This is Part 2 in a three-part series on Covid-19's impact on the economy, nationally and locally. Part 1, "Covid-19's Economic Impact on the United States and Idaho", can be found here. Part 3, "How Covid-19 has Impacted the Skilled Trades Industry", can be found here.

There is perhaps no industry more affected by Covid-19 than healthcare.

As discussed in last week’s article, many industries such as restaurants and movie theaters were all but shut down during the height of the pandemic. Others, like tourism, came to a halt, hurting the economy of those cities who relied on them. 

Healthcare faced a different problem. It didn’t have a lack of patients coming, it had too many. Hospitals and other care facilities didn’t have time to figure out how to adapt, they were forced to. The doctors, nurses, and other professionals in the field faced—and continue to face—overwhelming challenges each and every day.

The Start of the Pandemic

Even before the pandemic began, the healthcare system was facing a shortage in the workforce. In a study published in June of 2020, the Association of American Medical Colleges (AAMC) looked at the projected demand for physicians from 2018-2033. The findings concluded that by 2033, there would be a shortage of primary care physicians of between 21,400 and 55,200, and a shortage across the non-primary care specialties of between 33,700 and 86,700 physicians.

The shortage was compounded in Idaho. In 2017, the AAMC ranked Idaho as 49th state on the list of physicians per capita. This was backed by the Idaho Department of Health and Welfare which stated the federal government had designated all but three counties in Idaho as Health Professional Shortage Areas (all counties in Idaho were short of mental health professionals). 

Keep in mind this was all before the pandemic even hit the United States. Once that happened, starting in January of 2020, doctors and nurses across the country felt the strain. 

Southeastern Idaho Public Health issued a statement in March 2020, during the early stages of the pandemic in Idaho. The organization warned, “The demand for testing by people who have mild symptoms is putting a strain on healthcare systems. Test materials and personal protective equipment are being used at a faster rate than normal because of the demand.”

Dr. Dan Snell, Portneuf’s chief medical officer, added that demand on Covid-specific supplies continued for the next 8-10 months. Capacity in Portneuf, and across the state, was forced to increase to keep up with the demand. 

Idaho’s Response to the Growing Need

One thing that is sure during a crisis is that people will rise to the challenge.

In response to the growing need for physicians, Idaho was one of three states to grant broad authority for the waiving of all licensure requirements in the case of unmet need arising from COVID-19. This opened the way for more people to enter the medical field right away, helping in part to alleviate the immediate need. 

Portneuf took measures to help their patients while keeping their staff safe. Dr. Snell stated that learning how to keep their staff and medical professionals safe before the vaccine was a difficult task. It meant meeting in the incident command center twice a day, 7 days a week in order to manage all the moving parts.

To meet the need for medical supplies, Portneuf, with the assistance of its parent company Ardent Health Services, was able to tap into a centralized pandemic warehouse, which Dr. Snell states “resolved all but intermittent supply chain choke points for routine hospital supplies”. 

More than just the patients, measures were taken to support the medical professionals. Before the pandemic began a system known as ECHO was already implemented across Idaho. ECHO is a telehealth program that allows for medical professionals to meet regularly with subject matter experts. 

Thanks to this system already being widely used across Idaho, ECHO was able to create a program designed to handle Covid within two weeks of the first case. As a result, information about the disease (which was still forthcoming at the time) could be easily communicated statewide as it was learned.

Portneuf also added extra counseling and support programs for the employees. Dr. Snell stated this helped to alleviate some of the stress of caring for patients and avoiding getting sick themselves. Still, he adds “the trauma of working through this pandemic is real”.

How Idaho’s Healthcare System Currently Stands

While most of us probably are looking towards the end of the pandemic, the reality is far different. On August 31st, Governor Brad Little announced one last effort to avoid Idaho’s first-ever activation of statewide crisis standards of care. Were we to enter a statewide crisis standard of care, medical professionals would be forced to decide who to care for, turning away many who might otherwise have received care.

Governor Little plans to add up to 370 additional personnel to assist hospitals with the surge. As it stands, every hospital across the state is at maximum capacity if not over. As of August 31st, only four adult ICU beds were available across the entire state. 

Portneuf is similarly strained. Dr. Snell states, “The difference at the beginning of the pandemic was that we could focus primarily on COVID-19 issues--everything else had slowed down.  The biggest challenge now is managing COVID-19 patients in conjunction with a high volume of patients seeking other types of care, from postponed surgeries to trauma cases”.

Working during the pandemic—a task that has now lasted more than 18 months—has taken a heavy toll on the staff at Portneuf and hospitals across the state. Dr. Snell points out that the emotional and mental strain of handling so many patients each day is draining. He hopes moving forward to see a lasting emphasis on support and balance for the employees.

Despite the hardships, however, he sees Portneuf as coming out from the pandemic stronger than ever. Due to the extended management of the pandemic, he feels they are better at handling crisis situations than they ever have been. 

He also still recommends the medical professions for anyone interested. “For people looking to get into the industry, I highly recommend healthcare as a career.  I love what I do and while it is challenging at times, I don't think there is a more rewarding job out there”.

The pandemic has exacted a toll on us all. But we should be careful about celebrating the end too soon. As it stands the healthcare system in Idaho, and indeed across the country, is still strained from Covid. The emotional and mental toll on the employees has been and remains lasting. 

Let’s all do our part to minimize the pandemic, not just for ourselves and our loved ones, but also for those who have sacrificed so much for our well-being.