St. Lukes McCall emergency medicine doctor Dr. Paddy Kinney says the hospital has been dealing with more severe cases of COVID-19 than they are equipped to handle.
The facility is a critical access hospital, meaning it serves anyone who walks in the door from the Valley County region.
“I take care of anything that walks in the door or heart attacks, ATV rollovers, hunting accidents, dog bites, strokes, whatever,” Dr. Kinney said. “What has changed since Delta became very prominent in our community is the number of COVID patients that have been added to that group of patients that we see in an average 12 hour day has gone up a lot. And we’re seeing more COVID patients, more people are coming in for treatment for COVID, and more people are being transferred and hospitalized for COVID and, and I think that has been the game-changer with Delta.”
Now, with the State of Idaho implementing crisis standards of care procedures across the state, Valley County’s primary hospital is sounding the alarm.
From September 1, 2021, to September 13, 2021, St. Lukes McCall tested 588 people for COVID-19, and of those tests, 135 are positive cases.
“The number of people that have been really sick, requiring admission has gone up dramatically in the last couple of months,” Dr. Kinney said.
St. Lukes McCall is a small hospital with 10 to 12 beds available depending on staffing. Because of its size, it’s also limited in several other critical areas of care, including the amount of oxygen the hospital can supply to patients.
Dr. Kinney said that if a person’s needs are going above seven, eight, nine, and 10 liters of oxygen per minute, it’s ‘pretty unsafe’ to keep that person in McCall. To put that number in perspective, he said there are patients in Boise who require 60, 70, and 80 liters per minute.
“(A) COVID patient was admitted last night that was requiring two or four liters of oxygen, and we were okay with that because we can support that,” he said. “This morning, they require seven to 10 liters of oxygen to keep their saturations up. And I was talking with my partner, who’s assumed care of that patient this morning, and she said, ‘Well, God, I mean, normally I would be looking to transfer this patient to the ICU,’ we have an increasing oxygen requirement. What is this patient going to be by noon? Is it going to be 14 to 16 liters of oxygen? Which is about the most that we can provide here. And we don’t know which way this person is trending. It makes us very uncomfortable.”
Throughout St. Luke’s entire health system, Dr. Kinney says 40% to 42% percent are patients with COVID-19.
When bigger hospitals fill up, transferring becomes increasingly difficult for critical access hospitals.
“I can think of a large hemorrhagic stroke that we kept here that normally we would have shipped. I can think of a GI bleed that we kept here and gave a blood transfusion to and watched overnight, hoping for the best, because they didn’t have the capacity to accept that patient in a timely manner down in Boise,” Kinney said. “And so it’s not just the COVID patients that we’ve been struggling to transfer, it’s all patients that we’ve been struggling to transfer, and so that makes us pretty uncomfortable. I get uncomfortable when I realize that I’m maybe not caring for a patient in the way that I would have a couple of years ago because of strains on the system.”
Last week St. Lukes McCall reported it was almost at full capacity. Since then, Kinney said it has cleared a bit, but there is no ‘wiggle room.’
“If two mamas come in, in labor and have their babies, that’s two rooms, and then two new baby patients to take care of,” he said. “There was a time when we were almost totally full last week, and then by the end of the week, it had dropped to only having two or three patients in the hospital. Right now, we think that we have four or five beds full, and I know of one or two COVID patients that are admitted. But it can change hugely through the week.”
Dr. Kinney added that critical access hospitals are not supposed to admit people who need care longer than four days.
Of its positive cases, Kinney said the hospital has seen its ‘fair share of breakthrough infections’ though he added the breakthrough infections are milder.
“To my knowledge, I have not admitted anyone to the hospital or transferred anyone to Boise that’s vaccinated,” he said. “I know that there are vaccinated people that are in the hospital; maybe 5% to 8% of our hospitalized patients in St Luke’s right now are vaccinated. But again, it’s only 5% to 8%. 92% to 95% are not. And those numbers become increasingly skewed when you look at the ICU. So, 98% of people that are requiring ICU-level care are unvaccinated right now.”
As BoiseDev reported here, St. Lukes McCall is expecting its positive cases to peak in the early weeks of October. Kinney is urging people to get the vaccine.
“Ninety percent or more of all COVID hospital admissions and severe COVID disease are preventable with vaccination,” he said. “The vast majority of these people DO NOT need to get sick enough to land in the hospital. Please reconsider getting vaccinated to remove yourself from the rising tide of illness that is currently overwhelming our ability to care of your friends, your family members, your neighbors, and your fellow Idahoans the way that we want to. Help us help others by getting yourself vaccinated.”
Correction: a previous version stated 50-60k people could walk into the hospital on a busy weekend. However, Dr. Kinney was referring to the number of people that could come to town