Hawaii officials get set for coming surge of coronavirus patients

Hawaii officials are preparing for a surge in demand for medical care due to the new coronavirus and are considering converting the Hawai‘i Convention Center and Neal S. Blaisdell Center into health care facilities.

The U.S. Army Corps of Engineers Honolulu District has completed assessments of both centers to prepare for the worst-case scenario if there are too many patients for Oahu hospitals to treat. It is unclear how the facilities would be staffed with a limited number of doctors and nurses practicing in the community, but state officials are considering help from medical students as well as retired and out-of-state providers. There are 4,000 doctors practicing in the islands and 9,000 physicians licensed to practice in Hawaii.

The team is also searching for buildings that could quickly be converted on the neighbor islands. Assessments on Maui are scheduled for today.

There were 11 new cases of COVID-19 in residents over 24 hours, bringing the total number of cases to 106. Three of the cases under investigation appear to be community-spread and not travel-related, said state Health Director Bruce Anderson. Among the new cases was a Wahiawa General Hospital employee.

Of the 106 cases, all but two are over the age of 18. There have been seven people hospitalized, and six of them have been released.

“Virtually everyone has recovered. Not to say that we’re not gonna see some deaths. I would expect we’re going to see some in the not-too-distant future,” Anderson said. “It’s the first sign that we’ve seen for a while that there is some localized community transmission occurring.”

More than 80% of cases are travel-related, but “that is possibly going to change in the near future.”

When asked where the localized spread is occurring, Anderson said, “I honestly don’t know the answer to that. We’re still investigating those cases. These are the first cases recently that we’ve had where we haven’t found the source of infection. I don’t think that should be alarming or surprising to individuals that we’re seeing some localized transmission.”

Roughly 5,000 people have been tested in Hawaii, mostly by private laboratories. A broad surveillance program in which negative flu samples are further tested for the virus has so far found no coronavirus cases.

“The next two weeks is very critical in this fight against COVID-19,” Gov. David Ige said. “It really is about flattening the curve to assure our health care facilities do not get overrun so that we can ensure each and everyone in the community can receive the care that they need. As Dr. Anderson had said, the best advice is to treat yourself as being COVID-19 positive, and ensuring that you keep distance from your loved ones so that you don’t infect them.”

Lt. Gov. Josh Green has been working with hospitals and supply chains to ensure adequate supplies in case there is a surge in infections.

“Each island faces different challenges due to limited resources and health care provider shortages. We pray that it will not happen, but we are prepared that it may or will happen and we have to save lives,” he said. “Right now among the biggest concerns is having enough ventilators to make sure people can breath if they get the severe disease of coronavirus and enough PPE, that’s personal protective equipment.”

As of Thursday, the state had 18,000 N95 masks, 3,800 face shields, 20,000 pairs of gloves and 22,000 surgical masks remaining. It also has up to 560 ventilators depending on what’s in supply and activated, Green said.

Hawaii has 3,031 licensed hospital beds with an average daily census of about 65 percent. Hospitals can “surge capacity” to another 500 beds if necessary, meaning the state will have 1,500 beds available if people get sick, he said. Of those, 328 are intensive care unit beds and 204 are in negative pressure isolation rooms.

“This is the first time we’ve had a global pandemic, we have to be ready,” Green said.

A mandatory 14-day quarantine for visitors and residents arriving in Hawaii began Thursday. State Department of Transportation spokesman Tim Sakahara said the order was working, with the number of passengers plunging to as low as 10 people on some flights.

Ige was joined by Green during Thursday’s coronavirus briefing. The two are now working together to stop the virus from spreading in Hawaii after weeks of separate public responses in the state’s COVID-19 effort.

Green, an emergency room physician on the Big Island who has been leading community preparedness efforts, had been conspicuously missing at the governor’s near-daily coronavirus briefings.

Ige started his briefings two days in a row addressing the controversy. The governor said he had not ordered some officials and state agencies to stop working with Green and that the lieutenant governor is a “health care liaison for the state of Hawaii” and “plays a vital role for this crisis.”