Video screenshot, KTVB-TV

The coronavirus pandemic continues to surge, as cases caused by the Delta variant overwhelm health care resources all over the country. It's especially bad in places where vaccination rates are especially low, like my home state of Idaho, where rightwing politicians have been especially effective in downplaying the seriousness of the pandemic and promoting anti-vaccination propaganda. For their efforts, hospitals in the northern part of the state are now rationing care, so good job, folks.

President Joe Biden plans to announce on Thursday a new strategy to bring the Delta variant under control, considering that national case numbers, hospitalizations, and deaths are rivaling the numbers prior to the availability of the vaccines, largely because too many people aren't getting vaccinated and instead are acting like everything's back to normal. White House Press Secretary Jen Psaki previewed the new "six-pronged strategy" in Tuesday's daily press briefing, saying it would involve the public and private sectors. Psaki acknowledged that the executive branch has limited power to mandate vaccinations, but suggested Biden will be looking to large companies to step up vaccine requirements:

We don't have any preview quite yet. I will note that we've seen that there are a range of ways that we have increased vaccinations across the country, or vaccinations have increased, I should say. One of them is private sector companies mandating in different capacities that their employees get vaccinated. Or certain school districts mandate.

As Biden noted in his comments Friday on disappointing job growth, the resurgent pandemic is beginning to hurt the economy, which is incredibly frustrating in a nation where almost everyone over the age of 12 could have already received a free, highly effective vaccine by now. [ABC News]

It's not clear whether one prong of the new approach will involve adding the vaccine to horse paste. It might be worth a shot.


Idaho: Now Rationing Healthcare Because Jesus Fuck, You Shitheads

Because of a "severe shortage of staffing and available beds," hospitals in two northern Idaho health districts will be putting in place the state's "crisis standards of care," the state Department of Health and Welfare (IDHW) announced yesterday. That translates to an emergency level of triage, rationing the most critical healthcare resources like ventilators, ICU beds, and life-saving medical interventions, based on the likelihood that a patient will survive.

The standards were developed in 2020 when Idaho faced severe hospital overcrowding earlier in the pandemic, but this is the first time they've actually gone into effect. Idaho is currently seeing higher hospitalization numbers than during last winter's surge of cases.

This NPR story, based on reporting by the Mountain States News Bureau, is just plain chilling.


Just to be clear, this is not a warning that hospitals will need to start rationing care. This is hospitals in northern Idaho are now rationing care to save as many lives as possible.

Boise State Public Radio reports that Friday, Kootenai Health in Coeur d'Alene admitted 93 patients with COVID-19,

more than a third of whom required critical care. Two weeks ago, Kootenai Health converted classrooms to make space for 22 more patient beds. The hospital said if it needed to care for patients in this makeshift space, that would trigger their request for crisis standards of care.

IDHW Director Dave Jeppesen called the crisis standards of care "a last resort. It means we have exhausted our resources to the point that our healthcare systems are unable to provide the treatment and care we expect." He added,

This is a decision I was fervently hoping to avoid. The best tools we have to turn this around is for more people to get vaccinated and to wear masks indoors and in outdoor crowded public places. Please choose to get vaccinated as soon as possible – it is your very best protection against being hospitalized from COVID-19.

Then he probably thought to himself, "Forget it, Dave, it's Idahotown."

Under the crisis standards, patients needing hospitalization are given "priority scores" to decide whether they should receive certain services, like a ventilator, with the aim of providing interventions that will save as many "life-years" as possible, Boise State Public Radio explains. "If a patient is in cardiac arrest and their survival is unlikely, for example, they could be passed up for mechanical ventilation."

For now, the crisis standards are only in place for 10 hospitals and health systems in the Panhandle and North Central health districts, but they may have to be implemented statewide if cases keep rising. Idaho has one of the lowest vaccination rates in the USA. [NPR / Boise State Public Radio]

Also Idaho: Anti-Vaxxer Quack Confirmed To Health Board

As an indicator of just how Idaho could have gotten here, Dr. Ryan Cole, an anti-vaccine and anti-mask doctor who has described the coronavirus vaccine as "needle rape," was confirmed this week to the board of health for Idaho's Central District Health board, thanks to votes from seven Republican county supervisors from the three counties in the district. The board of health is required to include at least one doctor, and Cole — who's a big fan of Ivermectin of course — will replace longtime CDH health board doc Dr. Ted Epperly, who was kicked out by Republican supervisors in Ada County because he favored masks and vaccines like some kind of extremist. [Idaho Statesman]

Cole's appointment was opposed by the state's medical community, so we should probably expect the legislature to start granting medical licenses to anyone who reads the quack site Natural Health News.

Mississippi: Babies Of Women Dying Of Covid Delivered By C-Section, Add Your Own Hollow Mordant 'Pro-Life' Joke

In Mississippi, the Idaho of the South, two top doctors in the state say there have been multiple recent instances of pregnant women who have died of COVID-19, necessitating emergency C-sections in the ICU to attempt to save their babies.

"I know at one of the major hospitals here in Jackson, there have been several pregnant women die with COVID within the past couple of weeks," Mississippi State Medical Association President Mark Horne said during a Mississippi State Medical Association discussion on Friday, Sept. 3, 2021.

Mississippi State Health Officer Dr. Thomas Dobbs, who attended the meeting, confirmed the deaths. "And we're talking c-sections in the ICU so you can get the baby out before the mom dies," Dobbs said.

"The seasoned OBGYNs and critical-care specialists said this never happens. Never," Horne replied, referring to the rarity of ICU c-section deliveries involving ventilated patients.

The Mississippi Free Press notes that the docs didn't specify where those deaths occurred, or whether the women had been vaccinated, although Dr. Dobbs did point out that among the 600 Mississippians who died in August from the virus, 61 were in the 18 to 39 age group, and "Not a single one of them was vaccinated."

I feel confident, if they had been vaccinated, every single one of those people would be with us today. It's a stark and painful truth, but it's just what the reality shows.

In early August, Dr. Dobbs had discussed on the Free Press's podcast another case of a woman in similar circumstances:

I'll tell you, last week I was visiting a hospital, and they had a woman who had to deliver a baby in her early 30s. I think the baby's OK, but the woman died from COVID. [...] We know that pregnant women do much worse with COVID, and we know that the preeclampsia rate is looking really bad for women with COVID.

Also in August, the US Centers for Disease Control and Prevention released data indicating that the COVID vaccines are safe and effective for pregnant people and for those who are breastfeeding as well. The health risks of the coronavirus — which can include death or permanent lung damage, among other serious effects — are far greater than any known side effects of the vaccines. The CDC also noted that miscarriages among pregnant people who'd received the vaccine (13 percent) were consistent with the expected rate in the general population (11 to 16 percent of pregnancies.) [Mississippi Free Press / CDC]

National: Brink Of Collapse? Our Health System Has Collapsed

In Slate, Vishal Ketpal, MD, a newly minted doctor, argues that we should probably stop saying the healthcare system is on the "brink of collapse," because in much of the country, that sucker has already been squashed flat. This paragraph makes the point eloquently, although the rest of the piece is worth a read. This isn't fear-mongering, this is a rational assessment of where we are.

As a resident physician who has only trained in an era of COVID—I was asked to consider graduating from school early in April 2020 to help with medical staff shortages—my time as a doctor has been defined by working in a system that has already collapsed. The American health system I work in has featured limited personal protective equipment, oxygen shortages, and the construction of field hospitals in convention centers and parking garages. Last winter, many hospitals across the country instituted crisis standards of care, forced to ration health services based on criteria that few people envisioned would be used outside of a mass casualty event, like a terrorist attack. Today, hospitals are full in much of the country, with patients requiring an ICU being airlifted thousands of miles in search of a staffed bed. These are not features of a health system that is approaching failure. These are features of a health care system that has broken down spectacularly, forcing doctors and patients to climb through the rubble looking for help.

The disaster is here, and has been for a while. We need to be shoring up our medical systems before matters get even worse. [Slate]

[Lead image: Screenshot, KTVB-TV video]

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Doktor Zoom

Doktor Zoom's real name is Marty Kelley, and he lives in the wilds of Boise, Idaho. He is not a medical doctor, but does have a real PhD in Rhetoric. You should definitely donate some money to this little mommyblog where he has finally found acceptance and cat pictures. He is on maternity leave until 2033. Here is his Twitter, also. His quest to avoid prolixity is not going so great.

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