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Health officials are warning the public that hospitals could reach their limits as COVID-19 cases surge again, coupled with the pent-up demand for in-patient care.

With limited testing capabilities, Idaho’s health experts still are unsure how much of the recent uptick in cases is a result of the highly transmissible delta variant. But they do know that numbers are heading in the wrong direction, and they know that the COVID-19 vaccines have been effective at keeping infections, serious cases and deaths at bay.

Dr. James Souza, St. Luke’s chief physician executive, said hospitals are “bursting at the seams” from a surge in all kinds of hospitalizations, including COVID-19.

Souza’s message to the public: “Get the vaccine, get the vaccine, get the vaccine.”

“The overwhelming majority of (COVID-19) patients remain to this day the unvaccinated cohort, and it’s really needless,” Souza told the Idaho Statesman on Wednesday. “It is needless suffering and needless dying, and that’s the message we gotta get out.”

COVID-19 vaccines are effective, state and hospital data show

Souza said vaccinated individuals who end up infected with COVID-19 — so-called breakthrough cases — typically have mild cases. The idea that those show the vaccines don’t work “couldn’t be anything further from the truth,” Souza said.

“Police officers and soldiers wear bulletproof vests so that they can do their job, and take a bullet and survive it,” Souza said. “Those patients that are breaking through the vaccine are presenting with a cold. They’re not being hospitalized, and they’re certainly not being ICU hospitalized.”

Since January, nearly 100% of deaths in Idaho have been among unvaccinated patients, according to the Idaho Department of Health and Welfare. The average age for those being hospitalized with COVID-19 also dropped, from about 69 in January to 56 most recently, Souza said — which he believes speaks to the success of the vaccines among the elderly population.

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In Idaho, 77% of those 65 and older have received at least one dose of the COVID-19 vaccine as of Tuesday, according to the state. Only 42% between the ages of 12 and 64 have gotten at least one dose.

Hospitals challenged by pent-up demand for in-patient care

During the last major spike of COVID-19 cases, in December and January, hospitals were solely focused on the coronavirus, Souza said. But this time, patients are being hospitalized for all kinds of problems, along with the virus.

“It’s everything,” Souza said. “It’s strokes, and heart attacks, and new infections, and new cancer diagnoses.”

Souza thinks a few factors may be at play. Patients were reluctant to go to hospitals to treat conditions as the COVID-19 pandemic surged, and now there’s pent-up demand for in-patient care.

Behavioral health problems, Souza said, and substance use also lead to the poor management of other chronic conditions. He said there’s also a question of whether COVID-19 exacerbates other health conditions.

Souza said that at St. Luke’s, COVID-19 admissions rose from 5% of hospitalizations two weeks ago to 10% this week. Any more increase could spell trouble for the health care system, he added.

The number of COVID-19 ICU patients has doubled since early this month, said Dave Jeppesen, Department of Health and Welfare director. Testing positivity went from 2.8% four weeks ago to 4.3% the week ending July 11. And the seven-day moving average rose from fewer than 50 new cases per day on July 5 to more than 146 per day by last Friday.

On Tuesday, Idaho had its largest single-day number of new cases — 245 — since late April. More than 70 of those cases were in Ada County.

“This has really become a pandemic for those that are unvaccinated,” Jeppesen said Tuesday.

COVID-19 case rise contributes to vaccine mandate at St. Luke’s

Two of Idaho’s largest health care systems, St. Luke’s and Saint Alphonsus, earlier this month announced that they would mandate COVID-19 vaccines among employees. Primary Health Medical Group, a major health care provider, also said it would require its workers to be vaccinated. This added the shot for the virus to the list of immunizations required to work for all of those health systems.

Since then, hundreds have protested at the Idaho Capitol and in front of hospitals. Lt. Gov. Janice McGeachin held a press conference over the mandates and asked the Idaho Legislature to reconvene to ban vaccine requirements by private employers.

“The issue here today is not the effectiveness of the vaccine,” McGeachin said at a press conference last week. “The issue at hand is a matter of individual liberty and freedom. Those who have made the personal medical choice not to take this vaccine deserve to have their decisions respected.”

Souza said the decision to mandate COVID-19 vaccines among employees had something to do with the surge in COVID-19 cases. Health officials have learned a lot from the past three waves of cases, he said, and “we don’t want to see another employee die from this totally preventable event.”

“Our true north on that decision was safety for patients and safety for our people,” Souza said. “We have very vulnerable, immune-compromised people come into our facilities, and it’s been well-demonstrated in the pandemic that transmission events occur in hospitals. We have an obligation to do everything we can, everything in our power, to prevent that from occurring.”

St. Luke’s and other health care systems in Idaho have contingency plans to ration care for when hospitals are close to reaching capacity, whether it’s ICU beds or staffing limits. In the past, hospitals across the U.S. closed their doors to elective procedures and shifted personnel to focus on more acute care.

“We really don’t want to have to activate those,” Souza said. “It’s only going to exacerbate this problem of the health of our communities, and the pent-up demand that we allowed to occur in the first three waves.”

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