Utah hospitals Covid: Proposed critera would ration health care at overwhelmed facilities

A group of administrators representing Utah’s hospitals presented Gov. Gary Herbert with a list of “criteria they propose doctors should use if they are forced to decide which patients can stay in overcrowded intensive care units,” The Salt Lake Tribune reported.

They told Herbert that they’d need to put the criteria in place if the coronavirus trend continues, Greg Bell, president of the Utah Hospital Association, told the Tribune.

To triage care, the proposal would take into account a patient’s age, health, situation and ability to survive, Bell told CNN affiliate KUTV on Sunday night.

“At the end of the day, some senior person, versus some healthy young person, probably would not get the nod,” Bell said.

Bell said Utah is suffering from a “phenomenal case growth and spread rate” of Covid-19.

The state reported more than 1,000 new cases per day for the last 12 days. On Sunday, Utah had its highest seven-day average for new daily cases, according to data from Johns Hopkins University.

Since the beginning of the pandemic, more than 104,882 people in Utah have been infected with coronavirus, and at least 572 people have died.

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Even before a formal rationing of health care, one Utah mother who suffered a heart attack was delayed in getting adequate treatment due to the Covid-19 surge.

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Laurie Terry needed special equipment in a hospital’s intensive care unit. But a doctor told the family there weren’t enough resources available amid the growing Covid-19 surge.

Eventually, Terry was taken to a hospital that had the specialized care she needed, but her condition has gotten worse.

“We’ve seen, in the past couple of weeks, that our health care system is at capacity,” state epidemiologist Dr. Angela Dunn said.

“I don’t know what to do anymore,” she said. “I’m really not trying to scare anyone. I’m just trying to inform you of what’s going on and give you the facts.”

Herbert had one wish for the public:

“I would hope that people will take this seriously,” the governor said.

CNN’s Holly Yan and Martin Savidge contributed to this report.

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Idaho county drops mask mandate despite warning of overwhelmed hospital

Boise, Idaho — Moments after hearing an Idaho hospital was overwhelmed by COVID-19 patients and looking at sending people as far away as Seattle for care, members of a regional health department board voted Thursday to repeal a local mask mandate.
“Most of our medical surgical beds at Kootenai Health are full,” Panhandle Health District epidemiologist Jeff Lee told board members in the state’s third most populated county.

The hospital in Coeur d’Alene reached 99% capacity a day earlier, even after doubling up patients in rooms and buying more hospital beds. Idaho is one of several states where a surge of COVID-19 infections is overwhelming hospitals, likely in part because cooler weather is sending people indoors, U.S. health officials said.

A Kootenai Health nurse works on a computer while caring for a patient on the COVID-19 isolation ward at the hospital in Coeur d’Alene, Idaho, in an undated photo provided by Kootenai Health. 

Kootenai Health/Handout

“We’re facing staff shortages, and we have a lot of physician fatigue. This has been going on for seven months — we’re tired,” Lee said.
He introduced several doctors who testified about the struggle COVID-19 patients face, the burden on hospitals and how masks reduce the spread of the virus.

But the board voted 4-3 to end the mask mandate. Board members overseeing the operations of Idaho’s public health districts are appointed by county commissioners and not required to have any medical experience.
Board member Walt Kirby said he was giving up on the idea of controlling the spread of coronavirus.
“I personally do not care whether anybody wears a mask or not. If they want to be dumb enough to walk around and expose themselves and others, that’s fine with me,” Kirby said. “Nobody’s wearing the damned mask anyway… I’m sitting back and watching them catch it and die. Hopefully I’ll live through it.”

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Another member, Allen Banks, denied COVID-19 exists.

“Something’s making these people sick, and I’m pretty sure that it’s not coronavirus, so the question that you should be asking is, ‘What’s making them sick?'” he told the medical professionals who testified.
Similar scenes — with doctors and nurses asking officials for help, only to be met with reluctance or even open skepticism — have played out across the conservative state. Idaho is sixth in the nation for new coronavirus cases per capita, with the average number of confirmed cases increasing by more than 55% every day over the past two weeks.
Still, Republican Gov. Brad Little has declined to issue a statewide mask mandate or limit crowd sizes beyond requiring social distancing at large events and in businesses, which is seldom enforced. Instead, Little has left it up to local health departments and school districts to make the tough decisions that sometimes come with blowback from the public.

Coronavirus cases surge in the Dakotas


In the southern city of Twin Falls, hospital officials told health board members this week that they too were

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COVID-19 Surges In Rural Communities, Some Midwest Hospitals Overwhelmed : Shots

Rural communities across the country, places largely spared during the early days of the pandemic, are now seeing spikes in infections and hospitalizations.

Daniel Acker/Bloomberg via Getty Images

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Daniel Acker/Bloomberg via Getty Images

Rural communities across the country, places largely spared during the early days of the pandemic, are now seeing spikes in infections and hospitalizations.

Daniel Acker/Bloomberg via Getty Images

As the coronavirus outbreak surges across the country, many rural communities — places which were largely spared during the early months of the pandemic — are now seeing an unprecedented spike in infections and hospitalizations.

The pandemic’s grip on rural America is especially alarming because many of these less populated areas rely on small hospitals, which don’t have the beds or staff to absorb a crush of patients, especially those who require high levels of care.

In early September, the rate of new infections per capita started climbing quickly in the country’s most rural counties reaching what are now record levels — significantly higher than what is being seen in the major urban areas, according to data from the Centers for Disease Control and Prevention.

There is a similar trend in smaller metro areas, although not quite as dramatic.

“Rural is not a refuge,” says Keith Mueller, a professor at the University of Iowa College of Public Health and director of the Rural Policy Research Institute. These counties may be sparsely populated, but it also means that sparsely populated is not an assurance that spread won’t happen.”

In the Midwest, cases have climbed on average nearly 60% over the past two weeks, compared to 35% nationally. And across the country, most non-metropolitan counties have now recorded at least 100 cases or more per 10,000 people since the pandemic began — that’s almost double what it was in early September.

Even though the raw numbers may seem small compared to cities, rural counties in states like Kansas, Montana, South Dakota and Nebraska now have some of the highest rates of infections per capita in the country. And in many places, hospitalizations are also at record levels.

The surge in rural America is not uniform across the country; some communities got hit during the spring and summer for example, when there were big outbreaks at food processing plants.

This week, Ohio Governor Mike DeWine reiterated his concerns about the pandemic’s foothold in his state’s rural counties, saying that many of the residents being hospitalized are coming from those communities rather than the major cities.

“Please wear the masks,” DeWine pleaded, “rural counties, we’re not seeing the mask wearing is high, we would like to really see it get up.”

In North Dakota, Dr. Misty Anderson, an internist, is worried about the pandemic’s hold on small cities and towns like Valley City, N.D., where she lives — just an hour west of Fargo.

“I never lost any patients until recently and I lost a couple in just one week,” says Anderson, who’s also president of the North

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Kansas City hospitals overwhelmed, some forced to divert ambulances as COVID-19 cases jump

Hospitals in and around Kansas City, Missouri, are overwhelmed amid a troubling spike in COVID-19 cases that has forced some facilitates to refuse non-emergency care and others to turn away ambulances due to over-occupancy.

Average daily COVID-19 hospitalizations were up about 10% this week across the Kansas City region as the Midwest grapples with record-breaking daily infection rates and intensive care unit bed shortages, according to the Mid-America Regional Council’s dashboard.

Earlier this week, the Kansas City metro area saw its highest number of new COVID-19 hospitalizations on record with the seven-day average rising to about 133. Separately, hospitals in the area reported a 28% increase in the average number of patients on ventilators, week-over-week, while daily ICU occupancy rose about 11% from last week, according to the dashboard.

All in all, total weekly hospitalizations jumped to 867, compared to 835 last week, pushing several area hospitals to refuse ambulances due to lack of beds.

Marc Larsen, operations director of Saint Luke’s COVID Response Team, the second-largest care provider in the region, said Kansas City area hospitals are “bursting at the seams.”

Hospitals being ‘pushed to the brink’

Saint Luke’s daily patient average rose to about 85 for the month of October, compared to about 63 per day in September, Larsen said. The system reported a daily patient average of only about 15 COVID-19 patients a day in May and June.

“The current trajectory and the rapid increase in infections is a big concern for me,” Larsen told ABC News in an interview Friday. “And with our numbers where they are coming into influenza season, I worry that the facilities will continue to be pushed to the brink on our ability to care for each and every single one of these patients like we need to.”

He added, “As a result, our emergency departments and having to leverage alternative care units in our facilities, meaning that we wind up seeing emergency department patients in our pre-anesthesia care units, recovery rooms and sometimes in waiting rooms.”

PHOTO: Fans take in a flyover before the Kansas City Chiefs take on the Las Vegas Raiders at Arrowhead Stadium in Kansas City, Mo., Oct. 11, 2020.

Fans take in a flyover before the Kansas City Chiefs take on the Las Vegas Raiders at Arrowhead Stadium in Kansas City, Mo., Oct. 11, 2020.

Larsen, who is also an emergency care physician at the downtown Kansas City hospital, said at least eight metro hospitals and emergency departments had to temporarily stop accepting ambulances due to the high volume of patients on Tuesday and Wednesday.

“We had eight facilities at one given time that were on ‘diversion,’ or what we call high-volume status,” he said. “That doesn’t mean that we don’t still take the time-critical diagnoses — we still take our stroke patients, our trauma patients and our heart attack patients — but it does limit our ability to provide care to the remainder of ambulances.”

“When we get to that volume and when we get to that

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