DAVID GREENE, HOST:
Small rural hospitals are growing anxious about bed capacity right now. They usually send their most serious patients to bigger hospitals, but now those bigger facilities are overwhelmed. Rachel Cohen of Boise State Public Radio has been taking a look at the impact of COVID-19 hospitalizations on the Rocky Mountain states.
RACHEL COHEN, BYLINE: Most rural hospitals are used to sending people to bigger facilities in cities in serious situations.
JOHN MCCARTHY: They're just not designed for 24/7 care.
COHEN: That's Dr. John McCarthy, dean of the University of Washington medical school's rural programs. McCarthy says doctors at these tiny hospitals are used to thinking on their feet, but they rely on being able to transfer patients to city hospitals.
MCCARTHY: You can't transfer your patient who's going to need neonatal intubation, and you don't have the care team to deal with that. The patient will suffer as a result of that.
COHEN: Normally, things work out OK. Patients get where they need to go. But now hospitals in many Mountain West cities which typically take them are filling up because of COVID-19, cutting off that lifeline - and not just for COVID patients. This week, the 17-bed Minidoka Memorial Hospital in Rupert, Idaho, a city of 6,000 outside Twin Falls, had a car crash victim.
TOM MURPHY: We realized that they had maybe a tear or some sort of internal injury that needed a higher level of care.
COHEN: Tom Murphy, the hospital's CEO, says it was a challenge to get that patient into the University of Utah hospital about 180 miles away. Last week, University's ICU was at 99% capacity with COVID patients. Utah's health department has warned nearby states to prepare for the possibility that nearly all out-of-state transfers could soon be cut off. And Minidoka is getting slammed by coronavirus, too. Murphy describes what one of his ER doctors faced last week.
MURPHY: He had, in the span of 12 hours, four COVID-positive patients that needed to be admitted to a higher level of care.
COHEN: His three-bed COVID unit was full, so the emergency department spent hours on the phone before they finally found space at a scattering of local hospitals. One in Twin Falls could only accept a patient after they discharged one of their own.
MURPHY: It is a critical situation. Our staff are worn out. We're tired. And we care. And that's why we're hanging in there.
COHEN: University of Washington rural specialist John McCarthy says hospitals like Minidoka might need to hold on to people for longer or send them further away.
MCCARTHY: And that works for some diseases, and it's not a problem. And that doesn't work for other diseases, and it's a very significant problem. So patient care suffers as a result of that.
COHEN: Hospitalizations are at record levels in five of seven Rocky Mountain states. Three are reporting serious hospital capacity issues. Minidoka Memorial Hospital CEO Tom Murphy.
MURPHY: If we don't have the capacity - we don't have a bed here, we don't have a bed in Twin or Pocatello or Idaho Falls and we can't transfer to Utah, what do those folks do that need more than just oxygen treatment? I don't know. I'm very fearful for the future and what lies ahead.
COHEN: Idaho hospital leaders say to come up with extra capacity within the state, they'll progressively turn the hospitals into COVID wards, unit by unit, delaying procedures like heart surgeries. And Murphy says if hospitalizations increase by just 10%, his facility could start rationing care and deciding who gets a bed and who doesn't.
For NPR News, I'm Rachel Cohen in Twin Falls.
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