North Idaho’s low coronavirus testing rate, high-profile defiance hamper response
Victoria’s fever had reached 102 degrees. She had an excruciating headache and painful body aches unlike anything she had ever experienced before.
The 51-year-old suspected she had been infected with the coronavirus and went to Kaniksu Health Services in Priest River to try to get tested for COVID-19. She was denied a test on March 23 and again on March 31.
“I don’t know if I had the virus or not. I have no idea,” Victoria said. “They told me: ‘If you’re struggling to get through a sentence, we’ll give you a test. But if you’re not struggling to get through a sentence, then we’re not going to test you.’ So basically, if you need hospitalization, you can have a test. But if you don’t need to be hospitalized, you’re not getting tested.”
It’s a familiar and frustrating experience that has been shared by many throughout Idaho and across the United States. And in North Idaho — where Nez Perce County had 11 deaths but only 30 confirmed or probable cases of COVID-19 as of Saturday afternoon — it highlights the inconsistent approach in Idaho to coronavirus testing.
State records for COVID-19 testing show North Idaho was testing less than other parts of the state as Idaho’s coronavirus outbreak took hold.
Coronavirus testing in North Idaho
The two northernmost health districts in Idaho contain 10 counties and about 20% of the state’s population. They made up about 24% of the COVID-19 tests processed by the state lab during the first three weeks of March. At first glance, that would seem to indicate a robust rate of testing — which can help guide medical treatment, curb spread of the virus and inform epidemiologists.
But of the 301 patients who were tested in the northern section of the state, 223 were at just one place: Kootenai Health in Coeur d’Alene.
Without Kootenai Health, all of the health care providers in the 10 northernmost counties of Idaho sent a total of 78 tests to the state lab in the first three weeks of March. (Those numbers don’t include tests sent to private labs — about one-quarter of the tests done in Idaho during that time. The Statesman has requested more recent versions of the state lab data and is working to obtain the same information about tests processed by private labs.)
The Panhandle Health District sent 15 of those 78 tests. Bonner General Hospital, Boundary Community Hospital and Gritman Medical Center each sent 10. The remaining 33 tests came from five hospitals, three nursing homes, six medical practices and one cancer center.
“We do know that, for the first month probably, we had (a significant) shortage of testing going on,” said Carol Moehrle, district director of the Idaho North Central District public health department and a member of Gov. Brad Little’s coronavirus working group. “Our hospitals had very few tests that they were able to navigate and negotiate through whatever means to do testing.”
The district doesn’t know why there have been so few confirmed cases of COVID-19 in Nez Perce County compared with the number of people who have died from the disease.
“We’re in touch with our clinics on a daily basis,” Moehrle said. “We know we’re seeing people that have flu-like symptoms. We don’t know how much they’re (being tested).”
Victoria was among those people exhibiting flu-like symptoms. At the time, it could take as long as two weeks to get results — a timeline that has improved recently.
“The really amazing part to me was, they’ll test you, and you’re already struggling to breathe, but they’re gonna send you home until they get the result,” said Victoria, who did not want the Statesman to use her last name to protect her family’s privacy. “You can be dead by then.”
Kaniksu Health Services, where Victoria went, has not tested many people for COVID-19, its CEO told the Idaho Statesman this week. That’s not because it wants to limit testing, but because it doesn’t have supplies to do the tests, Kaniksu CEO Kevin Knepper said.
More testing in Idaho is “absolutely critical,” Knepper said. But across its clinics in Bonner and Boundary counties, Kaniksu could test fewer than 50 patients right now, he said.
With such a short supply, the Kaniksu clinics are only testing people who meet federal and state guidelines — and whose COVID-19 status would make a difference in medical treatment.
“Testing supplies have been extremely limited. Anything COVID-19 related has been extremely limited,” Knepper said. “Our people who work on sourcing supplies, they’ve been (making) a Herculean effort in terms of getting whatever we can.”
As a small rural health center, Kaniksu has struggled to get enough of everything from its medical suppliers — the swabs, the liquid used to transmit samples to a lab and the personal protective equipment staff must wear while they test a patient.
“We’re calling several times a day, and if they get stock in (when) you happen to call, they’ll ship it to you,” he said.
It’s not just clinics like Kaniksu that haven’t been testing in droves.
St. Joseph Regional Medical Center in Lewiston — the sixth-largest hospital in the state — sent a total of four tests to the state lab in the first three weeks of March.
At the time, the state lab was doing most of the tests for Idaho, and the state’s guidance was to only test patients who were sick enough to be hospitalized and most likely to have caught the virus, for example, by traveling to a hot spot.
A spokeswoman for St. Joe’s declined to comment or answer questions about its testing practices. She said officials would defer to the local public health district.
Some defy stay-home order, protest
To protect her family, Victoria self-isolated at home and is now feeling better. But she still has no idea if she had the virus.
Victoria’s level of frustration over a lack of testing is only compounded by the actions of those around her in North Idaho who are encouraging residents to question or outright defy Gov. Brad Little’s stay-home order. On Wednesday, Little extended the order through April 30.
Republican Rep. Heather Scott, who lives in Bonner County, posted a video urging people to “push back” on Little’s order, saying he does not have such authority. A few days later, Bonner County Sheriff Daryl Wheeler publicly released a letter he sent to Little asking him to call an emergency session of the full Idaho Legislature to explore whether public health officials have been misleading the public about the severity of the coronavirus.
And Idaho Freedom Foundation has publicly claimed Little overstepped his legal authority in issuing the stay-home order on March 25. Republican Rep. Tim Remington of Coeur d’Alene, also known as “Pastor Tim,” led a church service in protest of the governor’s order on March 29.
“The people that have good common sense are staying at home,” said state Republican Rep. Bill Goesling, who lives in Moscow. “There are those that, in my opinion, don’t have common sense, and they’re out and about.”
North Idaho has a longstanding history of extremism — remember Ruby Ridge and the Aryan Nations compound in Hayden Lake? — but defiance of the governor’s stay-home order has an impact on more than just the individual willing to risk exposure. Goesling isn’t surprised by the actions of Scott and Wheeler — he’s disappointed.
“Heather Scott and that group up north, they’re on that right fringe, and they’ll continue to fight against anything that exists beyond their absolute control,” Goesling said. “… It’s been a tendency, in my experience in the (legislative) sessions, of those representatives of that group up there, and they’re reflecting not only their opinion, but the opinion of many of their constituents.
“So I sort of expected that, but not to the level that I see now with Idaho Freedom Foundation. They’re fanning the fires, taking advantage of a situation that really we should be using common sense with. ... Prevention is the best method of providing safety to people.”
Health care workers speak out
Worried that residents in the northern panhandle will follow the likes of Scott, Wheeler and Remington in ignoring social distancing guidelines, members of the health care community felt compelled to speak out.
“We are aware that some would like you to relax and let life return to normal. We wish that were possible,” reads a letter from the Bonner County medical community that includes the signatures of more than 320 medical professionals.
“We acknowledge how one might think this is a reasonable recommendation given the fact that as of April 5, only two members of our community are known to be infected with COVID-19. However, it is really the unknown cases in the community that will spread the most disease.”
Bonner General Health, which is located in Sandpoint, has four ICU beds, according to the letter. And as of April 3, nearby Kootenai Health’s ICU was “completely full, and they were using the recovery room as an overflow ICU.” There were 82 confirmed coronavirus cases between the Panhandle Health District and Idaho North Central District as of Saturday afternoon.
“Our regional ICU capacity is already stretched, and the pandemic has yet to fully penetrate our area,” the letter continues. “This is a health emergency! We are rising to this challenge. Will you join us now?”
Victoria says she and her family have diligently stayed at home except for essential trips to the grocery store. But what she’s witnessed outside her home hasn’t been reassuring.
“Pretty much everybody is socializing at the grocery store now. No joke,” Victoria said. “And there’s like one person out of every 50 or so that has a mask on.”
From what Goesling has witnessed in Moscow, most residents are taking the stay-home order seriously. Grocery stores have put up glass screens to protect checkers, and the University of Idaho sent its students home to finish the semester with virtual classes online.
U of I also turned Targhee Hall, a dormitory on the edge of campus, into a 32-bed facility that could be used by Gritman Medical Center if additional hospital beds are needed in an emergency.
But the collective efforts of the majority could easily be undone by a careless few. In addition to the deaths in Nez Perce County, which includes the city of Lewiston, community spread has been confirmed in Kootenai County.
“Staying home is an act of love and community solidarity,” wrote Amelia Huntsberger, an OB/GYN physician at Bonner General Health, in an email to the Idaho Statesman. “We take flattening the curve and trying to protect our elderly and more vulnerable members of society very seriously.”
This story was originally published April 19, 2020 at 4:00 AM.
