Kootenai Health on Friday recorded a record high of 127 patients hospitalized with coronavirus, including 42 people requiring critical care.

There are also three patients under the age of 18 hospitalized with the virus in Coeur d’Alene .

While hospitalizations appear to be declining elsewhere in the Pacific Northwest, Eastern Washington and North Idaho, both regions with lower vaccination rates, are seeing less improvement.

Dr. Robert Scoggins, medical director of the critical care unit at Kootenai Health, said the hospital is still operating in crisis standards of care when it comes to staffing levels. That means rationing of care is possible in some situations.

Team nursing also is in effect in the ICU, where one ICU nurse is working with two other non-ICU nurses to treat six patients, he told reporters Wednesday.

The vast majority of patients with COVID are unvaccinated, and Scoggins said the number of COVID deaths recorded in September was a record high for the number of coronavirus patients dying at the hospital in a single month. The hospital had 57 deaths in September, and 38 of those were from COVID-19.

Many younger patients, he believes, didn’t need to die and could have been saved if they’d been vaccinated.

“It’s been disheartening to see these patients die; several of them are younger,” Scoggins said earlier this week.

In the five-county North Idaho region, 47% of eligible people who are 12 or older have received at least one dose of a COVID-19 vaccine.

Some counties in Eastern Washington have even lower vaccination rates, and health officials expect that to continue impacting caseloads.

Some parts of the Northeast Tri-County Health District have case rates double that of the Washington state average, which is decreasing.

“We think we have weeks ahead of us before we see some type of substantive decrease within those case rates,” Matt Schanz, administrator at the health district, told reporters Friday.

The three northeastern counties in Washington have an average vaccination rate of 41% for those 12 and older receiving at least one dose.

Hospitalizations in Spokane County have plateaued in the last week, allowing more transfers into the system. But Dr. Dan Getz, chief medical officer at Providence Spokane, said hospitals are still at uncomfortable levels, which is why they haven’t resumed all surgical procedures.

Getz said that declining hospitalizations in western Washington are not being seen in Eastern Washington yet.

“We’re not there yet because we don’t have the same rate of vaccination,” Getz told reporters Friday.

In Spokane County, nearly 63% of eligible residents have received at least one dose of a COVID-19 vaccine.

Hospitals are still evaluating staffing levels on a daily basis and waiting for assistance from the state for more contracted employees.

About a month ago, the Department of Health requested some 1,200 contracted workers to help staff hospitals in the state through the General Services Administration. The department requested both medical and nonmedical personnel after receiving requests from more than 50 hospitals and long-term care facilities statewide.

The Department of Health is currently working with the vendor, as well as licensing boards, to authorize staff for clinical practice in the state. As of Friday, the state still does not know how many personnel will come into the state. No one has been dispatched so far.

The state also requested additional federal support, but there was no update on whether those requests will result in more staff as of Friday.

Here’s a look at local numbers

The Spokane Regional Health District reported 222 COVID-19 cases and no additional deaths.

There are 190 people hospitalized in Spokane hospitals.

The Panhandle Health District reported 252 new cases and 1,647 backlogged cases on Friday.

There are 124 Panhandle residents hospitalized with the virus.