT THERE.

WE ANTICIPATE QUITE A BIT OF GUIDANCE COMING DOWN THE ROAD HERE AND WE WILL HAVE TO SORT THROUGH IT.

>> IS THERE CONCERN MORE HEALTH CARE WORKERS WILL QUIT IF THAT REMAINS IN PLACE?

AND SURVIVES WHAT I IMAGINE ARE ALMOST CERTAIN COURT CHAL CHALL?

MIGHT THAT EXACERBATE THE STAFFING SHORTAGES THE HOSPITALS ARE FACING?

>> I CERTAINLY HOPE NOT.

ONE OF OUR CRITICAL SHORTAGES IS STAFF.

FOR THE HOSPITAL THAT IS HAVE ALREADY INSTITUTED A REQUIREMENT FOR VACCINATION, THEY'RE REPORTING THAT THEY HAVE NOT SEEN A SIGNIFICANT DROP IN STAFFING.

BUT WE WILL SEE IF THIS KIND OF SYSTEM STATEWIDE.

COUNTRYWIDE REALLY.

REQUIREMENT IF THAT HAS AN IMPACT OR NOT.

>> IN THIS POLITICIZES AN ISSUE TO BE BLUNT THAT PUBLIC HEALTH OFFICIALS HAVE BEEN TRYING SO HARD NOT TO POLITICIZE.

BUT WHY SHOULD PEOPLE STILL CHOOSE TO GET VACCINATED?

>> YEAH, IT'S A GREAT QUESTION.

AND WE HAVE HEARD MANY OF THOSE REASONS HERE TONIGHT.

THE FIRST IS IT IS BY FAR AND AWAY THE BEST PROTECTION FROM GETTING COVID.

EVEN IF YOU HAVE A BREAK THROUGH CASE, THE PROBABILITY, IT'S VERY EFFECTIVE AT KEEPING YOU OUT OF THE HOSPITAL AND PROTECTING YOU FROM AN ICU VISIT OR EVEN DEATH.

THE NUMBER OF BREAK THROUGH CASES IN THE STATE IS .53%, LESS THAN 1%.

WE LOOK AT THE HOSPITALIZATONS, PARTICULARLY THE ICU, ROUGHLY 90% OF THOSE ARE FROM UNVACCINATED INDIVIDUALS.

AND IT'S HAPPENING WITH YOUNGER AND YOUNGER PEOPLE.

AND SO THE VERY BEST THING WE CAN DO TO PROHIBIT YOURSELF IS TO GET VACCINATED.

IT'S BEEN PROVEN TO HIGHLY, HIGHLY PREVENT YOU FROM GETTING IN THE HOSPITAL IT'S THE BEST WAY WE CAN RETURN TO NORMAL HOSPITAL CAPACITY.

>> DR. GOOD, I WANT TO TOUCH BASE WITH YOU ONE MORE TIME.

AS YOU KNOW, YOU HAVE PARTICULARLY LOW VACCINATION RATES IN NORTH IDAHO.

WITH CRISIS STANDARDS OF CARE, WITH THE HOSPITAL CRISIS YOU ARE SEEING, ARE PEOPLE STARTING TO BE MORE OPEN TO GETTING VACCINATED?

IS THERE ANY MESSAGING THAT YOU FOUND WORKS?

>> I AM MAYBE A LITTLE BUT NOT MUCH AT ALL.

IT'S REALLY POLITICAL UP HERE.

AND WE ALSO FIGHT -- THERE'S A LARGE POPULATION UP HERE THAT BELIEVES COVID DOESN'T EXIST.

I WILL DIAGNOSE PATIENTS WITH COVID.

FAMILY MEMBERS WILL DIE OF COVID AND THEY WILL STILL ARC WITH ME AND SAY IT DOESN'T EXIST.

THERE IS NOT MUCH OF A CHANGE UP HERE.

HONESTLY THAT'S ONE OF THE BIGGEST BATTLES WE'RE FIGHTING RIGHT NOW WITH THIS.

>> IF YOU COULD SAY ANYTHING TO PEOPLE WHO STILL DON'T BELIEVE THAT THIS IS A CRISIS, WHAT WOULD YOU SAY TO THEM?

>> THERE'S NO REASON WE WOULD MAKE THIS UP.

I DON'T WISH THIS UPON ANYONE.

I WOULD GIVE ANYTHING TO GO BACK TO WHY I BECAME AN ER DOCTOR AND THE PATIENTS THAT I TREAT.

AND I THINK EVERYBODY FEELS THAT WAY.

AND WE HAVE A WAY TO HELP MITIGATE THIS.

AND GET IT UNDER CONTROL.

>> WELL, THANK YOU SO MUCH.

AND THANK YOU TO ALL OF OUR GUESTS.

I KNOW HOW BUSY ALL OF YOU ARE AND WE REALLY APPRECIATE YOU JOINING US TONIGHT.

THANK YOU SO MUCH FOR WATCHING.

THE 50th SEASON OF "IDAHO REPORTS" BEGINNINGS OCTOBER 29th ON IDAHO PUBLIC TELEVISION.

IN THE MEANTIME WE WILL CONTINUE OUR COVID-19 AND HOAFDZ POLITICAL COVERAGE ONLINE.

MAKE SURE YOU FOLLOW "IDAHO REPORTS" ON FACEBOOK AND TWITTER FOR THE LATEST AND SUBSCRIBE TO OUR WEEKLY NEWSLETTER FOR A ROUND-UP OF OUR REPORTING.

YOU WILL FIND A LINK TO SIGN UP AT IDAHO PT.ORG/IDAHOREPORTS.

>> PRESENTATION OF "IDAHO REPORTS" ON IDAHO PUBLIC TELEVISION 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 BY THE CORPORATION FOR PUBLIC BROADCASTING.

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