Current Hospital Status as of 10/21/2021, 8 a.m.
- Total Number of COVID-19 Inpatients: 135
- Number of COVID-19 Patients Requiring Critical Care: 44
- Number of COVID-19 Pediatric Patients: 1
Data to be updated each morning by 10 a.m., Monday to Friday.
Questions and Answers – August 20, 2021
Kootenai Health put together an updated document on August, 2021 to help address new and frequently asked questions we have heard circulating regarding the COVID-19 pandemic.
Thank you for your continued support of our health care community during these challenging times.
As a regional hospital, it is our job to care for the patients of northern Idaho. We are doing our best to care for every patient, to advocate for the safety of our community and keep our employees safe from harm.
This pandemic is new to all of us and we are learning as we go. We are learning more each day from reliable sources including the CDC, WHO, peer-reviewed scientific papers and studies as well as our own experience in caring for COVID-19 patients at Kootenai Health.
Here is information addressing some of the questions surrounding COVID-19.
What percentage of unvaccinated versus vaccinated are hospitalized at Kootenai Health?
Since the beginning of our most recent surge, we have found 97% of patients hospitalized for COVID-19 are unvaccinated.
Why should I get vaccinated?
- COVID-19 infection and death is largely preventable with vaccination.
- The COVID-19 vaccinations are safe and effective.
- The risk of serious side effects with COVID-19 vaccination is extremely low.
- Contracting COVID-19 infection can be mild, lead to long term health concerns or it can be deadly, even in young people.
- By getting vaccinated you are protecting yourself, your loved ones and your community.
How many hospitalizations have you had as a result of the COVID-19 vaccine?
Kootenai Health has not admitted a single patient for adverse reactions to the COVID-19 vaccine.
Are any of the vaccines approved by the FDA?
The Pfizer vaccine received full approval by the FDA on August 23, 2021.
What are potential side effects to the vaccine?
Common side effects are pain, redness and swelling at injection site. Other symptoms can include flu-like symptoms that should subside within 24 hours. Visit the Center for Disease Control’s website for more information on vaccine reactions: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html.
Is there anyone who should not get the vaccine?
No, the vaccine is proven to be safe for people with a variety of different health backgrounds (pregnant, breast feeding, autoimmune diseases, etc.). However, it is always best to speak to your health care provider about what is right for you.
If you have only had one dose of the vaccine, does that put you at greater risk than people who haven’t received either vaccine?
No. Being fully vaccinated gives an individual the most protection, but only having one dose of the vaccine will not cause greater harm than not being vaccinated.
I’ve had COVID-19, why should I get vaccinated?
Even if you have had COVID-19, you still need the COVID-19 vaccine for full protection. The COVID-19 vaccination provides longer, stronger immunity and if you have had COVID-19 in the past, it provides an immunity boost for longer protection. Read more from John’s Hopkins <https://www.jhsph.edu/covid-19/articles/why-covid-19-vaccines-offer-better-protection-than-infection.html>
What information should I trust?
When looking for information on COVID-19 vaccination effectiveness and safety, trust reliable, medically peer reviewed sources. Kootenai Health follows the guidance of the Centers for Disease Control, CDC <https://www.cdc.gov/coronavirus/2019-ncov/index.html> , the foremost experts in disease, infection and population health, and recommend our patients and community do the same.
Kootenai Health strongly encourages every person who is eligible for vaccination to get the COVID-19 vaccination as soon as possible.
Vaccination is the best protection available to prevent serious illness and hospitalization from COVID-19 infection. The vaccinations available today are more than 95% effective in preventing illness, hospitalization and death. It also helps protect our community by limiting the spread.
Are COVID-19 vaccinations safe?
- They were rigorously tested and have now been used by millions around the world to prevent infection. More than https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-events.html> Learn about the safety here. <https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/safety-of-vaccines.html>
Does Kootenai Health mandate the COVID-19 vaccine for employees?
Kootenai Health does not mandate the COVID-19 vaccine for employees. We strongly encourage our employees to get the vaccine as we believe it is safe and effective.
ICU Physicians discuss COVID-19
Drs. Scoggins and Hoopman discuss the recent surge in COVID-19 cases, the delta variant, and the importance of vaccination. Recorded on 8-11-2021
COVID-19 and Pediatric Patients
Kootenai Health’s Medical Director of Pediatrics gives an informative presentation addressing concerns related to COVID-19 and our pediatric community. Recorded on 8-30-2021.
What is the Delta variant?
When a new variant of the COVID-19 virus is sequenced, it is provided a unique name (B.1.617.2) and letter in the Greek alphabet for tracking. The Delta variant was first identified in India in December 2020 and has been identified as a “Variant of Concern.” It has since spread more than 80 countries around the world and all 50 states. It now makes up for 83 percent of all US cases according to the CDC. It is spreading rapidly, especially in areas with low vaccination rates. More on Delta from Yale Medicine. <https://www.yalemedicine.org/news/5-things-to-know-delta-variant-covid>
Why is this variant concerning?
According to the World Health Organization, this variant spreads 50 percent faster than the original alpha variant. According to scientists in China, some patients infected with this variant had viral loads that were 1,260 times higher <https://www.medpagetoday.com/special-reports/exclusives/93717> , making the infected much more ill.
Who is getting infected?
Most people who are getting infected, sick and hospitalized with COVID-19 are unvaccinated.
COVID-19 Stats from January 1, 2021 from the Idaho State Department of Health: <https://pbs.twimg.com/media/E6xFhTrUUAMK887?format=jpg&name=medium>
- 98.9 % of cases were not fully vaccinated
- 98.6 % of people hospitalized were not fully vaccinated
- 98.7 % of people who died were not fully vaccinated
What are breakthrough infections?
A breakthrough infection is when a vaccinated individual becomes sick from the same illness that their vaccine is meant to prevent. This may happen if the vaccine did not produce enough antibodies to fight off infection (often when patients are immunosuppressed or have other complications). Breakthrough infections for those vaccinated for COVID-19 is rare and if someone does get COVID-19 after being fully vaccinated, they are likely to experience a much milder case of illness than they would have experienced without vaccination.
Viruses and Masks
How can a mask help if viruses are so small?
Viruses are very small. However, viruses don’t move on their own, they must be transmitted in some way. The novel coronavirus (COVID-19) is transmitted in droplets that come through the nose and mouth. Using a mask creates a barrier that greatly decreases the potential to transmit droplets that could be carrying virus. If everyone wears a mask, we can keep everyone’s germs (droplets) to themselves.
Just as we all cover our cough or sneeze with our elbow or a tissue to keep droplets with germs and viruses from spreading to others, masks also help keep the droplets with germs and viruses from spreading. Wearing a mask is about protecting others.
Can people get sick from increased carbon dioxide intake while wearing a mask?
No. There is enough filtration of air through a mask that wearers do not have increased carbon dioxide intake. Viruses, although very small, are much larger than molecules of oxygen or carbon dioxide which readily pass through masks.
CO2 makes up only about 0.04% of the air we breathe, and is considered life-threatening when its concentration is greater than about 10%.
Surgeons and nurses regularly wear masks for long periods of time as part of their normal work. While it may take time to get used to, and may be uncomfortable, we are all doing our part to keep each other safe. You may want to experiment with different styles and types of masks to see which is best for you.
I have heard masks don’t work, is that true?
CDC provides information on how masking helps prevent the transmission of respiratory illness. Wearing a mask has long been used to help prevent the spread of respiratory illness such as tuberculosis and the pneumonic plague. Masking helps us keep our germs to ourselves, protecting others.
Why weren’t masks recommended at the start of the pandemic?
According to the CDC, at the beginning of the pandemic experts didn’t know the extent to which people with COVID-19 could spread the virus before symptoms appeared. Nor was it known that some people have COVID-19 but don’t have any symptoms. Both groups can unknowingly spread the virus to others.
These discoveries led public health groups to reconsider the use of face masks. The World Health Organization and the CDC now include face masks in their recommendations for slowing the spread of the virus. The CDC recommends cloth face masks for the public and not the surgical and N95 masks needed by health care providers.
Did Kootenai Health mandate masks for the community?
Kootenai Health does not have the authority to mandate masks in public. The only organizations and people capable of mandating masks in public are: the federal government, the state government, the city government or the public health district.
Kootenai Health does require all people who enter our buildings (employees, patients, visitors) to wear a mask at all times.
The hospital has the obligation and legal right to implement rules and restrictions to keep patients and staff safe.
We support the decision to mandate masking to help keep our community safe
If you test the same person twice, and both tests are positive, are they counted as two cases?
No. The tracking numbers for the county represent the number of COVID-19 positive individuals, not the number of positive test results.
How do we know if someone has the Delta variant?
Not every COVID-19 case is sequenced due to cost and limited resources. When Kootenai Health identifies a COVID-19 case with an extremely high viral load, we send a sample to the State of Idaho laboratory for sequencing. Panhandle Health District then shares a percentage of what tests are which variant. At this time, it has been determined nearly 90% of positive tests sent to the state lab are positive for the delta variant. This is a similar finding at hospitals across the country. At this time, we are unable to determine what variant each individual patient is infected with. The medical care each patient needs does not differ between the different variants.
Is the COVID-19 nasal swab test accurate?
Our medical professionals believe the nasal swab test that checks for the virus is accurate and the results can be trusted. It is much more likely to have a false negative (testing too early or insufficient sample) than a false positive.
If tested too early, or submitting an insufficient sample, a test could result negative. This same individual may test positive at a later date in time. It is extremely rare that a false positive result is seen.
Recently we have seen a number of home tests and antibody (serology) tests on the market. If a test sample is not collected by a trained professional and/or the test is not processed in a lab that follows appropriate clinical protocols, its accuracy can be negatively impacted.
Are unvaccinated and vaccinated people both tested when they come to Kootenai?
All patients, regardless of vaccine status, are tested for COVID-19. This helps determine what type of PPE staff needs to wear when treating the patient. It also helps us keep non-COVID-19 patients safe from contracting the virus if we are able to isolate COVID-19 positive patients from non-COVID-19 patients.
Can the numbers be trusted?
As with all infectious disease cases, Kootenai Health, other health care organizations, and laboratories provide the number of COVID-19 positive tests to Panhandle Health District each day. The Panhandle Health District reports this information in their dashboard online and sends the information to the State Department of Health and Welfare, who then passes it onto the CDC. This information is then used by the state and federal government.
Diagnosis and Hospitalizations
Are people who are admitted for COVID-19 admitted for other reasons and just happen to have COVID-19?
Most people who are admitted with COVID-19 are admitted because they have oxygen levels so low they are in respiratory distress and need hospital-level care.
While it is possible that someone comes in for something other than COVID-19 and happens to be COVID-19 positive, this is less common. The overwhelming number of patients currently admitted to the hospital with COVID-19 are in need of medical care because of their COVID-19 infection.
How many hospitalized patients previously had COVID-19?
We are seeing some re-infected hospitalized COVID-19 patients. However, it is not possible to give an accurate number of this statistic. We only know what is in a patient’s medical record, and if they were not previously hospitalized for COVID-19 we are unable to say definitively if they have had it before. Additionally, a patient may have had COVID-19 previously and was never tested.
Do you keep COVID-19 patients for 10 days regardless if they are well enough to be discharged?
Patients who require hospital level of care remain at the hospital. If they are well enough to go home, they are discharged from the hospital.
How do you know if patients have COVID-19 or the flu?
Kootenai Health uses highly accurate Polymerase Chain Reaction (PCR) tests to determine if a patient has SARS-CoV2 virus (which causes COVID-19).
Doctors use symptoms and tests to diagnosis patients. Patients are often tested with a “full panel” of viral tests which checks for a range of viruses including respiratory syncytial virus (RSV), influenza, and SARS-CoV2. The results of these tests help a doctor determine a patient’s diagnosis.
Any patient listed as positive for COVID-19 at Kootenai Health has the SARS-CoV2 virus.”
Is COVID-19 real?
Yes. As of August 11, more than 617,307 Americans have died with COVID-19.
Across the globe, there have been more than 203 million cases and 4.3 million deaths.
In Kootenai County we have had 226 people die.
Any implication that this virus is somehow unreal, a hoax or insignificant is false.
What is a coronavirus?
Coronaviruses are a type of virus and should not be confused with influenza, the flu virus.
Human coronaviruses were first identified in the mid-1960s. Four of the common coronaviruses cause the common cold. Three other coronaviruses have been identified that originated in animals and evolved to infect humans:
- MERS-CoV (causes Middle East Respiratory Syndrome, or MERS)
- SARS-CoV (causes severe acute respiratory syndrome, or SARS)
- SARS-CoV-2 (the novel coronavirus that causes COVID-19)
The new, novel coronavirus SARS-CoV-2 is causing a global pandemic of respiratory illness.
How many rooms do you have?
Kootenai Health is currently licensed for 330 beds (up from 254 in 2015)
- 200 of those are for medical/surgical patients including acute care and critical care. Our COVID-19 isolation unit is included in this number.
- 77 are for behavioral health including adult, youth and chemical dependency.
- 52 are for women’s and children’s services including labor and delivery, postpartum, pediatrics and NICU.
When we share capacity numbers, we are providing the capacity of our medical/surgical area as a whole. Not all rooms can serve all patients.
The rooms designated for women and children’s and behavioral health are not set up for medical/surgical patients. They have different equipment for different types of patients and the employees have different skills and training.
Why can’t all rooms be used for critical care?
Critical care requires highly specialized equipment, supplies, and most importantly, specially-trained critical care staff to care for patients. We have converted additional rooms to be critical care rooms, but not all rooms can be converted.
Do you have enough room to care for patients?
Hospitals accept new patients in a few ways. Some patients are pre-scheduled for a needed surgery. Some come to the emergency department and require hospital-level care. Others come through “direct admissions” meaning they come direct from a doctor’s office or another hospital.
Ideally, we want to keep all patients close to home for their care.
If we cannot accommodate a direct admission patient, we must “decline to admit.” These patients and their doctors are then forced to find another hospital with capacity for admission.
With our current capacity constraints, the number of patients we are forced to decline has increased significantly.
- In Q4, 2019, we declined to admit 9 patients
- In Q4, 2020, so far – still six weeks left to go, we have already declined to admit 52 patients
Why is Kootenai Health stopping elective procedures?
The rise in hospitalized COVID-19 patients has resulted in the need to cancel elective procedures. The additional beds and staff need to be reallocated to care for the rise in hospitalized COVID-19 patients.
How old are the patients hospitalized? Is it just the old and frail who are impacted?
No. Hospitalized patients range in age from pediatric to 80+. With the Delta variant, our average patient needing critical level of care is under 60. This is a much younger and sicker patient population than we treated with other variants.
Can you add more beds?
It is important to note that not only do patients require physical beds, equipment and space, but they also require qualified staff and the personal protective equipment to keep them safe.
Kootenai Health is currently transitioning a number of our current rooms into double occupancy rooms to accommodate more patients and has a surge plan to accommodate an influx of patients which would require more isolation units and shutting down other parts of the hospital to care for COVID-19 patients.
No resource is infinite.
Will you close the emergency department?
No. Our emergency department is open and will always remain open to care for patients, however, there may be increased wait times or instances when patients must remain in the emergency department for care.
Why can’t you hire more staff?
Kootenai Health is actively hiring nurses, medical staff and physicians.
However, there is a national nursing shortage and hospitals around the country are experiencing the same capacity and staffing concerns as the need outpaces the available resources.
Kootenai Health has hired a number of “traveler” nurses to help care for the increase in patient hospitalizations, however, this resource is also stretched thin as nurses are needed throughout the country.
Why is Kootenai Health hiring so many traveling nurses? Why aren’t they hiring local?
Kootenai Health is looking to hire travelers because there are not enough nurses in our region to meet the demand of the influx of patients. More specifically, nurses with critical care training. Nurses with critical care training require an additional level of training.
What does “requiring critical level care” mean?
Patients requiring critical level of care are cared for in our Intensive Care Unit. They need close attention from physicians and nursing staff.
At Kootenai Health a patient requires critical level care when their illness is severe enough to require the oversight of an intensivist (a specially trained critical care physician.) Patients requiring critical care may have respiratory failure, septic shock, multiple organ dysfunction and require oxygen assistance.
Community and Hospital Growth
Is the hospital full because the community’s growth has outpaced the growth of the hospital?
It is true that we live in one of the most rapidly growing regions in the nation. Idaho was the fastest growing state in 2019 and Kootenai County is predicted to grow at two times the national average in the coming years.
While our region is expanding exponentially, Kootenai Health has anticipated this growth and completed more than $130 million dollars in expansion over the past five years.
While no resource is infinite, we have steadily increased our services and accessibility for our community over the past five years (see next).
In communities around the nation, hospitals are overwhelmed by the growing COVID-19 pandemic.
It is important to note, these capacity issues are not unique to Kootenai Health. We are one of many now struggling to keep up with the mounting demand.
How has Kootenai Health expanded to meet the growing needs of our community?
In 2015, Kootenai Health had 254 beds (please note, many of these are designated for behavioral health and women’s and children’s and were double occupancy).
In 2016 we began our expansion project. It included:
- East wing first floor, Family Birth Center which includes:
- 10 labor and delivery rooms
- 18 postpartum rooms
- 12 private neonatal intensive care rooms (two that can accommodate twins)
- 2 cesarean operating rooms
- East wing second floor unit with 32 rooms for neurosurgery and orthopedics
- East wing third floor unit with 32 rooms. This unit was initially closed for future growth. It was opened in November 2019 and transitioned into the COVID-19 isolation unit in July 2020.
With the expansion, Kootenai Health is now a 330 bed hospital (third largest hospital in Idaho).
- In 2017 we completed a $10.5 million, two story, 22,000 square foot expansion on our campus in Post Falls which provides access to specialty practices such as cardiology, OB/GYN.
- In 2018, we expanded our surgical services from eight to 11 operating rooms and built a new recovery and waiting area including a hybrid operating room, which can be used for both cardiac and general surgery.
- In 2018, our emergency department expanded from 23 to 36 rooms with new efficient work flows so patients can be seen more efficiently.
- Our number of employees has grown from 1,800 in 2012 to more than 3,500 in 2020.
- Our number of employed physicians has grown from 75 to more than 200.
- Overall we have added more than 200,000 square feet (100,000 in East Expansion; 20,000 in ED; 10,000 in Surgery; 30,000 in Post Falls; 45,000 at 1919 Lincoln Way).
- We have hired OB, pediatric, neuro and acute medical hospitalists to provide the highest level of coverage for our hospitalized patients at all times.
How do the Panhandle Health District numbers compare to Spokane Regional Health District numbers?
Does Kootenai Health get money for identifying a positive COVID-19 case?
No. Kootenai Health does not receive money as the result of positive COVID-19 lab results. Kootenai Health is providing community drive through testing as a public service. The lab testing fees charged for these tests do not cover the cost to run the center.
Why do people say Kootenai Health is making extra money due to COVID-19 patients?
As much as we would like it to be otherwise, hospital billing is complex.
Different insurance companies will handle reimbursements differently, however, here is an example and more information about how reimbursement for COVID-19 works with Medicare patients.
- Medicare patients only: Beginning around March 2020, the Federal waivers increased DRG reimbursement rates by 20% for any Medicare inpatient admitted with one of the newly established COVID-19 diagnoses (DRG’s). The government made this adjustment in recognition of hospitals’ increased costs incurred for care of COVID-positive patients, (e.g. personal protective equipment, dedicated units, extended lengths of stay) applicable to all hospital facilities across the country. The expectation is that this federal support of increased expense to care for COVID-19 patients will continue until the Federal Government ends the COVID-19 Emergency status.
- Commercial and Medicaid patients: This does NOT apply to commercial or Medicaid patients. The hospital bills and is paid at previously established rates, with no additional compensation to accommodate for increased cost of care. Commercial and Medicaid reimbursement is directly connected to the diagnosis, care provided, length of stay, and rates contracted with each payer through individual negotiations. These rates are disclosed openly by all U.S. providers through the Price Transparency initiative passed by Congress prior to the COVID-19 emergency.
This information has been used to suggest that physicians and hospitals are gaming the system by falsely identifying COVID-19 patients to get more reimbursement for the hospital. However, there are strict criteria to identify a COVID-19 positive patient and even with the increased level of reimbursement, in most cases the reimbursement does not cover the cost of caring for these patients due to their extended length of stay.
Falsifying data about patient diagnoses would be illegal and unethical. It would also mean our employees and physicians have collectively agreed to put their professional reputations on the line by providing false information. This is not happening.
Breakdown of Rooms in Kootenai Health
Not all rooms are the same within Kootenai Health. Rooms have different layouts, equipment or are reserved for certain types of patients (cancer, birth center, etc.)
Medical/Surgical/Critical Care Units: 200 “beds” – some rooms have been converted to double occupancy, adding beds, due to high census. Number of beds changes daily based on census and need.
Names of Units: 1 North/2 East/2 South/3 South/CC3/CC2/3 East/3 North/1 West
Behavioral Health: 77 beds
Chemical dependency rehabilitation, adult, youth
Women’s and Children’s: 53 beds
Labor, Postpartum, NICU, Pediatrics