Updated: 9/16/2020, 12:19 p.m.
Fourteen people have now died of COVID-19 at the Yukio Okutsu State Veterans Home in Hilo operated by Utah-based Avalon Health Care Group. The nursing home operator has also recorded deaths at its two other Hawaii facilities, five at the Hale Nani Rehabilitation & Nursing Center and three at Avalon Care Center.
The state Department of Health today reported one more death, bringing the toll to 100 and marking another milestone in the pandemic. There are 66 new COVID-19 cases statewide, the second time in as many days that the number of daily infections has fallen below 100.
The department said there were no new deaths yesterday, but a total of 25 deaths associated with a positive result are pending receipt of records. Ten are pending a final medical examiner report.
It's not immediately clear if any are related to the mounting deaths at the Yukio Okutsu State Veterans Home.
On Sunday, the state reported two deaths, both on Oahu. The deaths were a man in his 50s and a woman in her 70s, both with underlying medical conditions. On Saturday, an Oahu woman in her 30s with health conditions who had been hospitalized also passed away
The latest counts mean total number of cases have. risen to 10,844.
There have now been 9,782 cases on Oahu, 599 on Hawaii Island, 378 for Maui County, and 58 on Kauai. Twenty-seven residents were diagnosed out of state. One case was removed from Hawaii County and one recategorized from Oahu to Hawaii County due to updated information.
New cases have been falling as Oahu, where most of the infections have occurred, remains under a stay-at-home, work-from-home order through Sept. 23. Solo activity is only allowed at beaches, parks and trails.
As of yesterday, a total of 68 residents and 30 staff have tested positive for the virus at the veterans home. Four residents are hospitalized at the Hilo Medical Center and 34 residents are being cared for in the veterans home's COVID-designated area.
Three agencies are now investigating the mounting deaths and infections at the nursing home, named after Yukio Okutsu, a Medal of Honor awardee from the famed 442nd Regimental Combat Team.
Hawaii Island Mayor Harry Kim acknowledged yesterday that he did not do enough sooner when the cases began multiplying at the nursing home.
"We asked people to trust us that we would create a home for them and I feel that we broke that trust," Kim told HPR. "(Dear God) Forgive me for not doing the right thing earlier."
Hawaii Sen. Brian Schatz wrote a letter last week to Avalon Health Care CEO Randy Kirton calling on the privately held company to improve its infection controls.
Schatz noted that the company has had COVID outbreaks in all three of its Hawaii nursing homes.
"Given that outbreaks have occurred at all three of Avalon's facilities in Hawai‘i, I am alarmed that Avalon's facilities are not able to adequately protect its residents and staff," the senator said.
"Therefore, I urge you to immediately review the practices, and in particular the staffing and infection control practices, at your facilities in Hawai‘i and in other states to identify and resolve any deficiencies that could result in the spread of COVID-19."
Avalon Health Care has not responded to HPR's request for comment on Schatz' letter.
The company stated on its website: "Please know that our staff has been working tirelessly to care for our residents. Being in the spotlight and so heavily criticized by the media and public officials has certainly been tough on all of us."
Avalon Health Care mentioned briefly that state and federal teams have been sent to the veterans home. "We appreciate their support and collaboration," the company said.
A federal team from the U.S. Department of Veterans Affairs is assessing the mounting deaths and infections at the veterans home at Schatz' request.
According to the mayor, the VA officials said they are recommending that the state send in a "tiger team," a specialized, cross-functional group, to manage the situation at the nursing home.
The Hawaii Emergency Management Agency also is assessing the outbreak as is the state Department of Health.
Schatz has been critical of the county's and state's lack of urgency in addressing the outbreak at the veterans home that he described as a public emergency.
Meanwhile, at the Hilo Medical Center, the number of patients testing positive for the virus stood at 18 yesterday, with six in the ICU unit and 12 in its COVID unit.
A long-term care resident at the hospital's extended care facility who had been receiving dialysis treatment tested positive yesterday and was sent to the medical center. Admissions to the extended care facility has been suspended for the time being.
The hospital earlier reported a death at the medical center on Sept. 8 unrelated to the veterans home.
Green remains in quarantine working remotely
Lt. Gov. Josh Green continues to quarantine at home after learning he tested positive for COVID on Friday evening. A deputy sheriff in his security detail received a positive test earlier in the day. A second deputy sheriff assigned to Green then tested positive.
All 11 employees in Green's office have been tested, with one result negative and others pending. Employees at KUMU radio station where Green had gone Friday have been contacted by the health department and given guidance.
The lieutenant governor's office on the 5th floor of the state Capitol has been cleaned and will remain closed for now. Green and his staff are working remotely.
Leftover surge test kits can be used through November
Honolulu has nearly 30,000 COVID-19 test kits remaining from the federal government-sponsored surge testing – and the city plans to use them strategically going forward.
Yesterday was the last scheduled day of a nearly month-long effort to test Oahu residents, regardless of whether they had symptoms.
Mayor Kirk Caldwell says more than 60,000 of the 92,000 kits provided by the U.S. Department of Health and Human Services have been used.
Federal officials are allowing the city to keep the remaining tests, but gave a deadline of Nov. 30 to use them.
Caldwell says the city will continue to test until then.
"Probably in a more strategic way going forward. Going into communities of need, into places where there are Pacific Islanders, and others we know that the virus is more present," he said. "So we can find out where it is and then work on contact tracing, and then isolating those. But there may be certain times when it will be testing large numbers of people through now to the end of November."
Caldwell says the results from surge tests have shown the virus is not spreading evenly through the island. Certain areas like Kalihi, Waipahu and Waianae have had more cases than other communities.
--HPR's Casey Harlow
What surge testing results tell us about the disease on Oahu
Surge testing has wrapped up on Oahu. So what do the low rates of positive tests tell us about COVID-19 in the community?
CEO Ray Vara of Hawaii Pacific Health told the state House COVID-19 committee yesterday that he thinks it says there's not a significant presence of asymptomatic people on the island.
Previously the state mainly tested those with symptoms and those exposed to the virus; surge testing accepted anyone.
One thing to know: the state has been adding the surge test results to those from people with symptoms and those exposed. That's pushed down the percentage of positive tests to the 2% and 3% levels, making things look rosier than they might be.
The good news is once the surge test results are taken out of the equation, it's clear the positivity rate has indeed been declining and recently stood at 6%. Under World Health Organization guidelines, communities can reopen if their positivity rate falls below 5% for 14 days.
The low positivity rates after the surge testing fueled more calls for the city to lift its stay-at-home order -- as well as raised fears of another surge.
Dr. Mark Mugiishi, president of the Hawaii Medical Service Association, has another metric he's watching.
"You're striving for a rate of transmission that's less than one. At our peak, we were the worst in the nation at 1.4 during this latest surge, and we're now as you saw on the [COVID Pau] dashboard, we're down to 0.8, which is really good.
"It means that we're going to, if we keep up our behaviors, we're gonna control this. ... We need to continue to modify public behavior. And we need to continue to make sure we have the infrastructure in place, public health and infrastructure, to keep control of the virus and then hopefully, we won't have a surge."
Oahu's stay-at-home order remains in effect through Sept. 23.
This is a developing story. Please check back for upates. Editor's note: We’d like to hear how you’re coping with the latest COVID-19 developments and the state's phased reopening. You can call our talkback line at 808-792-8217. Or e-mail us at talkback@hawaiipublicradio.org.
