BOISE — As omicron spreads widely in Idaho, local hospitals are gearing up for a massive surge in patients. Public health leaders are worried it may be even worse than the surge that began in September and caused hospitals to enter crisis standards of care.

Since Monday, Jan. 3, St. Luke’s Health System, the largest hospital system in Idaho, has seen an “exponential” increase in the demand for testing. At Saint Alphonsus Health System, more than one in four tests this week are coming back positive.

Dr. Mark Nassir, president of the Saint Alphonsus Medical Group, said at a Thursday, Jan. 6, press conference that the demand for testing has increased dramatically in the past week. Last week, the system was conducting 100-200 COVID-19 tests per day. This week, it’s risen to 300-400.

“It is very difficult to get a test right now,” said Dr. Laura McGeorge, St. Luke’s medical director for primary care, at the press conference. She noted that testing sites are facing supply chain issues and staffing woes.

McGeorge and Nassir said they think the Treasure Valley is mostly seeing cases of omicron already. Early data show the variant could be at least twice as contagious as the delta variant, which caused Idaho’s surge last summer and fall.

Nassir said the current uptick “suggests an increase in transmissibility that is slightly different than what we’ve seen with some of the other curves, and that would be consistent with an increasing ratio of the omicron variant.”

‘It’s going to flatten us’

With local hospitals roughly six weeks out from a surge in patients, health leaders are concerned this next wave — which they say is hurtling toward Idaho — will be even worse.

“This is very much like the beginning of the pandemic again,” said Dr. Steven Nemerson, chief clinical officer for Saint Al’s. “And this time it’s going to flatten us, quite honestly. And we need to be prepared for that.”

Early research shows omicron likely causes less severe illness in most people, especially those who are vaccinated, but its rate of spread and the high number of breakthrough cases pose different challenges.

Already, hospitals have many employees staying home from work because of COVID-19 positive tests or symptoms. Nemerson said Saint Al’s had 14 employees on COVID-19 leave two weeks ago. By Jan. 6, that number rose to 125.

By comparison, during the surge that peaked last fall, Saint Al’s had 74 employees off work for COVID-19-related reasons on Sept. 30 and 38 off work on Oct. 19, said spokesperson Mark Snider.

“That’s going to have very dramatic implications in our ability to take care of patients,” Nemerson said. He called omicron “among the most contagious viruses known to man.”

“We’re seeing a direct operational impact on the ability to maintain our clinic staff and hours because of not only the demand, but because of the increased numbers of health care workers that have been exposed to COVID or are out sick on COVID leave,” said Nassir, of Saint Al’s.

McGeorge said St. Luke’s also has seen a “significant uptick” of employees out in recent days. And as staff calls out sick, more beds are filling up with COVID-19 patients.

After the surge that subsided in November — which Nemerson called the fourth surge — Saint Al’s had an in-patient volume of COVID-19 patients below 20. On Jan. 6, the hospital had 43, which he called an “explosion.”

“We’re likely to need to go into crisis standards of care sooner with this surge than we were in surge number four,” he said. Though Saint Al’s risked having to triage and ration care during the fourth surge, Nemerson said that didn’t happen.

“But I’m afraid it may this time, because our resources are more constrained, our flexibility is less, and functionally that means we’re going to be able to care for fewer patients,” he said.

McGeorge said St. Luke’s hospitals are “extremely busy right now,” seeing COVID-19 patients as well as those with influenza and respiratory syncytial virus — better known as RSV — and other patients in need of surgeries or other procedures whose care was put on hold during the last surge.