Idaho’s ICUs are filling up again — this time, patients are in their 30s
An ICU doctor this week had three COVID-19 patients in their 30s. One didn’t make it out alive.
Boise’s Saint Alphonsus hospital is the trauma center for the region. Its emergency department, medical units and ICU have been strained at many points during the pandemic. (Otto Kitsinger for Idaho Capital Sun)
They survived 15 months of COVID-19 swabs, patients gasping for air, intubations and body bags. They survived the bottomless pit of sorrow that is a patient’s family saying goodbye over Skype — and being the one to hold that patient’s hand as they died.
The arrival of COVID-19 vaccines in Idaho gave these health care workers hope. They lined up for shots in December and cried tears of relief.
Now, the hospital beds are filling up again. The number of people hospitalized with COVID-19 in Idaho has doubled this month. And they’re sicker; the number of ICU patients with COVID-19 nearly tripled.
It is July 2021, and health care workers are exhausted. But now, they’re frustrated, too.
“I’m so annoyed. I’m … um … it’s hard to not be angry, you know?” said Dr. Meghan McInerney, ICU medical director at Saint Alphonsus Regional Medical Center in Boise. “Our job is to take care of whoever walks through the door. We pride ourselves on that as physicians and health care workers … no matter the poor decision they may have made in life.”
The cost of COVID-19 vaccine misinformation
The patients in the ICU now are “relatively young,” McInerney said. Their lungs are so inflamed and full of fluid that they just stop working.
“Yesterday, I had a 37-year-old patient die of COVID,” she said. A couple weeks ago, they sent a patient in their 50s to get a lung transplant because COVID-19 had damaged their lungs beyond repair.
The ICU patients all have one thing in common, she said: “Every single one of them is unvaccinated.”
It’s a similar situation at St. Luke’s hospitals, according to Dr. Jim Souza, chief physician executive for St. Luke’s Health System.
“With this so-much-more infectious variant now, your likelihood of being able to dodge that sucker is getting smaller and smaller,” he said. “It’s going to find the pockets of unvaccinated folks and non-immune folks.”
Most of Idaho is a pocket, waiting to be found.
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This week, a 35-year-old patient expressed to McInerney “just a lot of regret and wished they could send the message to everybody to get vaccinated.” But a 31-year-old patient also in the ICU with COVID-19 told her “he still doesn’t think the vaccine is safe and that it works.”
She couldn’t believe that someone so sick from a preventable disease was still in denial, she said.
“There’s this onslaught of misinformation that so many people in Idaho have completely bought into,” she said.
Hospitals on alert as delta spreads, with ICUs already full
Saint Alphonsus and St. Luke’s hospitals are full of patients, and have been for weeks. It’s not just COVID-19. It’s a tower of health problems: car crashes, summertime recreational injuries, heart attacks, strokes, surgeries.
Saint Alphonsus had a total of 379 patients admitted in its hospitals as of Monday. About 10% of them had COVID-19.
St. Luke’s hospitals had a total of 545 patients admitted as of Monday. About 7% of them had COVID-19.
Idaho had a total of 136 people hospitalized with COVID-19 on Friday, the most recent day with near-complete reporting from Idaho hospitals. Of those, 43 patients were in the ICU, according to Idaho Department of Health and Welfare data.
COVID-19 patient counts remain lower than in the summer and fall 2020 surges. But the counts are creeping higher, which is why Souza is concerned.
“Our ICU census today, right now, is as high as it was at the (COVID-19) peak in December,” Souza said in an interview last week.
“What’s different between now and December? Back in December, the story was COVID. COVID was literally 50% of our acute care admissions … and we were pushed to near capacity, and we were all worried and frightened we were (headed toward having to ration care).”
This summer, the COVID-19 patient load has been “super stable,” at only about 5% of patients, he said.
“Two weeks ago, all that started to change, and over the last two weeks, that’s doubled. It’s now 10% of our inpatient admissions,” he said. “I mean, adding that on, it’s not only like the straw that could break the camel’s back. It’s like a straw that’s going to become a hay bale, if it does anything like it did in the last three surges.”
The other thing that’s changed since December is that vaccines are available at pharmacies, mobile clinics, urgent care offices and community events. Idaho is awash in doses. But hundreds of thousands of Idahoans who can get them, still haven’t.
McInerney is starting to feel unsafe again when she goes to the grocery store. She doesn’t have company in her home unless she knows they’re vaccinated. She’s wearing her mask again. She has two young children at home, and she doesn’t want them to catch the fast-spreading delta variant.
“I’m counting down the days until they can be vaccinated,” she said.
She also worries about her ICU team.
Saint Alphonsus will always be ready to care for patients, she said. But health care workers are not an infinite, expendable resource.
“We’re so tight, after going through a pandemic together,” she said. “We are all so close, and we’re in this together. And we’re at the point where we’re in this together with the frustration.”
She worries that morale will suffer if the team has to endure yet another surge of COVID-19, at a time when vaccines are readily available.
Health care in Idaho has already lost a slice of its workforce due to burnout and trauma. Some nurses fell out of love with their career after months of grueling work in hot PPE, trying to save people who didn’t trust medical experts.
“I don’t know if our health care system can tolerate another exodus of health care workers,” McInerney said.
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