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Gov. Brown calls up National Guard; OHA issues ‘interim triage tool’ for hospitals in COVID surge

Oregon National Guard Spc. Toby SeWell assigned to the Oregon Army National Guard Medical Command, administers the COVID-19 vaccination to a Salem resident at the Oregon State Fairgrounds in Salem in January 2021
Major Heather Bashor, Oregon Military Department Public Affairs
Oregon National Guard Spc. Toby SeWell assigned to the Oregon Army National Guard Medical Command, administers the COVID-19 vaccination to a Salem resident at the Oregon State Fairgrounds in Salem in January 2021

(Update: adding St. Charles comment)

125 soldiers to be initially deployed; OHA lays out care principles

SALEM, Ore. (KTVZ) — Gov. Kate Brown announced Friday she will be deploying up to 500 Oregon National Guard members to support frontline health care workers as the state issued new triage policies for Oregon hospitals facing a surge of hospitalizations due to the rapid spread of the Omicron variant that has led to record daily COVID-19 case counts.

Beginning next week, an initial 125 Guard members will be deployed to hospitals around the state to provide needed logistical support as materials handlers and equipment runners, as well as assisting with COVID-19 testing and other necessary non-clinical services to support hospital operations.

The Oregon Health Authority and Oregon National Guard will continue to work with the hospital systems to monitor ongoing need and determine additional deployments as necessary.

“With more than 500 current hospitalizations and daily record-breaking numbers of COVID-19 cases, we are at another critical point in this pandemic—and the Oregon National Guard is stepping up again to assist,” Brown said in her announcement..

“I would like to thank the employers of our Guard members—we cannot call upon these hardworking Guard members without your sacrifice and support as well. While Guard members work to support our frontline health care workers, I am asking all Oregonians to continue to do your part to help. Get vaccinated, get boosted, wear your masks, and stay home when you are sick.”

While the Oregon National Guard also has members with health care, nursing, and medical training, many of those members are already hard at work for their civilian employers––Oregon hospitals and health care providers, the governor noted.

Meanwhile, the Oregon Health Authority on Friday provided the state’s hospitals with an interim crisis care tool to help them prioritize treatment, if they reach a point when critical care beds, specialized equipment, such as ventilators, and other resources become scarce due to surging COVID-19 admissions.

https://youtu.be/Byp9QYrTsd4

Oregon hospitals may activate crisis standards of care if their critical care resources are severely limited, the number of patients presenting for critical care exceeds capacity, and there is no option to transfer patients to other critical care facilities.

Hospitals may implement OHA’s interim crisis care tool -- or one of their own that is consistent with Oregon’s Principles in Promoting Health Equity in Resource Constrained Events – if they have taken specific steps to extend their capacity to deliver care. Those steps include stockpiling supplies, delaying non-urgent care, and repurposing existing beds and staff that are not typically used to provide critical care.

Under the interim triage tool, all patients who can potentially benefit from treatment will be offered care, if health care resources are sufficient. If hospital staff, beds and treatment are insufficient, all patients will be individually assessed according to the best available objective medical evidence. According to the tool:

  • No one will be denied care based on stereotypes, assumptions about any individual’s quality of life, or judgement about an individual’s “worth,” based on the presence or absence of disabilities.
  • Care decisions should be based on the likelihood of survival to hospital discharge.

Under Oregon’s interim crisis care standards, state health officials expect providers to treat all patients with respect, care and compassion. Hospital clinicians may not base care decisions on an individual’s use of past or future medical or social resources. They should apply reasonable modifications to any triage scoring criteria when considering individuals with underlying disabilities or certain underlying health conditions.

Triage decisions will be made without regard to morally or scientifically irrelevant considerations such as income, race, ethnicity, gender identity, sexual orientation, immigration status, health insurance coverage or other factors.

OHA developed the interim tool based on several existing triage tools, such as those published by Arizona, Massachusetts and Washington state. State health officials made adjustments according to Oregon’s health equity principles of non-discrimination, patient-led decision making and transparent communications.

State health officials consulted a limited group of clinicians, medical ethicists, disability advocates and others before releasing the interim triage tool.

Oregon remains committed to developing a permanent tool based on broader community input. Dana Hargunani, M.D., OHA chief medical officer, said, “Right now, we want to put a triage tool in the hands of clinicians who are likely to face very difficult decisions in the coming weeks, as the Omicron variant takes its toll and puts more patients in the hospital. This interim tool isn’t perfect, but it ensures that clinicians can be confident they are using criteria firmly grounded in Oregon’s values of non-discrimination and health equity as they face these gut-wrenching decisions.”

St. Charles Health System Public Information Officer Lisa Goodman said, "We will be reviewing this state-issued guidance in detail and will adjust if necessary. But we created our current constrained resources policy based on the Principles in Promoting Health Equity in Resource Constrained Events document, as required, and as such believe that we are in alignment with the new guidance."

At the same time, OHA also is calling for applicants to serve on a new Oregon Resource Allocation Advisory Committee.

The Oregon Resource Allocation Advisory Committee’s role will be to:

  • Review and inform updates to OHA’s Principles in Promoting Health Equity During Resource-Constrained Events, which ensures health equity in decision-making when resource shortages occur.
  • Review and inform future amendments or changes to the interim crisis care tool.
  • Guide development of any additional necessary resources – including triage tools, guidance, best practices – to ensure these principles can be readily applied in Oregon during a resource-constrained event.
  • Inform the norms and expectations regarding patient communication and transparency when health system allocation decisions are necessary due to resources constraints.

OHA is seeking applicants representing: the state’s health care delivery system, including hospitals, health care providers and local public health agencies; and organizations and community members who can speak to community needs, especially communities of color, tribal communities and people with disabilities, including people with intellectual and developmental disabilities.

The committee will meet virtually once or twice a month over nine to 12 months and will be supported by a project team and a contracted facilitator. Care will be taken to support a trauma-informed, collaborative and inclusive process that recognizes the diversity of professional and lived experiences among committee members.

For individuals with disabilities or individuals who speak limited English, OHA will provide free help during advisory committee meetings, such as with sign language and spoken language interpreters, real-time captioning, braille, large print, audio, and written materials in other languages.

Those interested in applying to serve on the committee should complete this form by Jan. 28, 2022. If you have questions about the committee or need assistance completing the application, contact OHA at OHAResourceallocation@dhsoha.state.or.us. OHA will select members and communicate to all applicants in February. Members will be selected to ensure diverse community representation, health care delivery expertise, geographic diversity and lived experience.

KTVZ news sources

Comments

48 Comments

      1. In this particular situation the “persons” responsible for our continuing pandemic are not Kate Brown but those folks that follow the leader of the insurrection. Statistically all across the country those that follow the Leader of the insurrection are the ones dying/overcrowding our hospitals.
        It’s rather strange if you think about it. The insurrection leaders people are working hard across the country to subvert the will of the people and making sure voting is harder so that they have a better chance of winning while at the same time Also ensuring that their own voters are dying at a much greater rate than what they considered the opposition. At this point you folks are going to have to work a little harder to suppress the vote because you’re not gonna have enough voters left to win anything. New report an organist 10,000+ cases in one day and 33 deaths we already know statistically that 90+ percent of those cases are people who are unvaccinated. How is this Kate Brown’s problem? If we have to go back into lockdown or like in the case of my sons school they’re considering sending everybody home. Again. It is people like yourself who are keeping us where we are and I resent that. I am tired of living in a mask. I am tired of listening to stupid ignorant people who don’t realize they are the problem.

  1. This is a good decision given a number of different factors.

    Few truly know how accomplished our Oregon Guard members are in the fields of combat medicine and behavioral health – not to mention administration.

    There is an amazing level of real world experience, professional acumen, and most importantly dedication within the ranks of our Guard.

    And their Chain of Command will ensure the politics of COVID will have a minimal impact on the duties and services the Guard members activated under Title 32 will need to endure.

  2. ‘treat all patients with respect, care and compassion.’

    I hope we all can emulate those standards in our daily lives with regards to our community, neighbors, friends and families.

  3. “No one will be denied care based on stereotypes, assumptions about any individual’s quality of life, or judgement about an individual’s “worth,” based on the presence or absence of disabilities.”

    That looks good til you realize that little stipulation at the end modifies the entire meaning of the first part. As in conditions that arent medically recognized disabilities will be allowed to be taken into account. That includes quite a few things like obesity, diabetes, certain mental illnesses, and other conditions.

    1. Since this started, hospitals, St Charles guilty as all, have denied healthcare to the sickest of our community. Now you see the results as the patients that are in the hospital are so sick they are not having the outcomes they should’ve had if care was given earlier. Remember when st Charles canceled elective surgeries last summer until December due to staffing, not Covid? Ask those people whose surgeries were canceled or not allowed to be scheduled, or rescheduled days before their appointment how they like Kate Brown and St Charles choices of how they decide who to give care to. Hey St Charles we are waiting for you to beg the non vaxxed employees you fired to come back to work. Too bad most are making way more money now and will never go back. It’s too bad you can’t get quality staff because they can’t afford to live in Bend.

      1. I’m no fan of St C, but I can say that what you’ve posted there is misleading in the best parts and fabrication in others. Looks much more like someone with a bone to pick…

  4. We wouldn’t be needing the minuet-men to step in if Kate Clown would have just ignored President Corn-Pops order to fire hospital workers over not wanting the covid suppressant. Just reverse that stupid decision and attempt to hire the nurses and doctors back! Pretty simple to figure out even for the boneheads that go along with all that.

    1. Blm ~ your screen handle is quite rude. As are you.

      Tell me ~ do you know the difference between stupid and ignorant? Guessing not based on your comment/ post.

    2. And none of this would have happened in the first place if former president OJ’s hadn’t botched the handling of the opening days of the pandemic and convinced his cultists that science is bad.

      1. Just a friendly reminder that more people have died due to Covid under bidens administration than under trumps. Joe told us he would end the pandemic. Yet another epic failure to add to his list of many.

      2. Well how come St Charles has so many staff out with Covid??? They are all fully vaxxed? Biden said you don’t get Covid if vaxxed? Seems like the science you are following is flawed. Get a booster yet? Might as well get 2, the IHU variant is already coming for the vaxxed and boosted. Water hide.

        1. Who cares what Biden says?!? Unlike the majority of the loudmouths here, people that CAN actually do reasonable research don’t listen to the medical advice of politicians. You should try it.

    3. It was these peoples choice to quit, and I would think the medical people would be smarter and would want to protect those they help. You should just move to Florida where you would fit right in. Thanks to governor Brown we have been safer than those states that follow Bunker Donnie. Our problem is those here that do not care about anyone but themselves and it is their right to not wear a mask or get a shot but complain about life saving measures. Go Brown and Biden.

      1. Florida. Where they have the lowest amount of cases in the country. Where all the radical left dems go to vaca after they dictate mandates on their constituents. AOC, gruesome Gavin, swallwell, hell even that toothless drunk pelosi bought a house there. And all were pictured maskless. Rules for thee but not for me. Typical hypocrite democrat behavior. Desantis 2024.

      2. You realize there are 50 st Charles healthcare workers out this week alone with Covid right? Fully vaxxed. Spreading it all over the hospital. St Charles, tell the community how many fully vaxxed employees you have. You claim transparency!

      3. No dale you are wrong it was not OUR CHOICE TO QUIT WE WERE FIRED for not taking a shot. Do you see the difference. When I was hired nowhere in the new hire packet or anywhere else in the mountains of paperwork did it say that they could force vaxx me or I lose my job. But that is exactly what they did.

      4. Dale, can you honestly say “go Brown and Biden” with a straight face? We all know (except for you) of Browns need to continually show her,”I have the POWER” and there is nothing you can do about it nah nah nah!! Now, if you can be proud of “your” President for having gas prices higher than they have been in years, inflation out of control, supply shortages that have never been seen….. oh, how about leaving our soldiers and billions of dollars of our military equipment in Afghanistan!! Hmmm, how about our total open border for illegals to cross over to our country? Let’s not mention the total COVID fiasco, Bumbling Joe told us that if we got the vaccine, this would all come to an end……more people have died this year from COVID than last year. So, your are funny to say go “Biden”, this guy is a complete failure!!

    4. You realize that only around 10% of the employees at St Charles were lost to the vax mandate, right? And the majority of those were non-nursing positions. They could hire every single one of those people back tomorrow and they’d increase capacity by maybe 5%? That’s likely generous.

  5. That’d 🐝 admission of them doing something wrong. At least we don’t have what’s going on in Australia although some in Washington DC has acted like they’d wish Biden do more

  6. Are people still believing its because of the virus and not the massive droves of people leaving the hospitals over the mandates and generally fleeing the self destruction of Oregon for freedom loving states?

    1. See above comment, and there are employees leaving healthcare in droves, but not because of the mandate. Far far more are leaving because the American healthcare system is broken.

  7. Hmmmm, fire thousands of healthcare workers over a vaccine ( which goes against current Oregon law) while there is already a shortage of staff, and in a pandemic, when these healthcare workers provided care for the previous 2 years without any cases of staff to patient transmission. Then add in that the fully vaxxed staff now work while having Covid, spreading it to each other, and are now calling out due being Covid positive and symptomatic at unprecedented numbers ( st Charles 50 this week, days ago) creating a healthcare crisis that could’ve largely been avoided. I’m going to get more popcorn while working as a non vaxxed ex st Charles employee at another Oregon hospital, that is thankful and respectful to all employees, even the non vaxxed. St Charles is sinking fast.

  8. St Charles, we want a weekly, rolling count of fully vaxxed employees out with Covid. Transparency??? Come on. Boosters going to be mandatory for staff? Where is the public outrage that staff isn’t 100% boosted. Let’s fire the non boosted!!! Maybe the marines can start recovering patients from surgery or start iv’s????

  9. Mandates short staffed hospitals
    Government is suppressing early treatments that work (Ivermectin)
    Government has financially incentivized hospitals to admit and treat covid patients

    Government wants this to go on forever.

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