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‘We Are Not Even Close to the Worst’
Saturday, September 4, 2021


On Dec. 14, as a nurse at Saint Alphonsus injected Idaho’s first dose of COVID-19 vaccine into a fellow employee’s arm, Dr. Steven Nemerson declared it D-day in the war against COVID.

This week the chief clinical officer of Saint Alphonsus Health System was not jubilant but, rather, somber.

“Sadly, today I must tell you we are losing the battle, and patients are dying unnecessarily,” he told reporters assembled on a video call with three of the state’s top medical officials.

Idaho is currently experiencing the most extreme health situations the state has ever experienced as the surge in Idaho and Oregon grows unabated. And there’s no evidence the state has reached its peak, he added: “Our predictive modeling shows the surge is likely to continue through the month of September.”

Dr. Richard Augustus, chief medical officer for West Valley Medical Center, concurred: “We are not even close to the worst, and that scares us because we went into this to care for people, to help people, to save them, and we can’t.”

Nemerson said at least 10 percent of the state’s residents have been infected with COVID since the  pandemic started. COVID infections and deaths are surpassing the level they were during the winter of 2020. And the test positivity at Saint Alphonsus alone is 22 percent—the worst it’s seen since the pandemic started.

Twenty percent of the patients in Boise have COVID and 35 percent of those in Nampa. And the critically ill and dying patients are younger than ever.

At least 95 percent of those hospitalized with COVID are unvaccinated, doctors said, and 99 percent of those with COVID in ICUs are unvaccinated.

"We continue to lose people who didn't have to die,” said Augustus. “We continue to comfort families after a death that didn't have to happen. There is heartache and there is pain, and there are folks who are suffering, who don't need to suffer. And we need to do our part to help."

With the exception of medical emergencies such as heart attack, Idaho residents should be prepared to care for themselves at home for the short-term foreseeable future, said Nemerson. Saint Alphonsus paused elective surgeries weeks ago and this week decided to delay or cancel medically necessary procedures for heart and other patients to provide hospital capacity while the surge continues.

The hospital has 48 employees quarantined because they’ve contracted COVID or been exposed to COVID—not in the hospital, but in their homes or elsewhere. But that’s an improvement compared with pre-vaccine days in December when the hospital had 170 out, Nemerson said.

Right now, the hospital is exceeding 100 percent of its capacity, in part filling up with people who neglected treatment for heart ailments and other conditions during the pandemic.

The situation is the same at St. Luke’s, said Dr. Frank Johnson, chief medical officer at St. Luke’s. On Thursday St. Luke’s had 430 hospitalized adults—200 of them with COVID. And that makes it impossible for all but St. Luke’s Wood River and McCall to provide hip replacements and the other types of care they ordinarily would.

“It’s hard when we go out in the communities and see large gatherings, schools back in session with little masking or other accommodations,” he said.

Johnson teared up as he praised his health care workers “who are stepping up in crazy, ridiculous circumstances to provide care for the people in our communities.”

“It is inspiring and people are going way beyond… We’re exhausted. Our teams are tired. We need help from our communities to turn this around,” he added. “Wear masks, close down large gatherings and get vaccinated. Slow this down. Shut this down and get back to normal.”

Hospitals currently have no capacity to transfer patients because there’s no place for them to go, Augustus said.

“We have sicker patients than we routinely take care of and we’re taking care of them because we have no choice. The ICU has 11 of 13 beds with COVID patients. We don’t routinely have patients on ventilators; now we have lots of patients on ventilators.”

“The people I work with are heroic in their efforts, but we’re losing people who didn’t have to die. There are patients who are suffering who did not need to suffer. All of us recognize things we can do to slow this down, and we need help from the community to do this. Wear a mask; wear a seatbelt.”

Johnson said the word “unprecedented” keeps taking on new meaning every day as hospitals continue to expand spaces to treat more patients, pull in nurses from other roles, shuffle units and work with  state and regional partners to move patients and supplies around.

Nemerson called it a crisis: "It's totally preventable with the vaccine, and the pandemic we are experiencing now is in people who aren't vaccinated and just don't care.”


Dr. Stephen Nemerson said even healthy young children have a high risk of contracting COVID in schools in communities with high infection rate if the schools are not requiring masks and other protective measures.


As of Friday, 94 percent of St. Luke’s 17,000 employees have gotten vaccinated or obtained a medical or religious exemption. The hospital is engaging with those who are still on the fence despite the hospital’s recent mandate that staff be vaccinated.

Johnson said he expects some employees to resign, “and that’s regrettable, but we anticipate the number will be small. But the vaccine important enough to accept that risk because the alternative is not acceptable.”

Nemerson added that Saint Alphonsus has seen a 70 percent reduction in the number of workers who are out sick because of the vaccinations.

“This is a manifestation of a vaccine working to keep people healthy and able to take care of their fellow man,” he said.


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