Healthcare Professionals Talk COVID-19 as Idaho Marks 2 Years Since First Confirmed Case

REXBURG, Idaho (KIFI) — Sunday marks two years since the first case of the coronavirus was reported in Idaho, making it the 49th state to have a confirmed case.

Dr. Jack Clark, director of the hospital program, and Misty Gordon, director of inpatient services at Madison Memorial Hospital in Rexburg, say the time allowed them to plan ahead for each scenario.

“A lot of people get together and talk about what the disease is, what do we do?” said Clark.

Clark says the concern initially was the need for ventilators.

“We planned for a disaster. Luckily, we never had to enact it,” Clark said. “But what do we do if we have more patients than we have ventilators? What do we do if we have more patients? We have hospital beds, we can set up field hospitals.”

They were able to watch and see what other hospitals in the country and other countries were doing and seeing.

“There were New York doctors doing weekly webinars and just sharing their fears. What we see, here’s what we do,” Clark said. “And that was very helpful for us in trying to plan what we might have to do. Listening to what the people who were already in the middle of it, and listening to what they were doing and trying to make plans if that’s the same arrives here, what do we do with it?

This helped Madison staff know what would work and what wouldn’t.

One thing that was different with other respiratory illnesses was the standard of care.

“Before, when someone came in really sick, the standard of care was to give them two liters of fluid and give them antibiotics,” Clark says, that’s not the case with COVID-19. “It’s a virus. Antibiotics weren’t going to help. But secondly, we learned very quickly that giving these patients lots of fluids was the wrong thing to do. So luckily we didn’t have to do that. We learned this by listening to what they were doing and what worked for them and what didn’t.

One thing that worked was prostrating or turning the patient onto their stomach, Clark said.

“Most of the time when we have someone with pneumonia, we have them on their back and sitting up,” Clark said. “And for those patients, lying prone, they did a lot better, which didn’t make sense. But it worked for COVID patients.”

Madison Memorial had its first hospitalization for COVID-19 in “May or June” and by then staff were ready, Gordon says.

“There was a lot of preparation to make sure we had the proper precautions in place,” Gordon said. “The proper PPE supply chain was always the priority from the early days and it still is today. We had to really make sure we were very proactive in getting the supplies we needed.”

Gordon says various departments and units worked together to strategize and set aside an area where they could treat positive patients.

“We did a lot of education, drills and preparation to make sure we could give optimal care and get the best results with the information and knowledge we had,” Gordon said. “Thinking about what has changed, the lessons we have learned over the past two years, it has been interesting to really reflect on nursing. Not much has changed. We still provide compassionate care. We strive always to provide exceptional care to our patients and follow evidence-based practice.”

Clark says the ER would see 35 to 40 COVID-positive patients a day at its peak, but not all would be admitted.

He also says the hospital has never had to close areas due to overcrowding or lack of nurses.

“Like everyone in the country, we felt the lack of nurses. We went through a few phases here during COVID, where we would want to admit patients and we had to count how many nurses (we had), how many rooms and let’s see, can we really take on more patients?” However, Clark said they had to transfer patients several times due to the shortage. “In our initial planning, we had a four-phase plan of how we fought each phase and then disaster. Luckily the highest we got was phase three, where we had two different areas of the separated hospital. But we didn’t take care of the whole floor. We had to close a service line for about two weeks. But luckily it was never busier than that.

Clark also says certain things have helped the cases go down.

“The vaccine was a huge, huge thing for us in terms of, just from personal experience, what I saw in our hospital. Ninety-five percent of the people we ended up admitting to this which I call phase two, phase three are not vaccinated,” Clark said. “If people got the vaccine, there was a very small chance that they would be admitted to hospital. It was like less than 5%. And we have had zero deaths in our vaccinated patients.”

The treatments also helped, Clark says.

“Monoclonal antibodies, polyclonal antibodies, a few different versions came out of things that people could get that might save them from having to be in the hospital,” Clark said the pill form of the drugs also helps. “If people get it within the first five days, (it) can slow down the symptoms and prevent them from having to go to the hospital. From the early days when we had two drugs we could use, we’ve been now up to four or five different drugs that we can use in the hospital setting.”

Gordon says that while things have been difficult, the nursing staff have been “absolutely amazing”.

“We attended a funeral. Contributing to the GoFundMe pages, our nurses really take care of the whole patient and the whole family, and I think that’s what makes them so special,” Gordon said, it was “incredible” to see their compassion, but that it is expensive. “When you’re in that PPE, you know, you see those pictures on the news and how miserable that outfit is, caring for a patient working twelve hours a day, that can be exhausting. And one thing that has been really hard on our staff, we’ve had patients who died here from COVID, and we also shipped patients (transferred them to other hospitals).”

Gordon says they’ve learned a few things during the pandemic.

“How important is human connection really and how important it is for mental health, especially with our healthcare workers,” Gordon said. “Our nurses are resilient and they’re not naive about difficult health care situations. But to see that repeatedly, in younger populations that maybe they’re used to, it’s been really difficult.”

To help with that stress, Gordon says they did a few things.

“We’ve created a zen room in our hospitals so nurses can really step away from the bedside and try to decompress,” Gordon said. “We created specific groups after a code or emergency event that we were able to debrief with experienced social workers. Lots of opportunities to use these social workers to really help our nurses deal with stress.”

Lillian L. Pena