H5N1

‘I hope you die’: How the COVID pandemic unleashed attacks on scientists

Via Nature News & Comment: ‘I hope you die’: how the COVID pandemic unleashed attacks on scientists. Excerpt:

Infectious-diseases physician Krutika Kuppalli had been in her new job for barely a week in September 2020, when someone phoned her at home and threatened to kill her.  

Kuppalli, who had just moved from California to the Medical University of South Carolina in Charleston, had been dealing with online abuse for months after she’d given high-profile media interviews on COVID-19, and had recently testified to a US congressional committee on how to hold safe elections during the pandemic. But the phone call was a scary escalation. “It made me very anxious, nervous and upset,” says Kuppalli, who now works at the World Health Organization (WHO) in Geneva, Switzerland.  

She called the police, but didn’t hear that they took any action. The threatening e-mails, calls and online comments continued. The police officer who visited Kuppalli after a second death-threat call suggested she should get herself a gun.  

Kuppalli’s experience during the pandemic is not uncommon. A survey by Nature of more than 300 scientists who have given media interviews about COVID-19 — many of whom had also commented about the pandemic on social media — has found wide experience of harassment or abuse; 15% said they had received death threats.

Some high-profile examples of harassment have been well documented. Anthony Fauci, head of the US National Institute of Allergy and Infectious Diseases, was assigned personal security guards after he and his family received death threats; UK chief medical adviser Chris Whitty was grabbed and shoved in the street; and German virologist Christian Drosten received a parcel with a vial of liquid labelled ‘positive’ and a note telling him to drink it. In one extraordinary case, Belgian virologist Marc Van Ranst and his family were placed in a safe house when a military sniper went on the run after leaving a note outlining his intentions to target virologists.  

These examples are extreme. But in Nature’s survey, more than two-thirds of researchers reported negative experiences as a result of their media appearances or their social media comments, and 22% had received threats of physical or sexual violence. Some scientists said that their employer had received complaints about them, or that their home address had been revealed online. Six scientists said they were physically attacked.  

Coordinated social-media campaigns and threatening e-mails or phone calls to scientists are not new: topics such as climate change, vaccination and the effects of gun violence have drawn similar attacks in the past. But even scientists who had a high profile before COVID-19 told Nature that the abuse was a new and unwelcome phenomenon tied to the pandemic. Many wanted the extent of the problem discussed more openly.  

“I believe national governments, funding agencies and scientific societies have not done enough to publicly defend scientists,” one researcher wrote in their survey response.  

Some researchers say that they have learnt to cope with the harassment, accepting it as an unpleasant but expected side effect of getting information to the public. And 85% of survey respondents said that their experiences of engaging with the media were always or mostly positive, even if they were harassed afterwards.  

“I think scientists need training for how to engage with the media and also about what to expect from trolls — it’s just a part of digital communication,” one wrote. Source: Nature analysis But Nature’s survey suggests that even though researchers try to shrug off abuse, it might already have had a chilling effect on scientific communication. Those scientists who reported higher frequencies of trolling or personal attacks were also most likely to say that their experiences had greatly affected their willingness to speak to the media in the future.  

That is concerning during a global pandemic which has been accompanied by a battery of disinformation and misinformation, says Fiona Fox, chief executive of the UK Science Media Centre (SMC) in London — an organization that collates scientific comment and organizes press briefings for journalists. “It’s a great loss if a scientist who was engaging with the media, sharing their expertise, is taken out of a public debate at a time when we’ve never needed them so badly,” she says.  

Tracking harassment  

In June, the Australian SMC in Adelaide asked researchers on its COVID-19 media lists about their experiences. The centre had been alerted to online bullying and hate campaigns directed at scientists, and wanted to know whether it was a broader problem, says Lyndal Byford, the centre’s director of news and partnerships.  

Byford shared the results with Nature. Fifty researchers answered the SMC’s informal survey. Nearly one-third reported experiencing emotional or psychological distress after talking about COVID-19; 6 people (12%) reported receiving death threats, and 6 said they had received threats of physical or sexual violence. “I think any organization involved in helping scientists communicate would find that quite disturbing,” Byford says.  

To get a broader sense of the scale of harassment, Nature adapted the Australian SMC’s survey, and asked science media centres in the United Kingdom, Canada, Taiwan, New Zealand and Germany to send it to scientists on their COVID-19 media lists. Nature also e-mailed researchers in the United States and Brazil who had been prominently quoted in the media.

The results are not a random sample of researchers who have given media interviews on COVID-19, because they represent only the experiences of the 321 scientists who chose to respond (predominantly in the United Kingdom, Germany and the United States). But the numbers reveal that researchers in many countries are facing abuse related to the pandemic, and the proportions reported were higher than in the Australian survey. More than one-quarter of respondents to the Nature survey said they always or usually received comments from trolls or were personally attacked after speaking in the media about COVID-19. And more than 40% reported experiencing emotional or psychological distress after making media or social media comments.

Politicized science
To some extent, this harassment of scientists reflects their rising status as public figures. “The more prominent you are, the more abuse you’re going to get,” says historian Heidi Tworek at the University of British Columbia in Vancouver, Canada, who is studying online abuse of health communicators in the pandemic. Most US public-health departments have also received harassment directed at staff and officials, adds Beth Resnick, a public-health researcher at Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, who has surveyed 580 departments in a study that is not yet published.

And such attacks might have little to do with the science itself and more to do with who’s talking. “If you’re a woman, or a person of colour from a marginalized group, that abuse will probably include abuse of your personal characteristics,” says Tworek. For instance, Canada’s chief public-health officer Theresa Tam is Asian Canadian, and abuse levelled against her included a layer of racism, Tworek says. Kuppalli, a female scientist of colour, says she also experienced this. Abusers told her she “needs to go back where she came from”.

Brazil's unvaccinated president misses soccer match

Via Reuters: Brazil's unvaccinated president misses soccer match.

SAO PAULO, Oct 10 (Reuters) - Brazilian President Jair Bolsonaro said on Sunday he was not allowed to attend a league match between Santos and Gremio because the home club did not allow unvaccinated supporters into their stadium.  

The soccer match was Santos' first with supporters present since the start of the COVID-19 pandemic, but the club insisted it would only permit entry of vaccinated people or those who had a negative PCR test.  

"I wanted to watch the Santos game now and they told me you have to be vaccinated," Bolsonaro said in a video posted on the website of the Metropoles news portal. "Why?"  

Bolsonaro, who has refused to get vaccinated and encouraged others to follow his lead, claimed he had antibodies because he had already contracted COVID-19.  

It was unclear whether Bolsonaro, a keen football fan who spent the weekend near Santos, tried to go to the game or whether his complaint was a general one about the need for what he called "vaccine passports."  

A spokesman for Santos said the club had not been approached by the president's team and that all fans must follow the country's sanitary regulations.  

More than 600,000 people have died from COVID-19 in Brazil.

Covid is killing rural Americans at twice the rate of people in urban areas

Via NBC News, a report by Lauren Weber of Kaiser Health News: Covid Is killing rural Americans at twice the rate of people in urban areas. Excerpt:

Rural Americans are dying of Covid at more than twice the rate of their urban counterparts — a divide that health experts say is likely to widen as access to medical care shrinks for a population that tends to be older, sicker, heavier, poorer and less vaccinated.  

While the initial surge of Covid-19 deaths skipped over much of rural America, where roughly 15 percent of Americans live, nonmetropolitan mortality rates quickly started to outpace those of metropolitan areas as the virus spread nationwide before vaccinations became available, according to data from the Rural Policy Research Institute.  

Since the pandemic began, about 1 in 434 rural Americans have died from Covid, compared with roughly 1 in 513 urban Americans, the institute’s data shows. And though vaccines have reduced overall Covid death rates since the winter peak, rural mortality rates are now more than double that of urban ones — and accelerating quickly.  

In rural northeastern Texas, Titus Regional Medical Center CEO Terry Scoggin is grappling with a 39 percent vaccination rate in his community. Eleven patients died of Covid in the first half of September at his hospital in Mount Pleasant, population 16,000. Typically, three or four nonhospice patients die there in a whole month.  

“We don’t see death like that,” Scoggin said. “You usually don’t see your friends and neighbors die.”

Part of the problem is that Covid incidence rates in September were roughly 54 percent higher in rural areas than elsewhere, said Fred Ullrich, a University of Iowa College of Public Health research analyst who co-wrote the institute’s report. He said the analysis compared the rates between nonmetropolitan, or rural, areas and metropolitan, or urban, areas. In 39 states, he added, rural counties had higher rates of Covid than their urban counterparts.  

“There is a national disconnect between perception and reality when it comes to Covid in rural America,” said Alan Morgan, head of the National Rural Health Association. “We’ve turned many rural communities into kill boxes. And there's no movement towards addressing what we're seeing in many of these communities, either among the public, or among governing officials.”  

Still, the high incidence of cases and low vaccination rates don’t fully capture why mortality rates are so much higher in rural areas than elsewhere. Academics and officials alike describe rural Americans’ greater rates of poor health and their limited options for medical care as a deadly combination. The pressures of the pandemic have compounded the problem by deepening staffing shortages at hospitals, creating a cycle of worsening access to care.  

It's the latest example of the deadly coronavirus wreaking more havoc in some communities than others. Covid has also killed Native American, Black or Hispanic people at disproportionately high rates.  

Vaccinations are the most effective way to prevent Covid infections from turning deadly. Roughly 41 percent of rural America was vaccinated as of Sept. 23, compared with about 53 percent of urban America, according to an analysis by The Daily Yonder, a newsroom covering rural America. Limited supplies and low access made shots hard to get in the far-flung regions at first, but officials and academics now blame vaccine hesitancy, misinformation and politics for the low vaccination rates.

How the US vaccine effort derailed and why we shouldn’t be surprised

Via The Guardian: How the US vaccine effort derailed and why we shouldn’t be surprise. Excerpt:

There are very specific, well-documented reasons that Americans are hesitant to take vaccines. They vary from the troubling way the medical system treats people of color, to vaccine misinformation campaigns overwhelmingly popular in conservative circles, to logistical challenges.  

But population health researchers, whose work considers how society as a whole is fairing, said low vaccine uptake may be looked at another way: as the predictable outcome of a campaign subject to entrenched social forces that have diminished American health and life expectancy since the 1980s.  

“When I look at this I do see a very familiar pattern,” said Dr Steven Woolf, a prominent population health researcher at Virginia Commonwealth University. “When Operation Warp Speed came out I thought I was just seeing a modern example of this old problem where the scientific community developed the vaccine at ‘warp speed,’ but the implementation system for getting it out into the community was inadequate”.  

Woolf calls this “breakthrough without follow-through”. In that light, the plodding vaccination campaign could be seen as one more aspect of the American “health disadvantage”.  

The phrase describes a paradox: the US houses among the most advanced medical and research centers in the world, but performs poorly in basic health metrics such as maternal mortality and infant mortality; accidental injury, death and disability; and chronic and infectious disease.

"So much of the whole issue of social determinants of health and the US ‘health disadvantage’ is rooted in a lack of trust and a lack of trustworthiness in many parts of our society,” said Laudan Y Aron, a senior fellow at the Urban Institute’s health policy center. 

A key piece of research in this area is a 2013 report by a panel chaired by Woolf, directed by Aron, and funded by the National Institutes of Health. Called US Health in International Perspective: Shorter Lives, Poorer Health, the report describes how Americans spend more than double per person on healthcare compared to 17 peer nations, but rank near the bottom in health outcomes.  

The phenomenon is described as “pervasive”, impacting all age groups up to 75, with life expectancy declining especially for women. In just a few examples, Americans have the highest infant mortality, children are less likely to live to age five, and the US has the worst rates of Aids among peer nations.  

The US also has the highest or among the highest rates of cardiovascular disease, obesity, chronic lung disease and disability. Together, these risk factors culminate in Americans having the worst or second worst probability of living to age 50.  

Americans know intuitively that their healthcare is expensive, frustrating and often unfair. Remarkably, even amid the pandemic, roughly 30 million Americans went without health insurance, exposing them to potentially ruinous medical debt.  

“It’s also really interesting how often the messaging is: talk to your doctor, talk to someone you trust,” said Aron. “Yet, we don’t really acknowledge how many people don’t have a doctor, or a doctor they have a trust-based relationship with them”.

COVID outbreaks plague LAPD and fire agencies, data show

Via The Los Angeles Times: COVID outbreaks plague LAPD and fire agencies, data show. Excerpt:

Los Angeles County health officials have identified hundreds of coronavirus outbreaks at police and fire agencies since the start of the pandemic, according to data obtained by The Times through a public records request.  

The outbreaks, accounting for more than 2,500 coronavirus cases, have occurred in public safety agencies large and small across the county. More than half, however, were in just two agencies: the Los Angeles Police Department and the Los Angeles Fire Department — where members are actively fighting public health measures to control such spread.  

Of 211 identified outbreaks of three or more coronavirus cases at police or fire agencies in L.A. County between March 2020 and last month, 112 were linked to the LAPD and LAFD, according to the data.  

The LAPD had 37 identified outbreaks, accounting for 1,061 cases, while the LAFD had 75 identified outbreaks, accounting for 553 cases, the data show.  

Another 18 outbreaks were identified at the L.A. County Sheriff’s Department, accounting for 334 cases, and 44 at the L.A. County Fire Department, accounting for 211 cases, the data show.  

The figures reflect a consistent and ongoing spread of infection within police and fire stations from the start of the pandemic through the present, and offer an important backdrop to the growing effort by police officers and firefighters to push back on measures such as vaccine mandates.  

In response to a new L.A. ordinance mandating that all employees be vaccinated by next month unless they are granted a medical or religious exemption, both LAPD and LAFD employees filed lawsuits challenging the requirement. Thousands more have filed notice that they intend to claim an exemption.  

City officials have said that 56% of LAPD employees and 58.5% of sworn LAFD employees have been fully vaccinated, according to recent data. Those rates lag behind the 68% of L.A. County residents 12 and older who are fully vaccinated, according to county data.

Most LAPD officers who have tested positive since June were unvaccinated. Ten LAPD employees have died from the virus.

US public health workers leaving ‘in droves’ amid pandemic burnout

Via The Guardian, a predictable but still alarming report: US public health workers leaving ‘in droves’ amid pandemic burnout. Excerpt:

Alexandra was working in the public health emergencies unit in a major north-eastern American city when the first wave of the pandemic hit. Although her job was in public health policy research, and not treating Coovid-19 patients on the frontlines of the healthcare system, she recalls the spring of 2020 as a blur of 24-hour shifts.

Beginning last March, Alexandra estimates that she and her colleagues worked the equivalent of three full-time years in 12 months. (Her name has been changed to protect anonymity.) 

“There was no overtime, there was no hazard pay,” Alexandra recalls. Throughout the public health department where she worked, symptoms of anxiety, depression and stress-related physical maladies were commonplace among staff.  

This summer, despite the protestations of her superiors, Alexandra quit. She says she’s one of roughly 25 staff members who have left the department since the start of the pandemic.  

Alexandra’s story is not unique. Just as the pandemic has fuelled a burnout crisis among frontline medical staff, it has been calamitous for the mental health of workers in public health – the data analysts and policy advisers whose recommendations are supposed to shape the nation’s pandemic response. Many feel stonewalled by elected officials and scapegoated for the death toll of Covid-19.  

Some, like Alexandra, are opting to leave the job for good.  

The results of a nationwide CDC survey of public health workers, released this July, were revealing. Of the more than 26,000 surveyed individuals working in public health departments across the United States, more than half reported recent symptoms of at least one major mental health condition. Their reported prevalence of PTSD was 10 to 20% higher than in frontline medical workers and the general public. Advertisement  

Some public health workers, including Alexandra, cite a lack of cooperation from elected officials as a driving source of widespread overwork and discontent. Others even say they have faced pressure from elected officials to alter their findings to fit a political agenda.  

“When they didn’t like how our [data on] vaccination coverage by race/ethnicity was looking, they actually asked me – the least senior member of the health department – to edit the data to artificially inflate BIPOC categories,” alleges Kristine, an epidemiologist at a Connecticut health department. (Her name has been changed out of fear for her job.)  

Meanwhile, public health workers are at the receiving end of mounting resentment. Since last March, threats against public health officials have increased. In a high-profile incident this past July, an angry crowd targeted Dr Faisal Khan – the acting director of the St Louis department of health – at a meeting on mask mandates. The disgruntled attendees lobbed racial epithets and surrounded Khan after the meeting like a mob.

Divorced Saskatchewan parents fight in court over COVID-19 vaccination for teen daughter

Via CBC News: Divorced Sask. parents fight in court over COVID-19 vaccination for teen daughter. Excerpt:

A judge has ruled the 13-year-old child of divorced Saskatoon parents should be vaccinated against COVID-19, despite legal opposition from the girl's mother.  

The father said his daughter was initially excited to receive her shot, but was then "bombarded" with false information by her mother and his own parents.  

CBC News agreed to grant the father confidentiality in order to protect the identity of the daughter.   

"[It felt like the] summer from hell," the father said of his efforts to get his daughter protected against the virus that causes COVID-19.  

He's speaking out about the family rift and the judge's decision in support of vaccination to offer comfort to other divorced parents who may be in a similar situation, he said.   

"I can't lose this case because it's going to affect so many other people."  

The law firm representing the mother said she is appealing the decision and does not want the case publicized.  

CBC News reached out multiple times to seek direct comment from her lawyer and did not hear back.  

Mother views Pfizer vaccine as dangerous: judge  

The father sought a court ruling that his daughter should get vaccinated in May, when she was 12.   

In a Sept. 9 decision in Saskatoon's Court of Queen's Bench, Justice Michael Megaw ruled in favour of the father.  

Megaw stated the mother expressed views challenging "the prevailing wisdom surrounding all of the health concerns arising from COVID-19," including skepticism about the seriousness of the pandemic and a view that the Pfizer-BioNTech is experimental and dangerous.   

"This case is not about whether there is, or has been, a pandemic with respect to the COVID-19 virus," Megaw wrote. "The Pfizer COVID-19 vaccination is safe and effective for use in people, including both adults and children."

BC: Salmon Arm schools locked and secured after anti-vaccine protesters enter on Friday

Via CBC News: Salmon Arm schools locked and secured after anti-vaccine protesters enter on Friday.

Schools in and around Salmon Arm, B.C., were put on hold and secure on Friday after anti-vaccine protesters entered them, according to a letter sent to parents from the school district.  

The temporary lockdown meant students could not enter or leave school during the day. The school district said schools would be locked in this way beginning Monday, Sept. 20. Parents who want to enter during school hours will need to notify the school, according to the letter.  

"We have recently experienced protests at our district office from those opposed to vaccinations and masking," said Donna Kriger, superintendent of School District 83, in the letter sent to parents.  

"This [Friday] morning these protesters did something which was completely unacceptable which was, choosing to enter schools in and around Salmon Arm."  

Salmon Arm RCMP confirmed that protesters entered a school on Friday and were confronted by a security guard. The protesters left before police arrived on scene, after the school's principal informed them they had no right to be there, according to an RCMP spokesperson.  

The school district declined an interview request Friday.  

In her letter, Kriger said SD83 would be working with RCMP to ensure protests would not reach schools going forward.  

'A complete and utter disgrace'  

Public Safety Minister Mike Farnworth described what happened in Salmon Arm as "absolutely unacceptable" in a media availability on Friday.  

"This is just a complete and utter disgrace. The word 'Covidiot' doesn't even begin to describe how inappropriate the actions of these wack jobs are. It's unacceptable in the extreme," Farnworth said.   

Live Facebook videos filmed by some of the protesters show them confronting health-care workers administering vaccines in a school parking lot.  

In the videos, the protesters express outrage that children over the age of 12 are allowed to receive the shot without their parents' consent. Under the Infants Act of 1996, "mature minors" can consent to their own medical care providing they fully understand what is involved in that care as well as the risks and benefits.  

The protesters are repeatedly told to take their questions to Interior Health and to stop pointing their phone cameras toward the vaccination booth.  

The videos also show police arriving on the scene and informing the protesters that they need to keep their distance from the pop-up clinics and respect the privacy and confidentiality of those receiving vaccines.

See also the school district's official statement on this incident.

Uncoupling vaccination from politics: a call to action

Via The Lancet: Uncoupling vaccination from politics: a call to action.

Political polarisation in the USA is impeding vaccination of the population against SARS-CoV-2. Today, the lowest COVID-19 vaccination rates in the USA are overwhelmingly in Republican-leaning states and counties. At a time when the delta variant is spreading, these are also the areas experiencing surges in admissions to hospital and intensive care. If political divides on COVID-19 vaccination become ingrained, the consequences could include greater resistance to all vaccination and outbreaks of other vaccine-preventable diseases. Understanding and countering this trend are urgent public health priorities. 

Historically, anti-vaccine rhetoric has had minimal policy impact because bipartisan political leadership strongly endorsed the safety and effectiveness of vaccines. However, in recent years, anti-vaccine activism has received support from some state-level Republican officials during legislative debates over bills to improve vaccine uptake. Today, anti-vaccination groups have successfully married their cause to opposing other COVID-19 mitigation measures, including masking and physical distancing. Misinformation is spreading through right-leaning media programmes and platforms, and on social media. Republican elected officials in multiple states have accepted the framing of vaccination as a matter of personal liberty, with several states passing laws prohibiting private businesses from requiring COVID-19 vaccination. 

Once a public health issue becomes politicised, walking back the partisanship becomes difficult, while addressing the challenge head on risks exacerbating the problem. Public and private sector leaders may fail to speak out, afraid of alienating a sceptical base. This is a moment to prioritise health over short-term political calculations. SARS-CoV-2 is agnostic in whom it infects, and COVID-19 vaccines protect liberals and conservatives alike. Leaders across sectors of every ideological stripe should work together to promote vaccination. 

We recommend five short-term steps. First, diversify messengers. Public officials should recognise that when promoting vaccination, the messenger is as important as the message. Promotion efforts will be most effective when communicated from an array of trusted speakers and perspectives, especially outside of government. Encouraging and supporting Republican leaders to amplify pro-vaccine messages are important priorities. 

Second, draw on broad expertise. As COVID-19 vaccine hesitancy is not just a public health problem, public officials need to convene experts from the social, behavioural, and communication sciences to create comprehensive response strategies. Routine public health messaging alone will be insufficient. 

Third, invest in research. Recognising that the politicisation of vaccines is now a problem of unprecedented scope and the dominant driver keeping down vaccination rates, public and private funders should invest in social and behavioural research to systematically monitor the phenomenon and develop solutions. 

Fourth, counter purveyors of misinformation. Policy makers and professional organisations should examine available legal, regulatory, and private sector options to reduce the impact of well-financed organisations spreading misinformation. The US Government should solicit the expertise of agencies outside the health sector, including the Departments of Homeland Security, Commerce, Justice, and State. 

Fifth, stop the misinformation. Conservative media outlets must stop amplifying falsehoods about COVID-19 vaccines. Advertisers should pull funding from programmes and websites that promote misinformation, as they put the lives of Americans and the health of our economy at risk. Social media platforms should enhance efforts to track, disclose, and stop the spread of misinformation.

‘Their crisis’ is ‘our problem’: Washington grapples with Idaho Covid cases

Via The New York Times: ‘Their Crisis’ Is ‘Our Problem’: Washington Grapples With Idaho Covid Cases. Excerpt:

SPOKANE, Wash. — Surgeries to remove brain tumors have been postponed. Patients are backed up in the emergency room. Nurses are working brutal shifts. But at Providence Sacred Heart Medical Center in Spokane, Wash., the calls keep coming: Can Idaho send another patient across the border?  

Washington State is reeling under its own surge of coronavirus cases. But in neighboring Idaho, 20 miles down Interstate 90 from Spokane, unchecked virus transmission has already pushed hospitals beyond their breaking point.  

“As they’ve seen increasing Covid volumes, we’ve seen increasing calls for help from all over northern Idaho,” Dr. Daniel Getz, chief medical officer for Providence Sacred Heart, said in an interview. As he spoke, a medical helicopter descended with a new delivery.  

At a time when Washington State hospitals are delaying procedures and struggling with their own high caseloads, some leaders in the state see Idaho’s outsourcing of Covid patients as a troubling example of how the failure to aggressively confront the virus in one state can deepen a crisis in another.

On the Washington side of the border, residents must wear masks when gathering indoors, students who are exposed to Covid face quarantine requirements, and many workers are under vaccination orders. On the Idaho side, none of those precautions are in place.  

“It’s ridiculous,” said Cassie Sauer, the president of the Washington State Hospital Association. “If you have your health care system melting down, the idea that you would not immediately issue a mask mandate is just bizarre. They need to be doing everything they can possibly do.”  

Last week, Idaho took the extraordinary step of moving its hospitals in the northern part of the state to crisis standards of care — the threshold at which facilities facing overwhelming caseloads are authorized to ration their resources, perhaps withholding or delaying optimal care for some patients.  

Idaho now has more than 600 patients hospitalized with Covid-19, about 20 percent higher than a previous peak in December. Only 40 percent of the state’s residents are fully vaccinated, one of the lowest rates in the nation, compared with 61 percent in Washington State, one of the highest.

The strain on health care facilities is particularly evident in northern Idaho, where the vaccination rate is even lower; the area just hosted the North Idaho State Fair, and in a region where there is deep wariness of government, no mask orders or other strategies were adopted to halt the spread of the virus. At Kootenai Health in Coeur d’Alene, a conference room has been converted to house excess patients.

With the Delta strain of the coronavirus sweeping the nation, Washington State has faced its own challenges and record hospitalizations, especially in areas on the eastern side of the state where vaccination rates are lower. This week, that state, too, began talking openly about the possibility that crisis standards of care could become necessary.  

But Washington is in better shape than Idaho, where hospitalizations as a share of the population are 45 percent higher.  

“We certainly need our friends in Idaho government to do more to preserve their citizens’ health, because we know that their crisis is becoming our problem,” Washington’s Democratic governor, Jay Inslee, said last week. “I’m asking the people of Idaho to adopt some of the safety measures — like masking requirements — like we have in Washington so we can help both of our states reduce this horrible pandemic.”  

In Idaho, Gov. Brad Little’s office said he was not available for an interview, but he has indicated in recent weeks that he has no plans to restore virus restrictions, even if hospitals entered dangerous territory, saying that he wanted residents “to choose to do the right thing and get vaccinated.” He issued a statement on Friday saying he was exploring legal action to halt a mandate from President Biden that will require millions of people to get vaccinated.