The Panhandle Health District board rescinded its mandate that people in Kootenai County wear masks in public spaces to prevent spreading the coronavirus – even as more than 100 new cases were reported Thursday and the local hospital is full.

While the intent of the mandate was to keep people safe from each other, it became widely ignored and was never enforced by the Kootenai County Sheriff’s Office.

Dr. Todd Hoopman, a critical care doctor at Kootenai Health hospital, told the board that the mask mandate had been effective, pointing to the dip in COVID-19 cases confirmed after the July 23 mandate took effect.

“I think we’re seeing it again where they’re not following (the mandate), and people are fatigued and got relaxed,” Hoopman said, urging the board to keep the mandate. “The simple act of wearing a face mask may help save the life of someone you care about or potentially save the life of someone at our hospital.”

The board instead voted 4-3 to end the mandate.

Health board member Glen Bailey, acknowledging that masks and distancing can help slow transmission of the virus, nevertheless introduced a motion to rescind the mandate.

“I agree we have a problem with this virus, but at the same time I object to the mandate the board passed because it restricts people’s right of choice and ability to comply or not comply under penalty of law,” Bailey said.

Bailey proposed making the mandate a recommendation instead, to eliminate the potential to make it a misdemeanor if a person violates it.

Both Kootenai County representatives on the health board – Jai Nelson, a nurse, and Dr. Richard McLandress – voted against rescinding the mandate, along with Chairman Marlow Thompson of Benewah County. The rest of the commissioners, representing Shoshone, Boundary and Bonner counties, voted to rescind the mandate.

Nelson voiced her concerns for the overly taxed hospital system.

“It’s not just about COVID, it’s about serving the entire community and everything that’s going on and every other need our hospital has,” she said.

Critical care physicians at Kootenai Health described treating COVID-19 patients and pointed out before the vote that the lack of beds is affecting the hospital’s ability to treat anyone in the community, not just the COVID-19 patients.

“We are at the point now where we are evaluating capacity on a case-by-case basis,” said Jeremy Evans, executive vice president at Kootenai Health. “This past week, we’ve been unable to accept a dozen transfers from other facilities.”

Kootenai Health is the largest hospital in the five-county region of the Panhandle, and the critical access hospitals in other counties have been sending COVID-19 patients who need critical care there.

The board unanimously voted to reaffirm its position statement from July 8 that recommends residents wear masks but does not include legal ramifications for not following that recommendation.

There were 112 new cases of COVID-19 reported Thursday, bringing this week’s total to more than 400 new cases. There are 33 patients hospitalized with the virus in the five-county region, 27 of whom are at Kootenai Health.

The virus has led to hospitalizations in both residents in their 30s or 40s as well as older residents, said Dr. Robert Scoggins, a critical care doctor on the COVID unit at Kootenai Health.

“We’re admitting grandparents who got it from kids. We’re seeing this in clusters. We’re seeing patients in church groups, where the whole church group came in,” Scoggins told the board.

The hospital has purchased more hospital beds, hired traveling nurses, and converted rooms to serve patients. The hospital was at 99% occupancy on Wednesday and announced people in North Idaho needing hospitalization may have to be sent to Spokane, Portland or Seattle.

The board, however, has some members who remain skeptical that the novel coronavirus even exists.

Bonner County representative Allen Banks voted to rescind the mask mandate and said he believes every positive test for COVID-19 is a “false positive.”

“The question I’d be asking myself if I were you is: Something is making these people sick – and I’m pretty sure it’s not coronavirus – so the question you should be asking is, what is making them sick?” Banks told two critical care physicians from Kootenai Health, who have been on the front lines of the pandemic and treating the sickest patients.

Scoggins disagreed with Banks, noting that isolating a virus is fairly simple and that scientific evidence backs up COVID-19 diagnoses.

“This virus is real and it is killing people in our community,” Scoggins said.

Health board member Walt Kirby, of Boundary County, said he took a lot of heat after mandating masks in Kootenai County back in July. He said he was “done.”

“I personally do not care whether anybody wears a mask or not. If they want to be dumb enough to walk out there and expose themselves or others to it, they can,” he said Thursday. “I don’t care if it’s mandated or not, but I don’t think I’m going to vote for it, because no one is wearing the damn mask anyway. They are all thumbing their nose at us.”

Kirby voted in favor of rescinding the order.

Kootenai and Boundary counties moved to the substantial COVID-19 risk category, or “Red,” due to increasing test positivity rates and worrisome limited hospital capacity.

Shoshone County moved to the moderate risk category, or “Orange,” with Bonner and Benewah counties remaining at “Yellow,” with minimal risk.

The substantial risk category kicks in when new daily cases on a seven-day rolling average are greater than 30 per 100,000 people, the testing positivity rate is greater than 20%, and hospital capacity is consistently at or above 100% with surge capacity that cannot be maintained or crisis standards of care have been implemented. Risk categories are reviewed and updated every Thursday.

“We put out the county risk level so our community knows basically the level of risk that we’re at,” said Katherine Hoyer, Panhandle Health District spokeswoman. “When we put those risk levels out there, we also have mitigation strategies that our community can take, but we’re not having any lockdowns or anything like that.”

Those mitigation strategies include limiting gatherings to 50 people or less, teleworking, limiting travel, recommending places of worship move to virtual services, and re-evaluating school strategies. Idaho is at Stage 4 of reopening without any statewide restrictions on businesses or individuals.

No matter the risk level, Panhandle Health encouraged the community to wear a cloth face covering in public, not attend large gatherings, frequently wash hands, and maintain physical distancing, among other public health recommendations.

Hoyer said moving to a different category means health officials have seen a trend rather than drastic one-day changes, which is also the requirement to move down a category.

“It could change next week if we saw a significant decrease in the metrics that we’re measuring this off of,” Hoyer said. “We really want to see a trend before we jump categories.”

There are many factors causing the current spike in cases, but Hoyer said the recent temperature drop is likely pushing people indoors, where the virus is more likely to spread.

“I also just think people are fatigued and they’re tired and they want this to be over with,” Hoyer said. “But we’re a long way from this being over.”