Jeremy Smith and his wife Sheena are on a four-wheeler, leading me up a dirt road on the 20 acres of mostly undeveloped land they live on near Sagle, in the Idaho panhandle. We stop near a big grove of trees and get out. It's beautiful.

"We've got some Douglas fir. This is a grand pine. This is a maple," Smith says as he walks along a private trail.

Smith and his extended family have been hunkering down here since the pandemic began. They are a minority in this very conservative part of Idaho. They take COVID-19 seriously and wear masks. And unlike 65% of the people in Bonner County, they're fully vaccinated.

"We've done everything we possibly could to stay healthy," Smith says.

Which is why they are so frustrated about the situation in North Idaho. Earlier this week, state public health officials activated crisis standards of care for at least 10 hospitals across ten Northern Idaho counties because of an unprecedented surge of hospitalizations due to COVID-19.

This means health care facilities are overwhelmed and are now rationing care for everyone, regardless of their diagnosis.

"If we get hurt and go in now, our health care is almost certain to be compromised," Smith says. "It's really frustrating."

Hospitals are cancelling most surgeries, warning of long wait times, and urging people to avoid risky activities that could land them in the emergency room because, bottom line, there might not be a bed available.

Smith says his elderly, handicapped father has had to put off back surgery.

"He's going to be in pain until Christmas because of other people's choices, not because of anything we've done wrong," he says.

Smith is angry, but understands what's going on. Many people in this part of Idaho have long been skeptical of authority, and any kind of government information. He's not surprised it has one of the lowest vaccination rates in the nation.

"This is a place that is very attractive to people who have an independent, self-sufficient mindset," he says. "The idea that if anything comes along, you can just take care of it."

Some shun the vaccine despite FDA approval

Driving around, you see a lot of yellow Gadsden flags that say "Don't Tread On Me." And since the beginning of the pandemic there have been loud protests against shutdowns, mask requirements and the vaccine.

"You don't plunge a whole entire civilization into an experimental vaccine," says Branden Sing, who lives in the city of Sandpoint.

The Food and Drug Administration fully approving Pfizer's COVID-19 vaccine in August hasn't swayed him to get a shot. He thinks the pandemic has been hyped up and that the vaccines were rushed.

"If you attach a death count clock on TV to any crisis it's going to be a fearfully driven situation," he says. "There's going to be a lot of people making a lot of mistakes."

Sing says he has friends and family who have had adverse side effects from the vaccine. His mother-in-law, for instance, recently had a brain aneurysm caused by a spike in high blood pressure.

"I think my mother-in-law is a victim of the vaccine," he says.

The Centers for Disease Control and Prevention says dangerous or deadly side effects from COVID vaccines are extremely rare.

But again, Sing and many others in North Idaho don't trust those agencies. Instead, some are taking supplements and non-FDA approved medications to combat the virus. Sing believes COVID-19 isn't that big of a deal for people who keep their immune systems healthy.

One man had to wait 2 days in the ER because there were no ICU beds

But there are a growing number of people here who aren't faring well. In the past week, 18 people have died in North Idaho from COVID-19 and there are currently more than 550 people hospitalized across the state. At the region's biggest hospital, Kootenai Health, 97% of COVID patients are unvaccinated and all of the intensive care unit beds are filled.

Part-time North Idaho resident Ed Crosby's brother-in-law, who recently took a hard fall and hit his head, had to wait two days for an ICU bed to open up at Kootenai Health.

"He had to spend two days laying in the ER not getting the care that he really needed," Crosby says. "It made me extremely angry."

The surge is also stressing out health care workers in the region as hospitals become overwhelmed.

"We are just seeing a huge influx of very actively sick people," says Kelli Hansen, a nurse at Bonner General Health, a 25-bed critical access hospital in Sandpoint.

She's surprised by how many young, unvaccinated people are getting seriously ill from the delta variant.

"These people are afraid," she says. "They can't breathe. Their anxiety goes up. That means increased pain. That means they're not sleeping well. They're exhausted. It's heartbreaking to see that suffering happening."

Hansen says her hospital is strapped for resources right now. It's also facing a staff shortage due to burnout, people getting sick, and skyrocketing housing prices that make North Idaho less affordable for nurses and other hospital staff.

But Hansen still loves the job. She also tries to not to judge patients and others for not getting vaccinated. She's worked for 17 years in Sandpoint and understands the prevailing ethos here.

"Because of the newness of this vaccine and this pandemic, there are unknowns. I can see where someone might be uncomfortable," she says. "If that's the case and they choose not to [get vaccinated], I really implore people to take those other precautions such as masking, social distancing and taking care of themselves."

But wearing masks and social distancing still isn't happening in much of North Idaho. Health officials fear that the worst may still be on its way because school just started. Most districts aren't requiring masks and there have already been reports of teachers and students testing positive for COVID-19.

The number of people getting vaccinated in Idaho has more than doubled since July, but for the last three weeks it's been flat.

This story was produced by the Mountain West News Bureau, a collaboration between Wyoming Public Media, Nevada Public Radio, Boise State Public Radio in Idaho, KUNR in Nevada, the O'Connor Center for the Rocky Mountain West in Montana, KUNC in Colorado, KUNM in New Mexico, with support from affiliate stations across the region. Funding for the Mountain West News Bureau is provided in part by the Corporation for Public Broadcasting.

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