Alaska, Idaho using crisis standards of care over COVID-19

Alaska now joins Idaho in establishing crisis standards of care as its largest hospital is now prioritizing treatment to patients most likely to survive COVID-19 infections.

"While we are doing our utmost, we are no longer able to provide the standard of care to each and every patient who needs our help," Kristen Solana Walkinshaw, MD, chief of staff at Providence Alaska Medical Center in Anchorage, wrote in a letter addressed to Alaskans and published yesterday.

"We have been forced within our hospital to implement crisis standards of care," Walkinshaw said. "We have been required to develop and enact policies and procedure to ration medical care and treatments, including dialysis and specialized ventilatory support.”

According to the Associated Press, at Providence, more than 30% of the adult patients who are hospitalized have tested positive. Statewide, 202 patients are hospitalized for COVID-19, including 33 on ventilators.

Last week, Idaho announced similar measures in the northern part of the state after it faced a deluge of COVID-19 cases due to the Delta (B1617.2) variant. Now, some hospitals in southern Idaho announced they will also be rationing care. Idaho has one of the lowest COVID-19 vaccination rates in the country.

According to the Washington Post, Idaho recorded a 44% average increase in COVID-19 deaths over the past week.

In total, the United States has reported 663,913 COVID-19 related deaths since the pandemic began, which means 1 out of every 500 Americans has died from the novel virus.

Yesterday the country recorded 152,177 new cases, including 1,888 deaths, according to the New York Times.

More litigation around vaccine mandates

Today President Joe Biden met with executives from companies including Microsoft, Walgreens, and Walt Disney Co. to discuss his COVID-19 vaccination requirements for the private sector, the Wall Street Journal reports. 

Biden stated last week that all companies with 100 or more employees need to mandate vaccines or testing. He has said the federal government would lead by example, and US Army officials said yesterday that all active duty soldiers are expected to be vaccinated by Dec 15, NBC News reports. Those who are not granted an exemption for legitimate medical, religious, or administrative reasons and continue to not comply with the mandate could be discharged or disciplined.

Biden also said any healthcare worker at a facility that accepts Medicaid or Medicare funding must also be vaccinated. But a federal judge yesterday temporarily blocked the state of New York from forcing medical workers to be vaccinated after a group of healthcare workers sued, according to CBS News. The state has until Sep 22 to respond to the lawsuit.

Kaiser Health News published a new report showing that in recent months 26 states, many Republican-led, have passed legislature that permanently weakens government authority to protect public health.

In 16 states, lawmakers have limited the ability of public health officials to make mask mandates, and at least 17 states have passed laws banning COVID vaccine mandates or passports.

Other US developments

  • The Biden administration took steps this week to address monoclonal antibody shortages, taking over their distribution and buying 1.4 million more doses.

  • A separate new Kaiser Family Foundation study finds that US COVID-19 hospitalizations cost $5.7 billion from June to August 2021.

  • The Centers for Disease Control and Prevention has released a new toolkit for K-12 school administrators on how to respond to COVID cases

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