By Dr. Kelly McGrath

The Coronavirus pandemic has accelerated nationally and locally in the past 3 weeks.  In fact, in the US, Covid has already has killed more than 6.5 times the number of Americans that die in a typical flu season.  Unfortunately, unlike our experience in spring 2020, Clearwater County is no longer on the sidelines of this battle.  In fact, Clearwater County now has a dubious distinction within Idaho. Of the 44 counties in Idaho, Clearwater County has had the highest 7 day incidence rate of Covid cases in the entire state. Nez Perce and Idaho counties are also performing poorly with rankings of #3 and #4 respectively.  In the absence of any demonstrable change in safe practices in the community, coupled with Thanksgiving holiday group gatherings which will likely drive spread, this high rate of cases almost certainly will continue to rise exponentially and wreak havoc.

What this means for individuals is really quite variable.  Not all those who are infected will suffer from severe or moderate disease but too many will.  In fact, 40% or 4 people in 10 infected with the Covid virus will have no symptoms at all.  This is the diabolic nature of this virus as these asymptomatic individuals, without following the simple standard public health recommendations of hand washing, wearing masks, physical distancing and avoiding large gatherings, likely are a strong force driving the infection of others – some of whom will be less fortunate.  Those with chronic diseases such as diabetes, high blood pressure, obesity, lung disease tend to have more severe disease.  With the tricky nature of Covid, however, even some people who are generally healthy may, through random factors, experience severe disease or death. The story on Covid continues to unfold.  Even after recovery, some who suffered moderate or severe disease, even without requiring hospitalization, go on to experience long term effects.  These can include chronic fatigue, lasting shortness of breath, brain dysfunction, stroke, kidney damage or heart damage.  Around half of those with moderate or severe disease have been shown to have lasting dysfunction of their heart beyond the acute infection.  It is unknown how long it will take to recover from these conditions or if they will have further downstream consequences.  It will take further time to tell. This is the unpredictable “wildcard” of Covid.

The impact of this current surge on the availability of our healthcare services is stark and foreboding.  Already the regional ICU capacity is tapped to the limit.  Many days over the past 3 weeks we have had no ICU capacity in the entire North Idaho region consisting of Spokane, Lewiston and Coeur D’ Alene.  Few days have there been more than 5 or 6 total critical care beds available in the region. This shortage impacts all of those needing critical care – not just those critically ill with Covid.  Due to local shortages, the physicians at CVH have sent critically ill patients as far away as Seattle or Boise for critical care. At times, these critically ill patients have had to wait for as much as 5 hours while the CVH ER physicians search to find a hospital with critical care beds able to take the patient. This rarely has occurred over the years but now is routine because of the unchecked surge of Covid cases.

Locally, as cases rocket upward with the resulting increased demands on the hospital and with some of our healthcare staff also falling ill with Covid, the situation is very concerning.  It takes little imagination to consider the dangerous situation if the community does not embrace measures to slow the spread of Covid and the resources of our local healthcare system are exceeded.

We can either embrace the measures proven to be effective in bringing Covid cases under control or not.  This is a choice we will make individually and as a community. With the system currently at capacity, the consequences of not embracing these measures will certainly bring on a scene that no one would wish to witness or imagine.  If we reach that point, the moment to have acted in a responsible and selfless manner to protect our community will have already passed.