‘A lot of me’s instead of we’s’: Weary Idaho health care workers face new COVID surge
January marks the 22nd month of the pandemic in Idaho. For many residents, the COVID-19 era has brought about a new normal: masks at the grocery store, events moved online and a new vaccination to add to the list of inoculations. For some, it’s been a series of frustrating restrictions.
But for health care workers, the past two years have been a grueling and exhausting slog of long days and nights, extra shifts and tremendous effort. And the labor of nurses, doctors and other hospital staff has been met in many corners with skepticism, derision and even aggression.
The omicron variant is once again pushing Idaho hospitals toward the brink. Though omicron is likely less virulent than the delta strain, it’s also more transmissible. Beds in hospitals and intensive care units are filling up, and doctors are watching record-breaking and out-of-control infection rates in the community, hoping that won’t translate into an unmanageable stream of new patients.
On Tuesday, Idaho’s director of the Department of Health and Welfare said the state would “likely” reactivate crisis standards of care in the coming weeks, a designation that allows health systems to ration care and take other extraordinary measures to treat a rash of patients that exceeds their available resources.
At St. Luke’s Health System, the state’s largest hospital network, hospital beds are not yet seeing the levels of patients they did during the last surge. On Friday, there were 123 COVID-19 patients in the hospital system, compared with 295 on Sept. 23, at the peak of last fall’s delta surge.
But Dr. William Dittrich, a pulmonary critical care physician at St. Luke’s Boise Medical Center, said rises in ICU patients usually lag multiple weeks behind increases in case numbers.
The high rate of infection in the community is affecting employees, too, causing staffing problems. Over the past three weeks, the number of St. Luke’s employees calling out sick has risen 20-fold, said Dr. Jim Souza, chief physician executive of St. Luke’s.
At Saltzer Health, which operates multiple clinics in the Treasure Valley and has 435 employees, anywhere from 10 to 25 staff members have been out per day over the past two weeks, said John Kaiser, the company’s chief medical officer, in an email. At Primary Health Medical Group, a major provider in the Treasure Valley, 51 staff members were out on Friday for COVID-19-related reasons, and over one-sixth of the company’s employees have tested positive since Jan. 3, said Dr. David Peterman, the group’s CEO.
“A big factor that’s different this time is that people are tired,” Dittrich said. “The last wave, which was brutal and really hard on everybody, seemed to have just ended, and here we are facing it again.”
He said hospital workers are “stepping up” to the challenge, but “people all across the hospital and even in the clinics and everywhere are just tired. It’s exhausting.”
A surge amid anti-science: ‘It feels like such a slap’
Though omicron is causing many vaccinated people to get breakthrough cases, the overwhelming majority of people being hospitalized or dying are unvaccinated, according to state data.
Since May 15, the rate at which Idahoans not fully vaccinated are getting hospitalized is more than four times the rate for vaccinated Idahoans, as is the death rate.
For several doctors and health care workers, their arguments about the safety or efficacy of vaccines don’t hold much sway with patients, and few people who are suspicious about the vaccines have changed their minds.
“We just shouldn’t be in this place that we are now, with what we have available as far as vaccines,” said Kathleen Anneke, a physician assistant in gynecology at Saltzer Health. “It just makes me really sad that I just feel like the dialogue has stopped about it. I mean, of course there have been so many mistakes in the pandemic, but it’s not a political issue. It is a public health issue.”
Anneke said she’s committed to helping patients make the best decisions for their health, which includes answering questions about medical issues. Though it doesn’t mean telling them what to do, she said the dialogue about vaccines “is not moving forward at all. People are on their sides, and that’s it.”
Anneke said she has been able to persuade only a handful of people to get vaccinated.
“I’m just getting tearful talking about it, because it feels like such a slap,” she said.
Anneke contracted COVID-19 in December and stayed home from work while she was ill. She had to cancel her family’s Christmas plans.
Dittrich said he has never seen this level of mistrust from patients, some of whom are unwilling to accept the treatment that he or his partners prescribe.
“I’m not sure when or where people decided to start trusting Facebook more than they do their physician,” he said.
He noted that there are patients or families who, after initial questions or skepticism about particular treatments, eventually come around after the benefits are explained to them. And he said he doesn’t fault families for doing their own research.
Dittrich also said he’s worried that the eroded trust from the pandemic, as well as the emotional toll, could damage health care for years to come.
“(The pandemic) has been particularly hard on nurses and therapists who are the heroes in this,” he said. “Who are there every day, 12-hour shifts, calling in extra, working nights when they’re day people, working days when they’re night people, and I worry that … they won’t be able to sustain that indefinitely.”
On Tuesday, an Idaho doctor spoke about her colleagues’ experiences with burnout and distrust from the public at a meeting of the Idaho Senate Health and Welfare Committee. Dr. Ann Huntington, a hospital medicine physician with St. Luke’s, said some sick patients or their families have accused doctors of trying to kill them or of changing death certificates to include COVID-19 as the cause of death.
Reading a comment from another St. Luke’s doctor, she said, “some of our nurses have been spit upon, some of our docs have, you know, we’ve been yelled at, we’ve … had legal threats, we’ve had physical threats to our safety, and we all have families, we all live in the community.”
She continued: “Despite the absolute worst experiences of our careers … we have chosen to stay in Boise because we truly care about this community and want to serve it. I suppose, despite all the protests, mask burning, harassment, disrespect and accusations, we still genuinely love our community, even if we don’t really like it right now.”
A hospital administrator, Tom Murphy, the CEO of Minidoka Memorial Hospital in Rupert, said his employees sometimes come to him in tears. During the delta variant surge, Murphy said he approached a forlorn doctor who told him: “I just don’t know what else to do. I don’t know what else to do to save these people.”
The disconnect: ‘Where are you? Where’s your head?’
Since the pandemic began, public health restrictions and recommendations have been a divisive topic in Idaho.
When Gov. Brad Little issued a stay-at-home order and closed certain businesses in the first months of the crisis, the state’s lieutenant governor, Janice McGeachin, openly defied him. McGeachin attended and supported rallies opposing the stay-home order, and reopened her family’s Idaho Falls tavern while the governor still had his directive in place for bars to be closed.
Right-wing activists have protested against masks at the Idaho Capitol, including in March, when a group encouraged their children to toss surgical masks into an open fire.
In Idaho, only 47.6% of the population is fully vaccinated, the least of any state in the country, according to the Centers for Disease Control and Prevention. And state and local public health recommendations have been ignored in many parts of the state.
Dittrich said that even though getting vaccinated is a personal choice, it has wider implications. A person’s decision to stay unvaccinated may mean that they infect a loved one, or even someone they do not know, who could become severely ill. And other people are affected if their surgeries are delayed because hospitals enter crisis standards.
“While I appreciate and respect someone’s personal freedom and personal choice, unfortunately this virus is just complex enough that it has an impact beyond the person who’s making that choice,” Dittrich said.
Anneke said the disconnect between the recommendations of health professionals and the behavior of much of the public is hard to bear, noting that she sees “a lot of me’s instead of we’s.”
“It just feels like a slap in the face when you go in and you work as hard as you can, and do the things that you need to do right now to protect yourself and your community and your patients and your family,” Anneke said. “And then to come out and just kind of see people at stores unmasked, and I just think: ‘Where do you live? Are you not reading the news? Where are you? Where’s your head?’ ”
