State, hospitals sync Ebola response

The state Department of Health, with the Healthcare Association of Hawaii, has convened a working group to plan how Hawaii would respond in the event of a patient turning up with a history that makes them suspect for an Ebola infection.

One of the first products of the group — co-chaired by Melissa Viray, deputy epidemiologist, and Toby Clairmont, the association’s director of emergency services — is the flow chart shown below. It delineates such issues as when a health care facility (HCF) summons state officials, when personal protective equipment (PPE) suits would be donned and at what point transfer to a specialized hospital would be considered.

What it doesn’t do is identify those hospitals. The state has declined to announce any designation out of concern that the public might consider that a stigma and avoid them, said Dr. Linda Rosen, state health director.

The decision on where to send a patient would be based on conditions and capacity at that hospital at that time, something officials track statewide on a daily basis, she said.

"A cornerstone of treatment for the disease is supportive care, and intensive care," Rosen said at a media briefing last week.

"Those facilities that have 24-hour physicians in their intensive care units — and that usually goes also with a very broad array of specialists and other support staff — would be the facilities that would provide the best chance for a patient, should they actually have Ebola virus disease."