Tribal medical director wary of vaccine mandates

Sep. 24—The head of Nimiipuu Health Clinic in Lapwai said she believes COVID-19 vaccine mandates violate the doctor-patient relationship when it comes to determining an individual's health options.

Dr. Kim Hartwig, medical director for the Nez Perce Tribal health clinic in Lapwai, addressed an audience Wednesday night about the status and effects of the coronavirus in the community. While she strongly supports the COVID-19 vaccines and testified to their safety, Hartwig said she does not favor imposing a vaccine mandate on tribal employees or employees of the tribe's business enterprises and programs.

"We've discussed this significantly," Hartwig said to a live audience in a forum that was broadcast on social media.

"There's a lot of information about a lot of different things from a lot of different sources and I would like you to be fully informed," Hartwig said.

"I feel that the vaccine mandate really encroaches and forces my hand as a clinician to perform a care measure that I might not feel is appropriate. ... That encroachment into the doctor-patient relationship (should) not happen," she said. "People need to be able to openly get information about the vaccine and their hesitancy."

Hartwig emphasized, however, that the decision about whether to impose a vaccine mandate for tribal employees is not her decision to make.

Samuel Penney, chairman of the Nez Perce Tribal Executive Committee, said at the beginning of the presentation that the tribe has declared a public health emergency because of the spread of the virus. People have experienced "fear, hope, frustration, gratitude and sadness," Penney said, but urged a compassionate response to this "roller coaster of emotions."

"Compassion is something everyone is capable of and (it) doesn't have a cost," Penney said. "Compassion is a must."

Hartwig said, as of Tuesday, there were 26 active COVID-19 cases that were being treated by the clinic with 2.93 positive cases a day, or a 16.60 percent positivity rate.

In the patients being seen at the Lapwai and Kamiah clinics, Hartwig said, 39 percent have been fully vaccinated and 59 percent are not vaccinated. Those age 65 and older had the highest percentage of vaccinations with 69 percent fully vaccinated.

Of the staff at each clinic, 55 percent were fully vaccinated, and among all other Nez Perce tribal employees, 62 percent are fully vaccinated.

Hartwig said she also has been working with local hospitals for people with mild to moderate symptoms to have access to monoclonal antibody treatment to help reduce the severity of infections.

Some people claim that the reason they are hesitant to get vaccinated, Hartwig said, is because they believe the vaccine has been around only eight months or so and they don't trust it.

But the building blocks that were use to develop the vaccines, she said, have been around since the 1990s.

"The science has been around for a long time, so it wasn't just found eight months ago and now we have this vaccine," Hartwig said. "So the science has been around for a long time and the ability to apply it to a specific disease, COVID, fit very well. That allowed us to use science that we had had around for a long time."

Hartwig added that third vaccine shots for people with compromised immune systems have been recently approved by the federal Food and Drug Administration but, as yet, booster shots have not been approved for the general public. She also said that the clinic will begin distributing flu vaccines to the community Oct. 18. That vaccine, she said, is only good for about six months and flu season generally flows into March and April.

Thursday was another deadly day for COVID-19 as Public Health — Idaho North Central District reported four new deaths in the region.

The deaths included two men in their 40s in Nez Perce County; a Latah County man in his 60s; and a Nez Perce County woman in her 90s.

Overall there were 52 new infections Thursday, including seven in Lewis County; one in Clearwater County; eight in Idaho County; 11 in Latah County; and 25 in Nez Perce County.

Whitman County reported 20 new infections; Asotin County had 27 new cases for a 14-day count of 273 with five current hospitalizations and 51 breakthrough cases since Sept. 1. Garfield County had no updates.

Tara Macke, spokeswoman for Public Health — Idaho North Central District, said there is a statewide shortage of COVID-19 testing options because supplies are in high demand.

Most clinics and hospitals continue to test symptomatic individuals but people need a physician's order for a COVID-19 test, Macke said.

People can also call 211 to request a COVID-19 test kit to be mailed to their home. These kits use a saliva-based sample and it takes about two to three days to get the result.

"We continue to recommend that you first try your local pharmacies, your practitioner, community walk-in clinics and, lastly, hospitals," Macke said. "We always encourage people who are symptomatic, or think that they may be infectious to call before arriving at any testing site or clinic as there may be a process for them to receive the test kit without going into the building and potentially exposing others. If you do need to go into a building when you might be infectious, please wear a face covering and avoid others as much as possible to reduce the chance of infecting others."

Gritman Medical Center in Moscow admitted five new patients to the hospital for inpatient care in the past week who have tested positive for COVID-19. Since the beginning of the pandemic, 114 patients have been admitted to the hospital for inpatient care who tested positive. Of those, 82.4 percent were unvaccinated, and 17.5 percent were vaccinated.

The Lewiston School District reported 27 active cases among students and 10 active cases among staff members Thursday.

Those include one student at Webster Elementary; two each at Camelot Elementary, Centennial Elementary and Jenifer Middle School; three at Whitman Elementary; seven at Sacajawea Middle School; and 10 at Lewiston High School.

Staff infections include one each at Camelot, Centennial, Whitman, Jenifer and Sacajawea; two at Lewiston High School; and three district assigned.

The Moscow School Board voted unanimously Wednesday night to extend its mask mandate for the remainder of the semester. Superintendent Greg Bailey made the recommendation and several patrons reportedly sent emails to board members endorsing the idea.

Face coverings for students and staff have been required indoors since the beginning of the school year.

The YWCA Lewiston-Clarkston has canceled its annual Inspiring Women Brunch because of concerns around the COVID-19 pandemic. This is the second year the brunch was canceled.

Hedberg may be contacted at kathyhedberg@gmail.com or (208) 983-2326.