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Idaho health leaders OK crisis health care rationing rule

December 11, 2020 GMT

BOISE, Idaho (AP) — Idaho’s top public health leaders on Friday cleared the way for state officials to impose crisis standards of care if the number of COVID-19 patients increases so much that the state’s already strained hospitals wind up completely overwhelmed.

Idaho Board of Health and Welfare members approved the temporary rule giving Department of Health and Welfare Director David Jeppesen the authority to enact the standards whenever needed.

The move, if enacted, would direct hospitals to use limited resources to provide potentially life-saving treatment to the patients most likely to survive, using a scoring system that takes into account the ages of the patients, how healthy their organ systems are and other factors.

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Other patients would still get as much care as possible, but in a worse-case scenario some could die of normally survivable illnesses and injuries.

It’s a crisis that Idaho hospital officials have warned could happen within weeks.

At least 400 Idaho hospital beds have have been filled with coronavirus-infected patients every day since Nov. 17, according to health department statistics. And increasing numbers of hospital workers have had to call in sick because they’ve contracted COVID-19 or have been exposed to people with the virus.

Experts have said the number of hospitalizations could increase sharply if residents continue disregarding basic recommendations like wearing masks, washing hands, avoiding unnecessary travel and keeping holiday celebrations to immediate households only.

More than 118,000 Idaho residents have been infected since the pandemic began, according to statistics from the Idaho Department of Health and Welfare. At least 1,136 of them have died and COVID-19 was the leading cause of death in the state in November.

Republican Idaho Gov. Brad Little has declined to issue a statewide mask mandate, despite repeated requests from health care leaders and some regional public health boards.

Instead he continues to urge members of the public to choose masks on their own. Many Idaho residents are disregarding his advice, however and some are aggressively protesting against local mask mandates.

Doctors, nurses and other health care workers are suffering under the heavy burden, said Idaho Board of Health and Welfare board vice-chair Jim Giuffre.

“They’re fatigued, they’re frustrated, they’re heartbroken that the public is not supporting them,” he said. “A statewide approach may be more prudent.”

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Under the temporary rule, Jeppesen is empowered to enact the crisis standards of care when he feels they are needed.

Previously, Little would have had to make a recommendation to various committees and health care entities and the final recommendation for the care standards would have had to come from the Idaho’s Crisis Standards of Care Activation Committee.

Having two pathways to activating crisis standards of care helps to ensure the state can move quickly if needed, said Jeppesen, even if a natural disaster or some other problem makes it hard to reach committee members or other stakeholders.

The rule gives a great deal of authority to one person, said Wendy Jaquet, a board member and former state lawmaker.

“Number one, that’s a huge responsibility for the director and number two, it’s a huge amount of power for the director,” Jaquet said.

Jeppesen said if he feels he must enact the standards, he will still convene the Crisis Standards of Care Activation Committee immediately to review his decision and decide if the standards should be used.