BOISE, Idaho — Leaders from the Boise area’s two largest hospital systems said Friday that they expect to reach “crisis standards of care” in a matter of weeks — and perhaps by the middle of December if residents don’t change their behavior.

The Central District Health Board of Health heard from St. Luke’s Chief Medical Officer Dr. Jim Souza and Saint Alphonsus Chief Clinical Officer Dr. Steven Nemerson, listening to the physicians explain the dire circumstances in their hospitals because of the COVID-19 pandemic.

Idaho health officials reported a record 2,205 new COVID-19 cases Friday and a record 496 hospitalizations midweek.

“We are keeping our neck at the waterline,” Souza said. “I want you to know, though, how fast we’re treading water.” Souza noted that all of the St. Luke’s ICUs are above 80% of capacity. St. Luke’s Health System reports nearly 100 staff members are forced to call in sick daily due to contracting the virus or being exposed. Staffing shortages play a key role in determining hospital capacity.

“I think it’s more probable than not that in the next two to four weeks, we will find ourselves” at a point of needing to ration care due to COVID-19, Souza told the board. Later, Souza and Nemerson said their models project reaching crisis standards in early January, but that’s without the expected Thanksgiving-related surge in cases.

Crisis standards of care would have to be declared by Gov. Brad Little. At that point, a scoring system would determine which patients receive life-saving care, Souza said. Souza and Nemerson said the situation also could lead to other care being delayed — such as removal of cancerous tumors.

Souza said St. Luke’s is operating under contingency care standards. Care today is not the same as it was nine months ago, he said. A daily meeting is held to determine how quickly patients can be sent home.

Nemerson started by outlining that “not all intensive care units are created equal,” nor are all hospital beds or doctors. He pointed out that just because there may be one hospital bed open, that doesn’t mean it is adequate for all patients.

And generally, when Idahoans need critical, complex care, they are taken to the Boise hospitals, which are nearing capacity.

“We are still meeting the needs of our patients, but not the way we would like to be and not the way we will be in the future,” Nemerson said.

Nemerson stressed that he does not want the public to panic, but under Saint Alphonsus Health System’s current modeling, not factoring in holiday gatherings, he anticipates the system will be at severe contingency care standards by Christmas and crisis care after Jan. 1. St. Luke’s projects hitting crisis standards perhaps a week sooner.

Souza stressed that all hospitals are struggling with staffing, but they have united in their effort to combat the virus.

“There is no right or wrong, Republican or Democrat, urban or rural, religious or non-religious when it comes to COVID-19,” Souza said. “There is one enemy. It’s the bug. And there is one victim. It’s humanity.” Both doctors urged residents to wear masks, stay home, and avoid contact with people who are not in their households.

“This is a totally preventable disease, and it’s dumbfounding we’re in this situation that we’re talking about limiting our ability to deliver care to patients that need us,” Nemerson said.

The board postponed a vote Friday night to discuss a new public health order in an effort to slow the spread of the coronavirus. The order would have further restricted residents in Ada, Valley, Elmore and Boise counties.

CDH Director Russ Duke said he wanted to delay the vote until Tuesday to provide time to revise the order and receive another round of public input. The revised order was published Friday night on the CDH website.

About 200 protesters showed up to the CDH building in opposition to the proposed order, and some tried to shove their way into the building. Most were not wearing masks.

Boise Police reported that due to COVID-19 restrictions a limited number of people were allowed in the building. Around 5:20 p.m., 5 minutes after the meeting started, additional people tried to force their way into the building by physically pushing through the door against security and officers.

No one was reported to have been arrested.

The CDH testing positivity rate was last recorded at 17.46%.

Under the proposed order, had it passed, masks would have been mandatory in all four counties, most adult and youth sports would have been banned, and employers would have needed to implement curbside and delivery services when possible.

The mask mandate would have been new for Boise and Elmore counties. In Ada and Valley counties, it no longer limited the mask mandate to public spaces.

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The Kuna School District Board of Trustees published Thursday a copy of the letter it sent to the Board of Health that argues against the impact the new order could have on sports.

“To be honest, it is very difficult for us to explain to our children and our parents why bars can be open, but healthy, engaging activities such as athletics and music are off-limits,” the Board of Trustees’ letter stated.

Duke indicated the sports restrictions could be changed.

“It’s definitely high risk,” he said. “But there are a lot of consequences to not allowing student-athletes to participate in sports. That’s just an example of something that we’re seriously evaluating.”

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Under the new drafted order, there is not a prohibition of sports and extracurricular activities, but masks must still be worn in all four counties.

Masks must we worn in public and private places, indoors and outdoors, when 6-foot distancing with nonhousehold members cannot be maintained. That includes inside businesses.

If the order passes, at athletics and other activities, spectators must wear a mask, regardless of whether they are indoors or outdoors, when physical distancing of 6 feet or more cannot be maintained. When inside a school, masks must be worn regardless of distancing.

The new draft allows for visits to long-term care facilities, if the facility is compliant with CDH guidelines. Outdoor visits are preferred, and indoor visits are only allowed when there hasn’t been new onset of COVID-19 cases in the past 14 days and outbreak testing isn’t ongoing.

Businesses must still offer curbside service and delivery whenever possible.

Gathering size is still limited to less than 10 people with the exception of political expression or religious worship, where masks are worn and participants are 6 feet apart.

Bars and restaurants may stay open, but staff must wear masks and bartops and dance floors are closed. Tables must be 6 feet apart and patrons cannot stand.

Gyms and fitness centers must limit capacity to no more than 50%, including during fitness classes.