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Crisis standards of care: Reaching a grim pandemic milestone

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Vaccination clinic

Dr. Tim Foote, left, inoculates essential worker Isvan Gomez, 28, of Fairbanks, during a Pfizer Covid-19 vaccination clinic Tuesday, Feb. 9, 2021, at the Carlson Center, 2010 Second Ave., in Fairbanks. 

News-Miner opinion: You hear your 4-year-old let out a blood-curdling scream and see she’s slammed the car door on three of her fingers. They’re visibly broken, crushed from the weight of the door, and her fingers are swelling, turning purple and blue. She’s crying uncontrollably as three contorted digits become unusable.

Meanwhile, across the street, your 65-year-old unvaccinated neighbor has Covid-19 and has reached the point where he can’t breathe. He’s gasping for air, is sick, weak, can’t walk. His vaccinated wife drives him to the emergency room.

You both arrive at Fairbanks Memorial Hospital at the same time, wanting to be admitted to the ER; you and your 4-year-old who’s in the worst pain of her young life and your 65-year-old neighbor who can’t breathe. The doctor comes out and looks at both of you. He tells an attendant to wheel the Covid patient into a room and hands you two tongue depressors, some heavy gauze, and tells you to go home, give your daughter some Ibuprofen, make a splint for her fingers with the gauze and wooden depressors, and hope that her bones heal properly.

That imagined scenario or a variation thereof could happen as Foundation Health Partners, which oversees Fairbanks Memorial Hospital, Tanana Valley Clinic and Denali Center, enacted its crisis standard of care level Friday. Staffing shortages, a lack of beds, a Covid-19 surge, a shortage of monoclonal antibody treatments and not being able to transfer patients to other facilities in Alaska have created a perfect storm no one wanted to see: deciding who gets health care.

Crisis care mode has already happened at Providence Alaska Medical Center in Anchorage, as well as at Alaska Native Medical Center and the Yukon-Kuskokwim Health Corporation. Those health care centers have been facing what we’re now seeing in the Interior. And it’s not projected to get better any time soon. On Thursday, the state saw 1,011 new cases of Covid-19. Statewide, we have 202 people hospitalized with Covid-19, and 35 of those are on ventilators. According to the latest state data, 20% of all hospitalizations in Alaska are Covid-related.

The hospital was uncharacteristically blunt about the change in care status. “This impacts all patient care, those with broken bones, traumas, heart attacks, strokes, Covid, anyone needing medical care could be impacted,” Chief Medical Officer Dr. Angelique Ramirez said.

That should give everyone pause — that if you need medical care, you might not get it. It’s a situation the hospital does not want to be in, but in a state with a low vaccine rate and little guidance from elected officials other than an occasional plea to consider a vaccine and maybe wear a mask if you feel like it, it’s the reality we’re facing. Someone will decide if you get care.

We are yet to see a unified message from any local leaders on the topic. A joint statement addressing our Covid surge, low vaccination rates, and the alarming scenario at Foundation Health partners might help the undecided in making up their minds about safety measures, which help all of us. Sadly, the “You have to do what’s right for you” message that elected officials like to espouse has led us to this moment. We are now at a point where doing what’s right for you has come back to hurt everyone.

Let’s hope none of them smashes their fingers in their car door.

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