In less than a week, the number of cases of coronavirus in Hawaii increased from 2 to 16. Are Hawaii’s hospitals fully prepared for the influx of coronavirus patients? Two studies say no.
According to a nationwide group of researchers, Hawaii’s emergency preparedness ranked below the national average in drawing from six years of data.
The National Health Security Preparedness Index looks at a state’s capacity to protect people during large-scale emergency events like a disease outbreak.
Each state is rated between 1 and 10 based on categories from healthcare delivery to health security surveillance.
Hawaii’s score was a 6.4 -- slightly below the national average and tied for 40th place.
"If larger numbers of people need to seek care in emergency departments or need to be hospitalized, you want to be sure that you've got health care facilities that can respond to that surge in demand," said Glen Mays, the leader of the study and a professor of health policy at the University of Colorado.
"That's an area of some weakness for Hawaii. There are relatively fewer resources and in terms of hospital and emergency department operations, those facilities are generally operated at pretty high level of capacity. The ability to accommodate a surge in demand may be more limited in Hawaii," he said.
A Harvard Global Health Institute study says in a scenario of moderate spread of COVID-19, 40 percent of adults in the United States would be infected over a year.
Of those infected, about 20% would need hospitalization and 5% would need intensive care, which could include the use of a ventilator.
In Hawaii, with an adult population of about 1.1 million, that would mean about 22,000 would need intensive care over the course of a year.
According to the Healthcare Association of Hawaii, there are about 3,000 hospital beds and 561 ventilators in the state. Oahu has the most resources while the other islands have significantly less.
"While we are very, very well-prepared, there is still a finite number of facilities. There's a finite number of beds, there's a finite number of health care personnel," said Hilton Raethel, the association’s president.
"Even more important that we in Hawaii do as much as we can to focus on prevention and the spreading of disease."
The Harvard study estimates in a moderate spread scenario, Hawaii would need almost four times the number of available hospital beds.
The Hawaii Healthcare Emergency Management coalition that provides for emergency services can also set up about 150 temporary beds.
Raethel says emergency management also stores extra supplies for hospitals.
"We have stockpiles of generators. We have stockpiles of masks and gowns and respirators, and a whole bunch of other equipment and supplies," he said. "And what we've done is we've tapped into the stockpile and given facilities ... whatever equipment or whatever supplies they need."
Mays notes that Hawaii’s score for health care delivery is low because of its doctor shortage, especially in the case of epidemiologists.
"That's a place where Hawaii tends to lag a bit behind other states is in the supply of trained public health professionals who are available to investigate and respond to disease outbreaks and other hazards," he said.
Dr. Melinda Ashton, executive vice president with Hawaii Pacific Health, which operates four medical centers, including Kapiolani and Pali Momi, said for now her hospitals have enough doctors to handle the outbreak.
But she has a concern about health care personnel.
"What we worry about and what's happened in some other locations is if the physicians, nurses, other specialists, are exposed or get sick themselves, then that puts a strain on the situation very quickly. And also, if these patients require care for a long period of time, and there are lots of them, that puts a strain on the workforce very quickly as well," she said.
That’s why Ashton is asking her physicians to be extra cautious, and HPH has been re-teaching staff how to properly use protective equipment.