Stickers are ready on Wednesday, May 26, for people entering Saint Alphonsus Medical Center Ontario. Each person is screened for the coronavirus and then wears the sticker during their visit. (The Enterprise/Les Zaitz)

ONTARIO – For those who become seriously ill from Covid, their first stop in Malheur County is often the emergency room at Saint Alphonsus Medical Center in Ontario, where Dr. Brian Kitamura is the medical director. 

“Generally speaking, the folks that I see that have Covid have been sick with flu-like symptoms for two or three days, and they typically come in at a point that they’re too weak to eat or drink,” Kitamura said. 

In its gravest forms, the disease “either makes it so that breathing is an impracticality, or so that you’re so lethargic that you can’t attend to your basic needs,” Kitamura said.

For those Covid patients sick enough to be admitted to the hospital, Ontario is often only the first stop on an odyssey that can take them out of state to Nampa, Boise, or beyond. 

As Covid once again ravages the Pacific Northwest, with Oregon reaching its highest case counts reported since the beginning of the pandemic, hospitals are filling up. The Delta variant, a new strain of Covid which is more transmissible, currently makes up more than 80% of cases reported in Oregon. As of Aug. 13, there were only two intensive care beds for adults reported available among all the hospitals in Baker, Malheur, Morrow, Umatilla, Union, and Wallowa counties. 

Local hospital administrators say that while their employees are determined to keep helping patients, they are exhausted by the conditions Covid has created for them. Staff, meanwhile, say that they are frustrated by the refusal of their friends and family members to get the vaccine.

One local health care provider, St. Luke’s Health System, based in Boise, has already temporarily stopped elective surgeries that include an overnight stay. 

“We are implementing this pause in order to accommodate and plan for increased patient volumes as our patients needing to be admitted has doubled in two weeks and the COVID-19 positivity rate continues to climb,” said Dr. Jim Souza, chief physician executive for St. Luke’s, in a press release. “We strongly encourage and are appealing to individuals to take measures to decrease the spread of COVID-19, including vaccinations for those who are eligible and wearing a mask indoors whenever you are around individuals who are not part of your immediate family.”

Kitamura said that although Saint Alphonsus in Ontario was somewhat sheltered from the worst effects of a bed shortage because of its sister hospitals in Boise and Nampa, “a perfect storm” of factors was still creating reduced capacity at the hospital. As such, some medical patients have had to board in the emergency department because the medical floors are filled up.

“All the people that needed things that got put off because of Covid, we’re now paying that bill,” he said, referring to delayed surgeries, procedures and checkups. “We’re catching up with those at the same time that we’re short on nurses.”

Kitamura said the nursing shortage was largely due to burnout after a trying 18 months.  

It is against this backdrop that the latest surge in Covid cases is taking place. 

To help the situation, Dina Ellwanger, president and chief nursing officer of Saint Alphonsus in Ontario, said that the hospital has brought in additional “traveling” nursing staff. The term refers to nurses who are contracted through an outside company and move between hospitals in the course of their 13-week to six-month assignments.

Ellwanger also said that leaders who normally do managerial duties are being pulled back into bedside roles because of the staffing shortage. 

“They continue to give 300%,” Ellwanger said of her staff. “I have never been so proud of staff, ever, for how they continue to give to this community.” 

Ellwanger explained that “we have no mandatory overtime. They do it by their own choice because they want to care for their community, they want to take care of their patients.”  

Despite this goodwill, Dr. Joshua Holweger, medical director of the Pulmonary Clinic and ICU in Nampa, where many Ontario Covid patients are sent, said that Covid care was taxing, and sometimes even demoralizing. 

“It’s really like getting super sick is, in my opinion, very preventable,” he said. “What we’re really dealing with is a pandemic of the unvaccinated. It sometimes can be really sad for us because there’s people coming in who are super sick and they didn’t have to be.”

Holweger said that people with Covid who are unvaccinated will be treated no differently by his staff. He noted that in fact, all of the very ill Covid patients he is seeing in the ICU are unvaccinated.

“It’s just a giant waste. it’s an emotional waste and it’s a waste of loss of life,” said Kitamura. “All of those people have family members that worry about them, they pass away prematurely, and it was never something that needed to happen. By this point of time in this rich of a country, we shouldn’t be admitting anyone to the hospital for coronavirus anymore.” 

Because of the vaccine and effective personal protective equipment, Holweger said he was no longer scared for his personal safety when treating patients. However, he said that while he has some tools in his arsenal for dealing with Covid, there was no “silver bullet.” 

“I don’t want to think so much about winning and losing, because it’s not a game, but that’s kind of how it feels,” he said. “If I can’t save this one, I lost this one.”

Kitamura said that he agrees with people who feel that life should go back to normal as much as possible. 

“Kids should go to school, people should go to work, I very much believe in that sentiment,” he said. “But I have a very hard time with the disconnect that people who share that view don’t recognize that the easiest way for that to happen is for people to get vaccinated. If that’s people’s goal, they should get vaccinated.”

“Wearing a mask is (also) a small price to pay for being able to go about their business,” he continued. “They’re both low-risk, small asks and if people would just do that, we wouldn’t be talking about this anymore. We’d be back to life as normal.”

“If I’m going to make you gamble on getting the virus and seeing how it goes, or getting the vaccine and seeing how it goes, your chances of doing better are so much higher with the vaccine,” said Holweger. “I think (unvaccinated people) are making a mistake on this one.”

Kitamura, who grew up in Ontario, said it was discouraging to hear community members ignoring the expertise he and his colleagues had gained through years of study and experience in favor of alternative sources. 

“Go to the right person for the right problem,” he said. “It’s frustrating that I have so many patients or community members who are taking advice from non-medical professionals in their lives, who don’t have the appropriate training or expertise to provide that advice, over medical professionals that are doing this day in and day out.” 

Kitamura said that while there were some doctors who disagreed with the vaccine, he believes their voices have been overemphasized in the media. He said that all the physicians he worked with personally had been vaccinated. 

“I’m not asking anybody to do anything that I wasn’t excited to do on Day One,” Kitamura said.

In the meantime, as Covid cases in unvaccinated people increasingly fill hospital beds, care for other patients is being postponed. 

At St. Luke’s, where elective surgeries at the Treasure Valley location are being paused until at least Aug. 27, Souza said the move would create space for about 60 more admissions per week. 

Still, “these aren’t surgeries being done as a convenience, so we are creating a backlog,” he said. 

Kitamura said he had recently had a patient in Ontario who needed “a very specialized procedure” unrelated to Covid.

“Folks at (Oregon Health & Science University), when we tried to transfer the patient, were very nice but they said they didn’t have a place to store her for 48 to 72 hours,” Kitamura said, alluding to the fact that that hospital was at capacity. 

Kitamura said the same thing then happened with the patient at the University of Washington and the University of Utah – they simply didn’t have capacity for the patient. 

“It’s just one person, but it’s a symptom of the bigger problem,” he said. “They had to wait 72 hours for something that was an urgent surgery. The best time to have done that surgery was right now and you couldn’t do it.”

Souza said that things were similarly grim at St. Luke’s, which has recently accepted patient transfers from as far away as Tillamook, on the Oregon coast, and Oklahoma, due to a lack of local hospital beds.

“My message is the same one we’ve all been giving now for the last 18 months. It’s ‘Please listen,’” said Souza. “We’re the ones who’ve been here for you, who will be here for you, who’ve delivered your babies and set the bones of your children and held the hands of your parents while they were dying. It’s been us and it will be us, not the hucksters on the internet.”

News tip? Contact reporter Liliana Frankel at [email protected] or 267-981-5577.

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