In the past month, hospitalizations for COVID-19 in Spokane County have nearly doubled, and the vast majority of those patients are residents of Washington.

There are 242 people with the virus in Spokane’s four hospitals. Despite local frustrations and national reports regarding Spokane hospitals overwhelmed by COVID patients from Idaho, the data doesn’t show such a scenario.

The vast majority of COVID patients being treated at MultiCare and Providence hospitals in Spokane County are Washington residents, hospital representatives confirmed on Monday.

Providence Sacred Heart Medical Center and Holy Family Hospital, for example, are currently treating 29 patients from Idaho, where masking and vaccination efforts are resisted. This figure includes all patients, not just those with COVID-19, a spokeswoman from Providence confirmed.

The vast majority of residents from Idaho’s five northern counties being treated for the virus are at Kootenai Health in Coeur d’Alene.

There are 113 Panhandle residents hospitalized with the virus, according to the Panhandle Health District, and on Monday, Kootenai Health was treating 97 COVID patients.

Smaller hospitals in North Idaho have been keeping and treating their COVID patients as well, rather than transferring them to larger facilities, in the midst of the largest surge of the virus to date.

North Idaho hospitals are in crisis standards of care, with patients treated outside of normal settings, staff stretched among patients and the potential for life-and-death decision-making should resources be exhausted.

Kootenai Health has opened a 22-bed alternative care COVID unit in a former conference room to make space for more patients. Projections from last week showed that Kootenai Health could need to treat 140 COVID-19 patients or more in the coming weeks.

With a crisis unfolding in neighboring Idaho, Washington hospital administrators are keeping a wary eye on this fifth wave of coronavirus, which is a much more concerning surge for hospitals than even last winter. There are 1,742 COVID patients in hospitals statewide as of Sunday, which is more than 600 patients past the state’s peak of around 1,100 hospitalizations from the virus last winter.

Hospital leaders and health care workers have sounded the alarm in the past week as capacity tightens and staffing is short essentially everywhere.

“As a health care system and a state, we are keeping our head above water, but barely,” Dr. Chris Baliga, an infectious disease specialist at Virginia Mason-Franciscan Health, told reporters Monday.

Washington state is not at crisis standards of care yet, a move that the Department of Health could enact if necessary. That doesn’t mean all is well in hospitals, however, and there are long wait times for emergency rooms, patients being treated in hallways or different settings and surgeries canceled or postponed.

“We’re in an extremely challenging situation; we’re delivering contingency care in a tenuous situation,” Taya Briley, executive vice president of the Washington State Hospital Association, said on Monday.

To avoid going into crisis standards of care, hospitals “level-load” patient levels, meaning patients are spread among facilities statewide as long as there is capacity and room, so no hospital gets overwhelmed. Washington hospitals committed to do this earlier in the pandemic, but now this commitment is becoming a reality.

The Washington Medical Coordination Center, based at Harborview Medical Center, is coordinating transfers among Washington state hospitals, and while this system does not accept or include patients from out-of-state, hospitals along state borders have relationships with other health care facilities across state lines.

Washington hospital leaders praised Gov. Jay Inslee’s updated mask mandate – which will cover events like fairs – that started Monday, and they continued to encourage vaccination as the best way to stop the current surge from getting worse.

In Idaho, there is no statewide mask mandate or requirement, including in most schools.

“We really want to support Idaho’s renewed efforts to promote vaccination and encourage Idaho’s leaders to step up requirements for masking indoors and out and cancellation of large gatherings,” Briley said Monday.

Much like in Idaho, Washington hospitals are struggling to hire and retain enough staff to keep up with the current COVID surge. Briley said staffing is the greatest challenge facing the state’s hospitals. The unions representing workers in hospitals statewide sent a news release saying the state was “on the brink of crisis.”

“We’re losing overworked nurses to overwhelming burnout, the distress of working short-staffed, better-paying traveler nurse jobs and even for signing bonuses of up to $20,000 to move to a different hospital. We’re worried for our patients and the impact of the staffing crisis on the care they receive,” Julia Barcott, an ICU nurse at Astria Toppenish Hospital and Washington State Nursing Association cabinet chairperson, said in a news release.

Here’s a look at local numbersThe Spokane Regional Health District reported 225 new COVID-19 cases on Monday, and 750 cases over the weekend.

The district confirmed an additional eight deaths from the virus. Since the pandemic began, 790 Spokane County residents have died of COVID-19. There are 242 COVID patients in Spokane hospitals.

The Panhandle Health District confirmed new 337 COVID-19 cases on Monday and over the weekend.

There are 113 Panhandle residents hospitalized with the virus.