Idaho hospitals to get staffing boost to avoid crisis standards of care amidst COVID-19 surge

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COVID-19 surges, spurred largely by the Delta variant, have delayed many hospitals and health systems on their road to financial recovery, and in the hotspot of Idaho, the state's governor has directed up to 370 new medical personnel to help out to avoid activating crisis standards of care.

By mobilizing the Idaho National Guard again, up to 150 guardsmen will support short-staffed medical facilities. They will be tasked with logistical support such as screenings, lab work, and other duties, according to Governor Brad Little's office.

In addition, 200 additional medical and administrative personnel will be available to Idaho through a contract with the U.S. General Services Administration. And a 20-person Department of Defense medical response team will be deployed to North Idaho, where vaccination rates are among the lowest in the state and where they are experiencing the greatest need.

In a statement released Tuesday, Governor Little said the move to deploy hundreds of additional healthcare personnel is an effort to avoid the state's first-ever activation of statewide crisis standards of care.

Crisis standards of care kick in when it's determined that crisis standards exist – as in the case of severe understaffing. When the standards are activated, the goal is to "gracefully degrade" services to the minimum degree necessary to meet the demands while maintaining the best patient and provider safety standards possible, according to the American Association of Medical Colleges.

Crisis standards of care have the joint goals of "extending the availability of key resources and minimizing the impact of shortages on clinical care," according to a 2020 NASEM working group report.

However, he added that the real solution to the crisis is more Idahoans choosing to receive COVID-19 vaccine.

Nearly all Idaho hospitals are overwhelmed with unvaccinated COVID-19 patients, he said, with more Idahoans in intensive care units with COVID-19 than at any point in the pandemic, the vast majority of them unvaccinated.

WHAT'S THE IMPACT?

Hospitals and health systems around the country are only now beginning to recover financially from the pandemic, but surges such as the one in Idaho threaten to undermine that progress, as providers are once again faced with the potential of staffing and equipment shortages, which were rampant during the early days of the public health emergency.

Idaho is trying to avoid this worst-case scenario.

Little has also directed new funds to help Idaho hospitals attract and retain the medical staff they need as they compete with healthcare systems across the nation for workers.

Other recent steps the state has taken to alleviate the crisis include the opening of three monoclonal antibody treatment centers across the state, where Idahoans at greatest risk of developing serious complications from COVID-19 will be able to receive therapeutic medications to hopefully avoid hospitalization and help preserve critical capacity in hospitals.

Plus, it was announced this month that temporary licensing fees are once again waived for retired or inactive nurses so they can activate their licenses and reenter the workforce more easily. Last year, that step cleared the way for more than 1,000 nurses and other health professionals to help out.

THE LARGER TREND

Staffing shortages are rampant nationwide, as clinicians find jobs outside of hospitals and health systems.

Some workers have gotten little relief as the COVID-19 cases are again on the rise due to the Delta variant. Efforts to tamp down the coronavirus pandemic and bounce back to normal, both in Idaho and nationally, are being threatened by vaccine hesitancy, with many patients wary of receiving their shots.

In March, Sermo's COVID-17 Real Time Barometer found more than 72% of physicians surveyed said that patients continue to voice concerns over vaccine side effects. Still others have reported ongoing misinformation discouraging people from getting vaccines. And close to 30% of physicians reported encountering patients who have skipped their second dose due to unpleasant side effects from the first dose, or concerns over side effects.

In addition to worries over side effects, physicians reported they have also heard ongoing concerns about safety and efficacy (60%) or erroneous or misinformation, such as, "You don't need a vaccine if you've had COVID-19" (32%), "The vaccine modifies your DNA" (29%) or "The vaccine contains a microchip" (15%).

Physicians are countering the vaccination resistance mostly by discussing the risk benefit profile (80%) and the impact COVID-19 can have on others (61%), while 14% are connecting patients to community resources such as peer engagement, but not finding success.

Last week, the U.S. Food and Drug Administration gave full approval to the first COVID-19 vaccine, with the Pfizer/BioNTech offering getting the nod, and the vaccine will now be marketed as Comirnaty. The vaccine has been approved for the prevention of COVID-19 for those 16 years old and older.

According to ABC News, following Pfizer's full approval, the U.S saw a 17% increase in the number of Americans getting vaccinated with their first dose.

ON THE RECORD

"On a daily call with hospitals this morning, we heard there are only four adult ICU beds available in the entire state, out of close to 400," Little said Tuesday. "Where hospitals have converted other spaces to be used as contingency ICU beds, those are filling up too. We are dangerously close to activating statewide crisis standards of care – a historic step that means Idahoans in need of healthcare could receive a lesser standard of care or may be turned away altogether. In essence, someone would have to decide who can be treated and who cannot. This affects all of us, not just patients with COVID-19."

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com