Virus Outbreak South Carolina

A Tidelands Health medical professional changes latex gloves during a drive-through COVID-19 testing site Friday July 17, 2020 at Myrtle Beach Pelicans Ballpark in Myrtle Beach, S.C. (Josh Bell/The Sun News via AP)

After weeks of talks, tweaks and public testimony, Eastern Idaho Public Health’s Board of Health adopted a regional pandemic response plan Tuesday.

With cities in eastern Idaho and southeastern Idaho officials looking toward the plan, the health district’s moves lay the groundwork for what coronavirus responses here might look like.

The plan, released last Thursday night, outlines measures the board could pursue in four coronavirus risk levels — minimal, moderate, high and critical. Individual areas and counties within the health district’s jurisdiction — Bonneville, Custer, Fremont, Jefferson, Lemhi, Madison and Teton — can be at different levels at different times, or the region could enter a risk level together.

Those risk levels depend on how quickly COVID-19 cases balloon here and how strained the resources at area hospitals become. Before issuing a legal mandate, the board must vote on it in a public meeting.

The mandates or guidelines could be tailored toward a city, county or broader region.

The plan doesn’t require that the board pursue any specific action.

Attorney Michael Kane said Thursday the plan doesn’t stop the board from taking actions it deems necessary for public health. He also noted that Idaho law allows health districts broad powers to pursue measures that protect public health, expansively including “all things required for the preservation and protection of the public health.”

As of Friday morning, eastern Idaho had 161 active COVID-19 cases, which translates to 7.2 active cases per every 10,000 people here. Throughout the pandemic, the area has seen 462 total cases and one death. Active cases are confirmed and probable cases that the health district is still monitoring. The total case count combines active and recovered cases.

The region has 44 staffed intensive care unit beds across three hospitals: Eastern Idaho Regional Medical Center, Idaho Falls Community Hospital and Madison Memorial Hospital, according to health district spokeswoman Mimi Taylor. She said the region has 520 total hospital beds.

During the past two weeks, between 60 and 80% of ICU capacity was being used, according to the health district’s reporting as of Friday.

The health district, regionally, remains at the minimal risk level, but Teton County breached the threshold to enter the moderate risk level last week. Here’s what each county’s caseload is as of Friday afternoon:

— Bonneville: 82 active cases; rate of 7 active cases per 10,000

— Clark: does not yet have a confirmed or probable case

— Custer: 1 active case; rate of 2.3 active cases per 10,000

— Fremont: 7 active cases; rate of 5.3 per 10,000

— Jefferson: 19 active cases; rate of 6.5 active cases per 10,000

— Lemhi: 1 active case; rate of 1.3 active cases per 10,000

— Madison: 36 active cases; rate of 9.2 active cases per 10,000

— Teton: 15 active cases; rate of 12.9 active cases per 10,000

Each higher risk level calls for more stringent restrictions than the last. The lower-level restrictions will stay in place as an area progresses into higher risk levels. The plan says schools should “implement strategies in response to” health district guidelines in each risk level. School safety measures should also abide by state guidance on going back to school, according to the regional plan.

To reach a higher risk level, an area needs to see cases rise or hospital resources become strained for multiple days.

Once the board says an area is in a higher risk level, the area will stay in that risk level for 14 days, the incubation period for COVID-19 cases. After then, the board will re-evaluate if it should go down a risk level. The board can decide an area is higher-risk at any time.

Minimal risk:

The region is currently in this risk level. This calls for the board to urge people to follow non-binding health recommendations, such as mask-wearing in public, maintaining physical distance and hand-washing.

Moderate risk:To reach this level, an area needs 10 active cases per 10,000 people. Two less populous counties, Custer and Lemhi, need to have 15 active cases per 10,000 residents. The board will decide Clark’s risk level for moderate- and high-risk levels on a case-by-case basis.

Hospital capacity concerns could also trigger this risk level. If 90% of intensive care unit beds in the area are occupied, the region should be considered at moderate risk.

If an area enters moderate risk, the plan calls for the board to mandate masks, ban social gatherings of more than 150 people and recommend people follow more careful precautions. On Thursday, the board found Teton County was in this risk level, so it mandated masks and barred large gatherings there.

High risk:To reach this level, an area needs 20 active cases per 10,000 people. Custer and Lemhi need 30 active cases per 10,000 people. Clark is on a case-by-case basis.

Aside from active case rates, an area could reach this level if one of two other things happened: outbreaks occurred at high-risk facilities, such as a police department or nursing home; or 90% of all hospital beds become occupied.

Mask mandates would stay in place at this level, but the plan also calls for the board to further restrict social interactions by banning gatherings of more than 50 people.

Critical risk:To reach this level, one of two things need to happen: more than 100% of hospital beds and ICU beds are used, meaning hospitals cannot maintain capacity for a surge in COVID-19 patients; or when hospital resources are so strained that doctors have to ration treatment between patients, something known as crisis standard of care.

In this level, the plan calls for the board to issue a stay-home order.

Reporter Kyle Pfannenstiel can be reached at 208-542-6754. Follow him on Twitter: @pfannyyy. He is a corps member with Report for America, a national service program that places journalists into local newsrooms.