Nurse shift change

St. John’s Health registered nurse Hillary Foster dons personal protective equipment in a small room sandwiched between sheets of plastic at the start of her shift. The process of putting on and stripping off PPE must be undertaken each time staff enters and exits the “COVID Cave” beyond.

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For three days last week, Tuesday through Thursday, the intensive care unit at St. John’s Health was maxed out.

The Jackson hospital reported its ICU 100% full on its daily dashboard, with three COVID patients consistently requiring intensive care. There were three non-COVID patients in the six-bed ICU.

Those patients are no longer requiring intensive care, and the ICU is down to just one COVID patient and one non-COVID patient, chief communication officer Karen Connelly confirmed to the News&Guide Tuesday. The hospital has not issued a daily update on its digital dashboard since Friday.

During the time the ICU was full, St. John’s went on diversion, notifying area hospitals, clinics and ambulance services that it didn’t have available beds for critically ill patients. That difficult decision is one St. John’s has been forced to make increasingly during this summer’s delta surge.

The community hospital is also having difficulty transferring its own patients to partner hospitals in Idaho and Utah because those locations have similar staff shortages and limited beds.

The situation at St. John’s comes as Wyoming and states across the nation report a decline in COVID cases, suggesting the delta variant may have run its course. Teton District Health Officer Dr. Travis Riddell hopes the trend will continue.

“Usually, there’s a little bit of a lag between when cases come down, and when hospitalization and ICU hospitalization starts to slow down,” Riddell told the News&Guide.

“So hopefully, we’ll see those numbers come down both locally and statewide.”

Since Sept. 22, daily average COVID cases have dropped from 400 to 300 statewide, and Teton County dropped from 21 to 7.

State health officer Dr. Alexia Harrist is also hopeful the trend continues, but she is also hearing daily from hospitals desperate for a break.

“When we start to see ICUs filling up ... or opening clinical beds elsewhere in the hospital, we do get very concerned that we may be reaching a point where not everyone who needs medical care can can get it,” she told the News&Guide. “And that’s something we really wanted to avoid all along.”

Several Wyoming hospitals are currently on the verge of transitioning to crisis standards of care, which would allow them to triage which patients receive medical attention.

Harrist called it the “last resort.”

“Obviously [we] don’t want to see people sick and we don’t want to see people die, but it’s something different when people who are sick can’t get the care that they need,” she said.

At the state level, the “extremely difficult and troublesome decisions,” are made in collaboration with a medical ethics committee, Harrist said, but individual hospitals can also begin allocating scarce resources without a statewide declaration.

St. John’s is not currently considering crisis standards of care, Connelly said, but it did transfer one patient to another hospital last week because its ICU was maxed out.

The communications officer acknowledged people in the community might want to know more about the people infected with COVID-19 who require hospitalization, but said it’s too much of a burden on staff to track specific demographic data on a daily basis.

Instead, she suggested people tune in to the monthly board meetings, where interim CEO David Robertson presents aggregate data.

Since July 4, 83 of 100 hospitalized COVID patients were unvaccinated and 23 out of 25 ICU admissions were unvaccinated, Robertson reported at the Sept. 30 board meeting. Thirty-three of those patients came from Teton County, 26 from Sublette County, and 33 were from out of state. Of the six people who have died of the virus at St. John’s since July 4, only one was a Teton County resident.

The report also found trends consistent with national reporting: Unvaccinated people with COVID are generally much sicker than vaccinated people with breakthrough COVID infections, and among the unvaccinated population, younger people (20 to 30 year olds) are more susceptible to the delta variant than they were to the original virus.

Wyoming’s vaccination rate rose slightly in August but remains the lowest in the nation.

Contact Evan Robinson-Johnson at 732-5901 or ERJ@jhnewsandguide.com.

Evan Robinson-Johnson covers issues residents face on a daily basis, from smoky skies to housing insecurity. Originally from New England, he has settled in east Jackson and avoids crowds by rollerblading through the alleyways.

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