Exhausted hospital staff at Kootenai Health got some relief from the COVID-19 surge this week from the federal government.

Just as the daily census of COVID hospitalizations reached a new record high on Wednesday, a highly skilled 20-person Department of Defense team began a 30-day rotation in the hospital, adding to the health care teams there.

The Department of Defense team is based in Colorado but has members from as far as San Antonio and as near as Washington state, and they will work at Kootenai Health for at least 30 days.

“This help couldn’t have come at a better time,” Dr. Robert Scoggins, medical director of the ICU at Kootenai, told reporters Wednesday.

The team, composed of nurses mostly, including critical care nurses, was requested by Kootenai Health more than a month ago. The team also has doctors and respiratory therapists.

On Aug. 9, Kootenai Health submitted a formal request for staffing support to Idaho state agencies as COVID hospitalizations began to escalate. At that time, there were 68 COVID patients hospitalized. Now there are 115 COVID patients needing treatment.

Even with the extra staffing, the Coeur d’Alene hospital still will be operating in crisis standards of care, meaning normal operations are adjusted to accommodate patient loads through the rationing of care.

Some less severely affected COVID patients are being treated in a conference room turned into a COVID ward.

Team nursing, in which one nurse cares for more patients with the help of other staff members, is also in place. That means patients might be seen less frequently. In addition, most operations and surgeries have been canceled at the hospital unless they are emergencies.

The hospital already has drastically expanded its ICU capacity and total bed capacity, but is largely limited by staffing challenges.

Kootenai Health has 200 beds for patients getting medical or surgical procedures. (It also has 130 behavioral health, pediatric and obstetrics beds).

Currently there are 218 patients in medical or surgical beds, exceeding normal capacity, however, and more than half of them are COVID patients. The Health Resource Center expanded hospital capacity by 22 beds, but beyond that, hospital leaders are unsure of how expansion would work with their staffing challenges.

Typically, Kootenai Health operates a 25-bed ICU. COVID meant the hospital had to expand its ICU throughout the hospital.

Currently, there are about 55 patients in the ICU, including 40 COVID-19 patients, Scoggins said.

Staffing all those extra beds is no easy feat. Kootenai Health has 550 open job postings, and nearly half of those are for clinical caregivers.

“Our biggest limitation has been the number of staff,” Jeremy Evans, the Kootenai Health COVID-19 incident commander, said on Wednesday.

Staff members who continue to work are putting in long hours and multiple back-to-back shifts. Scoggins said the ICU team is tired.

Since the COVID unit opened at Kootenai Health, there has never been a time with zero patients.

“The emotional trauma wears on you over time,” Scoggins said.

ACI Federal Labor, a contracting agency, is expected to send nearly 100 health care workers to the hospital later this week; further details on these workers were not available.

If hospitalizations plateau, there’s a chance the hospital could get out of crisis standards of care with that contracted help; however, hospital leaders are expecting the surge of COVID patients to continue, especially with Labor Day weekend activities and schools reopening.

“We’re still at risk of getting more patients,” Scoggins said. “I’m concerned about what happens in the next few weeks.”

North Idaho is the least vaccinated region of the entire state, and 90% or more of patients hospitalized with the virus are not vaccinated. Scoggins said many patients in the hospital with the virus regret not taking it more seriously.