Idaho recently passed a grim, sad pandemic milestone. More than 5,000 Idaho residents have now died from COVID-19 related factors.

Let’s take a look at the demographics for those 5,017 deaths, which amounts to 274.6 deaths for every 100,000 Idahoans.

More men have died from COVID-19 related factors than women. Dads, brothers, husbands, uncles, and grandfathers make up 58.3 percent of all the COVID-19 related deaths, while moms, sisters, wives, aunts, and grandmothers make up 41.7 percent.

More than half of the Idahoans who have died were younger than 80, including two younger than 18; 21 who were in the 18-29 age group; 64 in the 30-39 age group; and 186 in the 40-49 age group.

Most Idahoans who died from COVID-19 related factors were white, at almost 95 percent of the COVID-19 related deaths in Idaho.

Smaller, more rural counties are hit hardest by COVID-19 related deaths. Lewis County has the highest rate of COVID-19 related deaths, at 781.7 deaths for every 100,000 people.

We seem to have hit a plateau in terms of the number of COVID-19 cases in Idaho. But there’s still a lot of disease in the state. While most people have only mild symptoms, the disease can be deadly for many. It is still important to limit your chances of getting COVID-19  by following the recommended precautions, not just for yourself, but the people around you.

We know what works to limit the spread of the disease:

• Get vaccinated and boosted. This is still the best way to protect yourself and loved ones from getting very sick or even dying.
• Wear a mask in crowded places.
• Stay home and get tested if you feel sick.
• Stay six feet apart in public.
• Stay informed.

Elke Shaw-Tulloch is the administrator of the Division of Public Health, and the state’s public health officer. She has worked for the department since 1996 and was promoted to division administrator in 2012. Since February 2020, she has focused most of her time on responding to the coronavirus pandemic. 

COVID-19 resources:

• Idaho’s Coronavirus website
• CDC COVID-19 website
• Masks are available for Idahoans: KN95 masks (one pack of 10 per household) are available for free at various locations around the state. Call the Idaho CareLine by dialing 2-1-1 or 800-926-2588 or your local public health district to find a location near you. https://healthandwelfare.idaho.gov/health-wellness/community-health/public-health-districts
• Free, at-home COVID-19 tests are available from the federal government at covidtests.gov. Every home in the U.S. is eligible to order four free, at-⁠home COVID-⁠19 tests. Orders will usually ship in 7-12 days.
• Find COVID-19 and flu vaccines/boosters near you: Use vaccines.gov to find a location near you, then call or visit their website to make an appointment. 

Follow the Department of Health and Welfare on Twitter, Facebook, and Instagram for updates and information you can trust.

The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at healthandwelfare.idaho.gov. 

I am very pleased to announce the completion of our new five-year Strategic Plan.

We will continue working toward the same four goals we pledged in our previous Strategic Plan because those goals are still relevant:

• Goal 1: Ensure affordable, available healthcare that works
• Goal 2: Protect children, youth, and vulnerable adults
• Goal 3: Help Idahoans become as healthy and self-sufficient as possible
• Goal 4: Strengthen the public’s trust and confidence in the Department of Health and Welfare

The plan guides the work done every day by dedicated staff throughout the department. We are focusing on the big ideas we will be turning into reality over the next five years. Our plan helps the department organize and continue transformative, long-term work as we also face day-to-day demands and challenges.

This year, we continued our efforts to write in plain language as part of our ongoing effort to communicate clearly with the public about how we serve Idahoans. This Strategic Plan also features important advances in two key areas: work to prevent adverse outcomes, and strategic work to overcome the current shortage of healthcare workers.

Strategic objectives involving work by several divisions to help people be physically and mentally healthier

• Conditions in the places where people live, learn, work, and play (known by some as the social determinants of health) contribute to preventable differences in disease, injury, violence, and opportunities to be healthy for different groups of people in Idaho.
  • Strategic Objective 3.2: Address health disparities in Idaho communities by implementing three strategies that focus on the social determinants of health by June 30, 2025.
  • This objective involves work by teams in the divisions of Public Health, Medicaid, and Welfare.
• Trauma experienced during childhood severely increases the likelihood of poor physical and mental health throughout life.
  • Strategic Objective 3.3: Prevent or reduce the impact of Adverse Childhood Experiences across the lifespan of Idahoans by creating a coordinated DHW program delivery framework by June 30, 2025.
  • This objective involves work by teams in the divisions of Public Health, Medicaid, Family and Community Services, Behavioral Health, and Welfare.

Strategic objectives to address the healthcare workforce shortage

• Idahoans in some areas of the state may not have access to needed healthcare services because of healthcare workforce shortages and limited access.
  • Strategic Objective 1.1: Develop and implement four cross-divisional initiatives to help reduce healthcare workforce shortages by Dec. 31, 2024.
  • This objective involves work by teams in the divisions of Public Health, Behavioral Health, and Medicaid.
• Economic pressure is making it tough to hire and retain employees, which can negatively impact services to customers.
  • Strategic Objective 3.4 (New for the 2023–2027 Strategic Plan): Reduce the department’s employee voluntary turnover rate from 21.7 percent to 14 percent by June 30, 2026.

You can read more about each of these objectives, as well as the updates to the other strategic objectives, in the plan on the DHW website. Also, throughout the year, I will regularly post updates in this blog to keep you informed about the progress we are making toward our mission of strengthening the health, safety, and independence of Idahoans.

I hope you have a safe and healthy weekend! 

The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at healthandwelfare.idaho.gov. 

Wildfire smoke can cause irritating symptoms for healthy people. It can cause more serious health issues for people with respiratory problems and heart and lung disease. It's important to know how to protect yourself and your family from smoky air whenever possible.

Who is most at risk for the harmful effects of smoke?

Infants and young children suffer more from the effects of smoke because they breathe more air than adults for their body size. Older adults and people with lung and heart conditions are also very sensitive to smoke in the air. Even low levels of smoke can cause breathing problems for sensitive groups with asthma, COPD, emphysema, and other chronic lung diseases. Smoke also can increase the risk of heart attack or stroke for people with chronic heart conditions and can increase the risk of premature birth in pregnant women.

When should we become concerned about the symptoms of smoke exposure? 

Smoke can cause your eyes, nose, and throat to be irritated. You should call your doctor right away if you have shortness of breath, chest pain or tightness, headaches, fatigue, or a combination of those symptoms that become severe.

What if I have an event outside or my child has a game we can't miss, and the air quality is low?

Visit the Idaho Department of Environmental Quality's air quality website or the Idaho Smoke Information Blog to check local smoke conditions. You can also download the AIR Idaho app on your mobile device for smoke conditions in your area. The Department of Health and Welfare (DHW) also provides activity guidelines for outdoor events and other resources to help determine your risk level.

If an outdoor event isn't canceled when it’s smoky, drink plenty of water and do your best to limit time outside. If smoke-related symptoms become difficult or get a lot worse, move indoors. Your family's health is more important than a sporting event.

Should we consider wearing masks when conditions are poor?

While the most effective way to protect yourself from smoke is to stay indoors, we recognize this is not always possible. People who must be outside in the smoky air may benefit from wearing particulate respirators or N95 respirators. Respirator masks worn correctly may provide protection by filtering out fine particles in the smoke. Even so, many people find it difficult to wear a mask correctly. If a mask does not fit properly, it will provide little or no protection. Masks also can make it harder to breathe normally for some people. It is a good idea to check with your healthcare provider before using a mask. 

How can we limit our exposure to smoke?

When conditions are poor, you should reduce your time and activities outside as much as possible. Stay indoors, in an air-conditioned area, if you can. If you don't have air conditioning, go someplace that does, like the mall or library. Otherwise, there are several things you can do to limit the smoky air you breathe:

• Keep your windows and doors closed.
• If you have central air conditioning, use an air filter rated MERV 8 or higher and turn the system fan on.
• If you must drive in smoky areas, keep all windows closed and turn the vehicle airflow to recirculate to reduce the amount of smoke in the vehicle. Use caution and drive slowly in smoky conditions.
• Do not add to smoky conditions by burning candles, using propane or wood-burning stoves or aerosol sprays, smoking tobacco products, or vacuuming. All of these and more can increase air pollution indoors.
• Change air-conditioning filters more frequently when the air is smoky.
• Use portable air cleaners to reduce indoor air pollution.
• Pay attention to local air quality reports and health warnings.

Where do I go for more information?

The resources listed below provide up-to-date information on smoke conditions and tips on how to stay healthy during wildfire smoke events:

• Idaho Health and Welfare Wildfire Smoke
• Guide for Staying Healthy During Wildfire Smoke
• AirNow
• Idaho Smoke Information
• Idaho DEQ Air Quality Information
• Wildfire Smoke and Face Masks

Brigitta Gruenberg is the Environmental Health Program manager in the Division of Public Health.  

The Idaho Department of Health and Welfare is dedicated to strengthening Idahoans' health, safety, and independence. Learn more at healthandwelfare.idaho.gov.

Note: Sen. Fred S. Martin is the chairman of the Senate Health and Welfare Committee, a member of the Board of Health and Welfare, and a champion for the 988 Suicide & Crisis Lifeline. Sen. Martin is our guest blogger this week, while Director Dave Jeppesen is on vacation.  

Many in Idaho (including myself) and in Washington D.C. (including Sen. Mike Crapo) have worked hard for years to have a three-digit number (like 911) for mental health and suicide prevention. We now have 988.

Suicide prevention is a critical need in our nation and in Idaho. Since 2008, suicide has ranked as the tenth leading cause of death in the United States. Suicide claimed the lives of more than 44,000 Americans in 2020.

I serve on the board for the Idaho Council on Suicide Prevention. During my time on that board I have secured ongoing funding for the Idaho Suicide Hotline. The Department of Health and Welfare has a major state mission to lower suicides in Idaho. As part of this, Idaho teachers are to be trained each fall so they can recognize when students might be thinking about suicide, and 988 in Idaho will get you to a trained behavioral health professional.

One death by suicide is one too many. Our goal is zero suicides in Idaho.

The 988 service takes effect July 16, 2022.

The goals of 988

• Provide behavioral and mental health support to those experiencing crisis
• Connect people to supportive resources
• Connect people with trained crisis personnel
• Reduce the stigma of behavioral and mental health needs
• Reduce the strain on our hospital system, law enforcement, and the criminal justice system

In August 2019 the Federal Communications Commission (FCC) in consultation with the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration, the Department of Veteran Affairs, and the North American Numbering Council, released a report recommending the use of 988 as the three-digit code for the National Suicide Prevention Lifeline. In July 2020, the FCC adopted rules designating this new phone number for individuals in crisis to connect with suicide prevention and mental health crisis counselors. In November 2021, the FCC adopted rules to expand access to the National Suicide Prevention Lifeline by establishing the ability to text 988 to directly reach the lifeline to better support at-risk communities in crisis, including youth and individuals with disabilities.

Resolution by the Idaho Legislature 

Be It Resolved:

WHEREAS, on October 17, 2020, the National Suicide Hotline Designation Act of 2020 was signed into Law; and

WHEREAS, the act designated 988 as the universal telephone number for the national suicide prevention and mental health crisis hotline system currently operating through the National Suicide Prevention Lifeline and the Veterans Crisis Line; and

WHEREAS, the Idaho Suicide Prevention Hotline is part of the existing network of the National Suicide Prevention Lifeline and currently receives calls from individuals dialing (800) 273-TALK; and

WHEREAS, as of 2019, Idaho's suicide rate is 41% higher than the national rate; and

WHEREAS, to prevent suicide, it is critical to transition the existing ten-digit National Suicide Prevention Lifeline number, (800) 273-TALK, to a universal, three-digit phone number and to connect people with life-saving resources; and

WHEREAS, the Idaho Suicide Prevention Hotline will experience an increased call volume when 988 goes live in July 2022 and becomes the equivalent of 911 for suicide and mental health crises; and

WHEREAS, Idaho has a shortage of mental health providers and primary care providers, making access to a 24/7 mental health and suicide prevention25hotline vitally important; and

WHEREAS, suicide prevention and mental health support delivered by a crisis hotline helps Idahoans de-escalate and stay safe, thereby avoiding unnecessary and costly trips to hospital emergency departments and decreasing dispatch of police, emergency medical services, or fire department services; and

WHEREAS, 988 will improve access to mental health support for all Idahoans, especially those in rural communities with few health care providers;

WHEREAS, promotion of 988 will help raise awareness of mental health and suicide prevention and decrease stigma associated with asking for help.

NOW, THEREFORE, BE IT RESOLVED by the members of the First Regular Session of the Sixty-sixth Idaho Legislature, the House of Representatives and the Senate concurring therein, that the Legislature recognizes 988 as the universal mental health and suicide prevention crisis phone number, effective July 2022.

The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at healthandwelfare.idaho.gov. 

For most people, the COVID-19 vaccine offers the most consistent protection from severe disease associated with COVID-19., However, for those who can’t get the vaccine or who aren’t able to develop a strong immune response from the vaccine because they have a weakened immune system, a medicine called Evusheld may be an option.

What is Evusheld?

Evusheld is a medicine that contains antibodies. These antibodies can help prevent COVID-19 in people who don’t have a strong immune system. The U.S. Food and Drug Administration (FDA) issued an emergency use authorization to make it available during the pandemic, and they recently changed the authorization to allow for additional doses.

How long will it provide protection against COVID-19 infection?

The additional protection lasts for as long as six months. Evusheld is given before a person is exposed or tests positive to help prevent COVID-19 infection. Evusheld is not used to treat COVID-19 symptoms.

Can I get Evusheld instead of the COVID-19 vaccine?

Unless you have a health-related reason you shouldn’t get the vaccine, you are still recommended to get the vaccine followed by Evusheld at least two weeks after vaccination. The vaccine is expected to build some natural immunity even in those with weakened immune systems. Evusheld is not a substitute for COVID-19 vaccination, because it doesn’t build any natural immunity in the body.

Who is eligible to get it?

You may be eligible for Evusheld if you are moderately or severely immunocompromised or have a history of severe allergic reactions to COVID-19 vaccines, and you meet the following criteria:

• You do not currently have COVID-19
• You have not recently had close contact with someone with COVID-19
• You are an adult or adolescent ages 12 years and older weighing at least 88 pounds

Your healthcare provider will decide if you are eligible for Evusheld and will help you get it if you are. It requires a prescription. Talk to your healthcare provider about whether you should get Evusheld in addition to COVID-19 vaccination.

Is this a shot or a pill, and how often does a person need to get it to be effective?

Evusheld is a combination of two antibodies, given as two shots on the same day. Based on what we know about current SARS-CoV-2 variants, you might need to receive additional doses of Evusheld every six months if ongoing protection is needed.

Your healthcare provider will monitor you for allergic reactions for at least one hour after you receive Evusheld.

Dr. Christine Hahn is Idaho’s state epidemiologist and the Division of Public Health’s medical director. She is board certified in infectious disease and works in an Idaho tuberculosis clinic twice monthly. She also serves on the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices, and since late February 2020, has been focusing almost solely on responding to the coronavirus pandemic.

COVID-19 resources:

• Evusheld fact sheet
• Idaho’s Coronavirus website
• CDC COVID-19 website
• Masks are available for Idahoans: KN95 masks (one pack of 10 per household) are available for free at various locations around the state. Call the Idaho CareLine by dialing 2-1-1 or 800-926-2588 or your local public health district to find a location near you. https://healthandwelfare.idaho.gov/health-wellness/community-health/public-health-districts
• Free, at-home COVID-19 tests are available from the federal government at covidtests.gov. Every home in the U.S. is eligible to order four free, at-⁠home COVID-⁠19 tests. Orders will usually ship in 7-12 days.
• Find COVID-19 and flu vaccines/boosters near you: Use vaccines.gov to find a location near you, then call or visit their website to make an appointment. 

Follow the Department of Health and Welfare on Twitter, Facebook, and Instagram for updates and information you can trust.

The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at healthandwelfare.idaho.gov. 

I recently sat down and thought hard about something I didn’t really want to think about – how I would want to be cared for if I were too sick or injured to speak for myself. It’s difficult to think about that. But it would be even more difficult if I were incapacitated.

The Idaho Healthcare Directive Registry was transferred from the Secretary of State to the Department of Health and Welfare. The secure, cloud-based system allows you to upload your existing directive, create a new directive, and/or share your advance directive for free.  The Department of Health and Welfare’s Advance Directives and Registry Services has several free and available resources to help you create your own advance directive.

For those who may not know, an advance directive is a written plan that helps your loved ones and healthcare providers make decisions about your care when you can’t. The advance directive gives them directions about the care you want or don’t want. This worksheet may help you think through your advance directive decisions.

An advance directive can be revoked at any time and a new one can be created at any time. It must be signed by you, but it does not need to be notarized or signed by a medical provider.

The Idaho Advance Directive includes two parts:

• Idaho Durable Power of Attorney for Healthcare, a legal document that allows you to name a person who will speak on your behalf if you are not able.
• Living will, which allows you to make choices about life-sustaining medical treatments you do or don’t want during a medical crisis or at the end of your life.

Take the time to think through what you would want in a crisis or end-of-life situation, and talk about it with people close to you who would be making those critical decisions for you. Writing down what you want will help you and your loved ones feel more prepared if you can’t speak for yourself.

I feel secure in the knowledge that my wishes will be followed if I am unable to speak for myself. The peace of mind is worth the discomfort of having that conversation with your loved ones.

You can learn more about the Advance Directives and Registry Services on the DHW website.

I hope you have a safe and healthy weekend!                 

The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at healthandwelfare.idaho.gov. 

Idahoans now have a simple, secure way to see their immunization records on their mobile devices if they choose. It’s secure, easy to use, and very convenient when you need to provide your or your children’s immunization records for travel, or for registration for child care or school.

Docket is an application available in mobile app stores that searches Idaho’s Immunization Reminder Information System (IRIS) using name, date of birth, and sex to display immunization records on a mobile device. Phone number verification is required.

The app displays vaccination history to anyone with a record in IRIS whose access has been authenticated through the app.

Who can use Docket?

Anyone at least 18 years of age with a vaccine record in IRIS can use the Docket® app to review their own immunization records or to review the immunization records of someone for whom they are the parent/legal guardian or authorized personal representative, usually for a minor child or vulnerable adult.

What data are stored in Docket?

The data are the same as what is contained in IRIS, which is Idaho’s secure, statewide immunization information system. Data include limited demographic information such as your name and phone number, details about what vaccines have been received and when.  

Based on algorithms in IRIS, previous vaccine administration dates are used to predict whether additional vaccines are due. A patient should always check with their health care provider before receiving additional vaccines.

Docket users can delete their search history in the app, which deletes the corresponding records from Docket. Users can also delete their Docket accounts, which deletes everything associated with the user’s Docket account, but does not impact their records in IRIS.

Is my personal data secure? Who can access my data?

Your personal and health data are securely stored and securely transmitted. Access is only allowed to someone who has verified they have the legal authority to access a specific immunization record.

Will I be able to access my complete vaccination history?

The app displays all your immunization records that are entered into IRIS by your healthcare or vaccine provider(s). This may be the complete history, but there may be missing records in some cases. There are various reasons why your complete immunization history may not be in IRIS (vaccines received many years ago from previous providers or from providers in another state); please check with your healthcare provider(s) if your record is not up to date.

If you have received vaccines in other states, they may not show up on this app because those out-of-state records have not been entered into IRIS by your healthcare provider.

Is the app required if I want to see my immunization records?

No, but it can make accessing your immunization record simple and convenient. The Docket app provides secure and easy access to your immunization information. Other ways to get this information include making a request to your or your child’s healthcare provider(s), or by submitting a Record Request to the Idaho Department of Health and Welfare. 

Can I use this as a vaccine passport?

The Docket app is not a vaccine passport, but it does provide a QR code for COVID-19 vaccinations that may be required for some travel or out-of-state events

How do I sign up?

To get started, download the free app by searching for “Docket” on the Apple App Store or Google Play. Or go to Docket® to download the app.

Resources

• Immunization records
• About immunizations

Sarah Leeds is the manager of the Idaho Immunization Program in the Division of Public Health.

Follow the Department of Health and Welfare on Twitter, Facebook, and Instagram for updates and information you can trust.

The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at healthandwelfare.idaho.gov. 

The Idaho Child Care Grants continue to provide funding for childcare providers in Idaho to make sure they can remain open and caring for children during the pandemic and as we recover. We’ve been accepting applications for the fourth phase of the grants, which are funded through the American Rescue Plan Act (ARPA). Eligible grantees receive monthly payments based on business expenses detailed in the applications and the maximum grant amounts.

The applications we’ve received have allowed our Idaho Child Care Program staff better insight into the expenses of running a child care business in Idaho. Applications are being accepted again starting today through July 15.

That insight, coupled with a review of the available ARPA funds for the grants, led to an increase in the maximum grant amounts for the fourth phase of the grant. These updates will help keep our much-needed child facilities up and running across the state.

The new maximum monthly grant amounts are based on the type of child care provider. Eligible family and relative providers may receive up to $1,000 a month. Eligible group providers may receive up to $2,500 a month, Small centers may get up to $5,000 a month. Large centers, $10,000 a month. Eligible large centers with demonstrated monthly expenses exceeding $40,000 may receive up to $20,000 per month for the grant.

More information about the child care grants is available at https://healthandwelfare.idaho.gov/providers/child-care-providers/child-care-grants

One of the very best parts of my job is to see the positive feedback from the Idahoans we serve. When child care providers in Idaho recently found out they would receive significantly more support this next state fiscal year, they had overwhelming gratitude to share. I don’t know about you, but these responses really helped to fill my gratitude cup! I am thrilled we can provide more support for such critical help for Idaho families.

Here are some of the responses we received:

“Omigosh! Thank you so much.” – a child care provider in Meridian

“I can't tell you how much this is appreciated! I was just telling my husband that I needed to keep our 'machine' running, and it seems that our enrollment is down a bit, rather than rebounding, as I had hoped. This couldn't have come at a better time, and will really help with the facility bills. Thank you.” – a child care provider in  Boise

“Thank you very much. God bless everyone putting their efforts into this.” – a child care provider in Middleton

“Thank you. Holy cow is that helpful.” – a child care provider in Meridian

“Thank you so very much for this opportunity from the State of Idaho. We so very much appreciate this financial assistance! This grant has helped our school with payroll, supplies, etc. etc.! Your work to get this information available out to Child Care Centers is invaluable! Just know all your hard work and others is truly appreciated!” – a child care provider in Moscow

“This will make a huge difference for our children, families and staff. Thank you.” – a child care provider who serves both Boise and Meridian

“Well amen!  I about had a heart attack!  Thank you so much for all you do and seriously if you need help with anything please let me know!”- a child care provider in Ammon

I hope you have a safe and healthy Fourth of July!  

The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at healthandwelfare.idaho.gov. 

Idaho public health officials are watching several metrics as the number of COVID-19 cases increases across the state this month. One of those metrics is the number of people hospitalized who also have tested positive for COVID-19.

There is debate in some communities about why all patients who are hospitalized with COVID are counted, instead of only those who are hospitalized because of COVID. That debate centers around which of those numbers are the best way to assess COVID-19 risk in communities.

What does it mean to be hospitalized with COVID-19?

This measure counts infected people who are admitted to hospitals because they need medical care that may be for something other than COVID-19. They may only find out they have COVID-19 when they are tested for it as they are being admitted. Some people hospitalized with COVID-19 are sick from the virus, and are admitted for the virus-related illness. “Hospitalized with COVID-19” includes both groups, and is based on positive hospital admission test results among people living in a defined area. This measure is also called “COVID-19-associated hospitalizations,” and does not imply that all those hospitalizations were solely or even partially due to COVID-19 infection.

What does it mean to be hospitalized because of COVID-19?

This includes only people who are admitted to hospitals because they need medical care for a moderate or severe case of COVID-19. They often either suspect or know they have COVID-19 before going to the hospital, but this also may include people who initially went to the hospital with symptoms of a heart attack, stroke, or pneumonia, and were only discovered to have COVID-19 when they were tested at the hospital.

Is it important to count both?

Ideally, keeping track of both numbers is important because it shows how much COVID-19 is spreading in communities. Realistically, however, it is complicated, as some of the examples show. Some people who may appear to be hospitalized for unrelated reasons may actually have underlying COVID-19 illness making their symptoms worse.

Overall, it is most critical for hospitals and public health agencies to better understand how COVID-19 is affecting hospitals. Caring for someone who has COVID-19 in the hospital requires additional healthcare staffing, supplies, and space, whether they are there because of COVID-19 or for another reason. In either case, they must be isolated, and staff needs to take special precautions while caring for them.

The hospitals are reporting this data to the National Healthcare Safety Network (NHSN). The Centers for Disease Control and Prevention (CDC) gets it from that source and displays it on their data tracker and incorporates it into their COVID-19 Community Levels.

The CDC is aware this metric contains a mix of people who are sick with the disease and those who may be admitted for other reasons. It’s also worth noting that sometimes a person’s COVID-19 diagnosis is not completely clear. A person could go to the hospital because they have chronic lung disease and are having worsening cough or shortness of breath. If they are also infected with COVID-19, that could mean the virus is causing their chronic lung disease to be worse.

It's not a perfect measure, but hospitals cannot easily separate the positive test results, so this overall measure is what's used. If the number of admissions of people positive for COVID-19 is increasing, this indicates more COVID-19 virus circulating in our communities, and very likely reflects increases in those severely ill with the disease.

Is it legitimate to include ALL hospital patients with COVID-19 in community risk levels?

Including all hospital patients with COVID-19 when assessing community risk levels reflects the burden of disease in our communities, even if the disease isn’t severe for most. It will be severe for some.

For example: If 10 percent of admissions have COVID-19, but only half of those are being admitted for COVID-19 disease and the other half just happen to have COVID-19, the result STILL reflects a high community burden of disease because it’s making a lot of people sick and it also reflects a burden on the hospitals.

It shows that COVID-19 is circulating and causing infections in a large percentage of the population. The more it circulates, the more often it can mutate and potentially become more dangerous for people it infects.

Elke Shaw-Tulloch is the administrator of the Division of Public Health, and the state’s public health officer. She has worked for the department since 1996 and was promoted to division administrator in 2012. Since February 2020, she has focused most of her time on responding to the coronavirus pandemic. 

COVID-19 resources:

• Idaho’s Coronavirus website
• CDC COVID-19 website
• Masks are available for Idahoans: KN95 masks (one pack of 10 per household) are available for free at various locations around the state. Call the Idaho CareLine by dialing 2-1-1 or 800-926-2588 or your local public health district to find a location near you. https://healthandwelfare.idaho.gov/health-wellness/community-health/public-health-districts
• Free, at-home COVID-19 tests are available from the federal government at covidtests.gov. Every home in the U.S. is eligible to order four free, at-⁠home COVID-⁠19 tests. Orders will usually ship in 7-12 days.
• Find COVID-19 and flu vaccines/boosters near you: Use vaccines.gov to find a location near you, then call or visit their website to make an appointment. 

Follow the Department of Health and Welfare on Twitter, Facebook, and Instagram for updates and information you can trust.

The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at healthandwelfare.idaho.gov. 

This is the final article reviewing our work to support DHW’s Strategic Plan 2022-2026 over the past year. This strategic goal includes six strategic objectives.

Improve our communication with Idahoans by reducing government jargon and writing in plain language.

• In Strategic Objective 4.1, the department has improved our communications by striving to use the language our customers use. This helps Idahoans understand DHW services and programs, increase engagement, and build trust in our dedication to our mission.
• Work on this strategic objective included developing an internal process to review, edit, and re-write customer-facing documents in plain language. Staff conducted plain language reviews (using the Flesch-Kinkaid tool, which is part of the Microsoft Word spelling and grammar check) in an effort to reach an eighth grade reading level on communications written for the public.
• The Office of Communications developed a plain language guide and presentation for staff to help improve plain language use for all customer communications.

Reduce the regulatory burden on the public imposed by our administrative rules.

• In Strategic Objective 4.2, the department’s Rules Unit worked with staff across the department to further reduce regulatory burden on Idahoans by completing the required review of 13 rule chapters in 2022. This involved decreasing the overall number of words in administrative rule chapters and reducing the number of restrictive words, such as “must,” “shall,” “required, “prohibited” and “may not.”
• Reducing the administrative rules may sometimes require changes in Idaho Statute. The Rules Unit is now collaborating with divisions to request changes to Idaho Code sections during the next legislative session.

Secure and protect the sensitive information entrusted to us by Idahoans.

• The Division of Information Technology has worked on Strategic Objective 4.3 to ensure the best value for the department in each IT contract. The division reviewed a year’s worth of licensing and support contracts, including the Adobe contract, the Microsoft contract, as well as contracts for various security tools and WebEx.
• The division is also working to provide value for the department by identifying features available in software and IT programs that will help staff improve processes and productivity without additional spending.

Proactively communicate with the public to share how our work consistently improves the lives of Idahoans in need.

• In Strategic Objective 4.4, the Office of Communications engaged with community organizations across the state to create unity and support in our messaging. This included support for consistent messaging on COVID vaccines and suicide prevention, through social media and media briefings.

• The department has provided transparency to Idahoans about the work we do. Part of this has included monthly “Living Strategic Plan” communications, which are real-time updates on the progress we are making toward our strategic objectives and goals.

Reduce financial risk through the adoption of enterprise-wide, integrated best practices.

• Resources – including people, money, and physical assets – are the lifeblood necessary to accomplish the department mission. For Strategic Objective 4.5, the Division of Management Services created a strategic calendar to help the senior leadership team focus its attention on key decisions that happen throughout the year regarding resources.

• This strategic initiative also includes developing budget-specific tools so the leadership team can make decisions and requests as a united group. It includes a long-term facilities plan generated by cross-division collaboration, which allows the department to be flexible with changing environmental and economic conditions.

Protect vulnerable Idahoans through an improved criminal history background check system, and improve public transparency of department regulatory activities so Idahoans are aware of the benefits of regulatory services to their health and safety.

• The department’s regulatory activities in Strategic Objective 4.6 are aimed at two important outcomes:
  • Being safe: Performing regulatory activities that improve health and safety.
  • Feeling safe: Making the results of regulatory activities visible to the public so Idahoans feel safer.
• The department focused on two main areas of regulation in this strategic objective. The first is the improvement of the criminal history background check system. The Criminal History Unit improved the timeliness of background check applications without sacrificing the quality of service.
• The Criminal History Unit successfully proposed to the Idaho Legislature a statute change to remove the requirement for notarization for background check applications. This will help to eliminate regulatory burdens on applicants and their employers. It will also reduce out-of-pocket costs for the applicants.
• The second area of regulatory improvement is to ensure timely inspections of licensed healthcare providers and residential care facilities. These activities help ensure that patients and residents remain safe and receive high quality care. The pandemic interrupted the department’s regulatory activities through stay-at-home orders that decreased the number of regular inspections during the year. The Division of Licensing & Certification completed a list of strategies to complete overdue surveys and complaint investigations. The division is now exploring all options for completing survey work and hiring more surveyors.

As we look to the new state fiscal year, which begins on July 1, we’ll also be submitting the 2023–2026 Strategic Plan to the Division of Financial Management. It will be available to the public shortly after. You can follow the DHW’s work toward our mission and read more about our Strategic Plan on our website.

I hope you have a safe and healthy weekend.

The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at healthandwelfare.idaho.gov.