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The Conversation

COVID-19 Cases Are Trending Down But Medical Facilities Are Still Strained

emergency room queen's medical center hospital ambulance Virus Outbreak Hawaii Health Care
Caleb Jones/AP
/
AP
In this Aug. 24, 2021, file photo an ambulance sits outside the emergency room at The Queen's Medical Center in Honolulu. (AP Photo/Caleb Jones, File)

COVID-19 cases are trending down across Hawaiʻi but medical facilities are still strained, facing a shortage of monoclonal antibody treatments and long-term care facility outbreaks.

"As of today, we have about 282 COVID patients in our hospitals, which is a lot better than it was at our peak, which was well over 400. But despite the fact that COVID numbers have come down, that number today is still fairly close to the peak we had in August of last year," said Hilton Raethel, head of the Healthcare Association of Hawaii.

"Just yesterday we had two of our hospitals that had more patients in their hospitals than they have licensed beds for," he added.

The latest area of concern for health care officials is an outbreak at The Care Center of Honolulu.

"That has been a real challenge and unfortunately, that's been one of the largest outbreaks we've had in a care facility during the entire pandemic," he said. "This is despite the fact that we have a very high proportion of both residents and staff vaccinated in that facility. Now, not every resident is vaccinated, not every staff member is vaccinated. But it just shows you how dangerous the COVID variant is, and how even with very high vaccination rates, you can still get these outbreaks."

Raethel said the more than 70 cases at the long-term care facility have strained the staff, but FEMA health care workers cannot be sent due to usage restrictions.

"While we've got a lot of personnel in the state that are helping our hospitals, and absolutely critical, because of the restrictions in terms of the funding, and the way the funds are used, we cannot take those staff or move those staff from an acute care facility to what we call a post-acute care facility or a long-term care facility like the Care Center of Honolulu," Raethel told Hawaiʻi Public Radio.

The state Department of Health's federal funding is earmarked for certain initiatives such as COVID-19 testing and vaccinations, Raethel said.

"This has put real stress on places like the Care Center of Honolulu, and the staff over there — just they all deserve medals for what they have been doing and for what they have been going through in the last couple of weeks," he said. "A lot of their staff have been out sick, they're either COVID positive, they're under quarantine because they're close exposure. So it has been an incredible challenge for that team."

But so far there have not been major fatalities like those at the Yukio Okutsu State Veterans Home on Hawaiʻi Island last year.

The new long-term care facility outbreak comes on the heels of a potential shortage of medical-grade oxygen. Raethel says it took a herculean effort to avert a crisis and he credits oxygen producers Air Liquide and Matheson Tri-Gas for stepping up production. Matson also helped by prioritizing shipments of additional oxygen containers.

"We're now in a much, much better place in terms of ensuring that we do have sufficient oxygen supplies in the state," he said. "We're working now on some better predictive modeling for any subsequent events that might happen to ensure that we have better transparency about the use of oxygen and the supply, so that we don't have to run this incredible fire drill that we had to do at the end of last month."

Monoclonal antibody treatments are another defense against COVID-19 infections. But health care providers are receiving only half the number of treatments that they requested amid a shortage.

The federal government has capped Hawaiʻi’s weekly allocation at 680 treatments. Raethel said Hawaiʻi will certainly use everything it can.

"For the immediate future, at least, we don't have enough of these monoclonal antibodies for everyone who needs them, which is frustrating because they are only useful in those seven to 10 days after someone test positive," Raethel said. "If you miss that window because the drug's not available, unfortunately, some of those individuals who could have gotten this drug, if we don't have enough, may end up in a hospital which is not a good thing."

This interview aired on The Conversation on Sept. 23, 2021.

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