‘On the cusp:’ Missoula hospitals close to crisis care as patients flood in

With no other option, Missoula's elected officials, school leaders and members of the medical community on Friday resorted to begging for personal responsibility as they struggle to address a record-setting spike in Covid-19 patients and its growing impacts.

Saying the situation in Missoula had reached crisis level, the city confirmed that the Montana National Guard will arrive next week to assist in pandemic care while hospitals are close to shifting to crisis standards of care.

“We're not at that state yet, but we're on the cusp of that state. We're not doing business as normal,” said Dr. James McKay, the chief physician executive at Providence. “We're at the point where we are having to limit some of the care we'd do on a normal day. In a sense, we're already triaging people.”

McKay and other hospital officials said local facilities are backed up and already are diverting patients from outlying areas. Those in surrounding communities who need the level of care provided by Missoula's larger medical facilities can't be brought in due to a lack of space.

As of Friday morning, Providence CEO Joyce Dombrouski said her facility was treating 30 Covid patients, four of them now on ventilators. Of those 30, around 23 are unvaccinated. The hospital this week opened its ambulance bay to triage patients.

At Community Medical Center, medical staff are treating 20 Covid patients, and 85% of them are unvaccinated. More than 90% of the hospital's Covid patients now in intensive care are unvaccinated, the hospital said.

“We're seeing unprecedented increases in hospital volume here in Missoula right now, largely driven by Covid patients, the vast majority of whom are unvaccinated,” said Dr. Nicole Finke with Community. “These patients are younger, they're sicker, and they're taxing the resources of our medical community. Healthcare resources are not unlimited.”

Missoula broke two Covid records on Thursday, including its number of hospitalized patients and its rate of daily incidents. The rising number of cases now rivals numbers seen last November, which once was considered the top of the pandemic.

And while the number of patients is accelerating, hospital officials and Missoula's medical leaders said the patient demographic also is growing younger. Of the 1,200 active cases in Missoula County, almost 20% are under the age of 20.

Another 20% represents those between 20 and 30 years old.

“The unfortunate thing is not just that young people are getting sick, but with the Delta variant, they're getting much sicker,” said Missoula Health Office D'Shane Barnett. “When we look back to November 2020, we had 36 hospitalizations due to Covid. Over the last month, that same number is now 76, and 70% of those hospitalizations have been among the unvaccinated.”

Barnett and other city leaders expressed frustration Friday over their inability to address the public health crisis. Earlier this year, the Montana Legislature passed and Gov. Greg Gianforte signed several bills handcuffing any local response to public health, including a ban on mask mandates and limiting the size of events.

“I get asked why we're not doing more to limit the spread of this virus,” Barnett said. “Now is the time when we would have those mandates in place. Unfortunately, we have anti-health state legislators who went out of their way to make that not possible. A lot of actions to mitigate Covid-19 have been taken out of our hands here in Missoula.”

With no other tools to combat the virus, and with the state's inaction, health officials and elected leaders resorted to pleading with the public Friday to take the proper precautions by getting a vaccine, wearing a mask and social distancing.

“This is largely a tragedy of our own making. The science is unambiguous: Getting vaccinated, social distancing and wearing a mask makes a difference,” said Commissioner Dave Strohmaier. “This is a civic responsibility to get vaccinated. It's all about caring for one another in our community. This is the heart of the matter right now.”