Like many hospitals across the state, Hilo Medical Center on Hawaiʻi Island approached a crisis situation at the height of the COVID-19 surge.
Elena Cabatu, the hospital's director of public affairs, likened it to a hurricane that was heading straight for the island and was broken up at the last minute by Maunakea.
Case counts are going down — average daily new cases have dropped by 35% over the past two weeks, but Hawaiʻi's health care infrastructure is still overburdened.
Cabatu said "post-COVID" patients — those who are still being treated but are no longer testing positive — are keeping hospitalization numbers up.
"Those folks are still with us in hospital and still very sick. For example, today we have 22 active-COVID, with 16 post-COVID," she said. "That shows that in a matter of a few days, I think we will have more post-COVID than active-COVID in our hospital, depending on new admissions."
With the recent Delta variant-driven surge, Cabatu said those who required hospitalization were more severely impacted by the disease than patients before.
"Earlier in the pandemic when patients went on the ventilator, at least they had some chance of coming off and recovering. In this surge, we are seeing that once a patient has to go on the ventilator, it's not good news after that," she told Hawaiʻi Public Radio. "We are dealing with a lot of end-of-life conversations."
Meanwhile, the hospital just started providing monoclonal antibody treatment for COVID-19.
"We're very excited to offer this to our community — and it's just one more tool in our toolkit to care for our community, with the caveat of saying that our main plea is for the community to still get vaccinated if they haven't yet," Cabatu said.
The treatments have been shown to reduce death and hospitalization if given early.
The drugs are laboratory-made versions of virus-blocking antibodies that help fight off infections. They are only recommended for people at the highest risk of progressing to severe COVID-19, but regulators have slowly broadened who can qualify.
Local health care providers are receiving only half the number of monoclonal antibody treatments for COVID-19 that they requested amid a shortage.
The federal government has capped Hawaiʻi’s weekly allocation at 680 treatments, said Brooks Baehr, a spokesperson for the state Department of Health.
There has been a spike in demand for the drugs in states where surging hospitalizations among the unvaccinated have overwhelmed health care systems.
Hilo Medical Center, which serves an area that has also experienced a high rate of infection, is expecting 70 treatments a week as well as a “little extra” for its emergency room and long-term care needs, Cabatu told the Honolulu Star-Advertiser.
The hospital is also analyzing which vaccines people with breakthrough cases received. They hope to make their findings publicly available in the future.
"What we know is that those who are vaccinated are experiencing less severe disease and less severe hospitalizations," Cabatu told Hawaiʻi Public Radio. "What we can see in our data is that there was a clear distinction when breakthrough cases started because we weren't seeing any, and then you can see when Delta came because the breakthrough cases started coming. The data is quite remarkable."
This interview aired on The Conversation on Sept. 22, 2021.
