What Happens When a State Can’t Flatten a COVID Curve

Ashley Carvalho received a text from her fiancé asking her how to do it hours after starting her night shift as a doctor at a hospital in Boise, Idaho earlier this month.

She thought of a COVID-19 patient, a man in his 40s who had deteriorated within an hour of starting work that night. She thought about a conversation with a young family about the switch to comfort care and his death shortly thereafter.

She said that a second patient with COVID who died shortly thereafter and another patient who filled all 14 beds in the intensive care unit (all with the same illness and all unvaccinated) needed her attention. I thought.

She thought about the abuse she received from an angry family member of a man. Ivermectin, An anthelmintic drug that was mistakenly advertised as a cure for the conspiracy world, FDA warns against use in COVID patients.. She pondered how the police had to take the man’s family away after his son-in-law told her. In my gun safe at home. “

Her eyes were full of tears, and she took a selfie and sent it to her fiancé. “It looks like this,” she wrote.

Like other health care workers in her state, Carvalho is exhausted and indignant. Idaho is currently The lowest vaccination rate in the country, And the number of vaccines given has not increased significantly, but infections have increased. As of Saturday 686 patients admitted to the state For COVID, 180 of them are in ICU. This is hundreds more than the flood of hospitals during the last surge in December 2020, before safe and effective vaccines became widely available.

Carvalho and her colleagues cannot understand how they got into this situation. She has anger — certainly — but it requires too much energy. She is almost sad and burned out.

“I think it’s a kind of desperate feeling,” she told BuzzFeed News after finishing the shift on Tuesday night. “At this time of last year, I was very worried about COVID and wanted a day to get the vaccine. Have got Vaccines, and I actually more I’m worried now because there is something that can really prevent this and people aren’t taking it. “

Current, 50 out of 51 COVID patients The ICU has not vaccinated parts of the St. Luke’s Health System, a chain that covers southeastern Idaho, eastern Oregon, and northern Nevada. Hospitalization has increased sharply. In July, there were 33 COVID patients at all hospitals in St. Luke. There were 289 people this week. Currently, more than two-thirds of all patients in St. Luke’s facility are being treated for the same virus, St. Luke’s doctor, Jim Sousa, told reporters. Online briefing on Tuesday.

“It’s an unprecedented event in modern medicine,” he said.

Idaho is what it looks like when it fails Flatten the curve.. Like other mountaineers, Not enough beds.. The Idaho Department of Health (DHW) is not expected to slow down immediately in response to patient setbacks last week. Crisis standards for care..If implemented by a hospital, these plans will be the first Formulated in April 2020 Help guide overwhelmed healthcare professionals on how to distribute the scarce resources, hoping that they rarely need to be used.

Crisis criteria apply to all patients, not just those with COVID-19. “There are already many patients who have had to delay surgery and other treatments. When they go to the hospital, they may be treated in the waiting room or in the hallway,” said Dave Jeppesen, director of DHW. .. “Each nurse and doctor takes care of more patients than usual. You may have to wait much longer than usual for care. To a care facility that may be hours away. You may need to transfer. “

Last Thursday, the day the crisis criteria were first invoked, an elderly adult came to the hospital after suffering a stroke. She was usually detained overnight for surveillance, but was discharged the same day instead. The woman was Jeppesen’s own mother.

“Not only was it stressful for my mother to have a stroke, but she also added concerns about the availability of medical care when she went to the emergency department,” he said. “The situation was different in the ER. There was another patient being treated in the waiting room.”

If things really get the worst in Idaho Crisis criteria guide doctors to triage which patients I will take care of you, but I will not.They are involved Complex calculation of health factors To save as many lives as possible. If there is a tie, the doctor may have to resort to the lottery system.The hospital Universal ban on resuscitation For all patients suffering from cardiac arrest — although this has not yet happened in Idaho and will never be the case for children.

Susie Keller, CEO of the Idaho Medical Association, told BuzzFeed News that she was hearing nightmarish stories from members who were beginning to face these ration decisions.

“It’s not a sudden nightmare. It’s a nightmare we had, and our doctors have warned about this,” Keller said. “We haven’t peaked yet.”

Souza, St. Luke’s doctor, said his network has already mobilized teams to help clinicians make “very morally challenging decisions.” He doesn’t know of any patients who have died due to ration care, but thinks it’s only a matter of time. “I don’t know the names of such people yet, but I believe we know their names,” he said.

As Coronavirus delta mutant Sousa, who wept in Idaho and elsewhere in the United States, said he and his St. Luke colleagues noticed some significant differences from the December 2020 surge. Patients are young (mean 58 years, decrease from 72 years), ill and require more ventilators, stay in the ICU longer and die more often (ICU mortality rate 28% to 43%) Jumped up to). ). In the last three weeks, about 80 people have died of COVID in a hospital in St. Luke.

“In a really morbid exercise, just in September, when we looked at the ages of the people we lost and applied life expectancy to them, we lost more than 1,100 years of life,” Souza said. Said. “Can you imagine it? And for those who say,” We all die someday. ” yes, I have. But these people didn’t have to die now.They didn’t have to die like this..

“Can you imagine all the life and experiences involved in that one, 100 years?”

Idaho Medical Group I appealed to the residents Vaccinated but facing resistance among many people who are in a very conservative state-symptoms Vaccine politics by part of the right..Idaho Republican Governor Brad Little Received COVID Vaccination He dubbed “safe and effective” In January, but a few months later, he signed — like any other conservative governor across the country. Executive order Prohibits state authorities from requiring residents to vaccinate to access the facility.Quoting the need for this month’s “relaxation of government regulations” Little also said he would challenge the plan From President Joe Biden Need a U.S. company with over 100 employees Mandatory either vaccines or regular staff inspections.

Incorrect information is also rampant.This month Republicans in one county, including Boise, voted to appoint Fringe doctor who called the vaccine “fake” To the local health committee. Elsewhere, a home medical nurse who watched a video of a fake conspiracy theory on YouTube told her family not to be vaccinated even if her mother was in a coma with COVID. After that, the nurse infects himself and Died last month.. Her mother recovered, but said she wasn’t sure if she would be shot.

Due to the harsh environment, healthcare workers have been abandoned and resented to continue advocating health measures that the public is no longer interested in. , A 15-bed clinic in the town of McCall’s ski resort Dirty with a swastika On the weekend.

Kenneth Krel, a doctor at Idaho Falls Hospital, said Idaho Legislature The early days of the pandemic, when he and his colleagues were applauded as heroes, were long gone.

“I think we all have something in common with the general public. [is no longer] “Our allies,” Krel told the newspaper. “But in a surprising example, patients sometimes have real hostility. They say that this is all a lie, even when we are preparing to intubate and they can have COVID. I say I couldn’t. “

Boise doctor Carvalho said he is currently comparing health workers to Vietnam War veterans. “We’re tired of being called bad guys for trying to promote life-saving vaccines,” Carvalho said. “I know there are good people out there, but it really feels like the masses aren’t on our side.”

According to Keller of the Idaho Medical Association, even primary care providers who have cared for patients’ families for 20 years are no longer trusted. She said that Idaho healthcare workers face unnecessary death onslaught at work, but are part of a community of people who act as if there were no pandemic outside. “It’s pretty disappointing,” she said. “I think they feel like they live in two different worlds.”

At Idaho Falls, Krel was driving to work last Saturday and was confused. He was overwhelmed by the ICU and went into the car, despite working on a 36-hour shift on holidays. My colleague knew that too.

Upon arriving at the Eastern Idaho Regional Medical Center, he stopped in front of the whiteboard and wrote a message to his colleagues. Later became viral When shared on social media.

“In the end, we remember that we supported us and survived this madness, the notable people who endured this with us, our best human beings, all of us. Showed our best calling, “he wrote. “We endured this together and supported each other. We saved lives, lost lives, and we did with both compassion and ability.

“We will never forget this.”


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