Hawaii health officials warn that the state is headed up a dangerous slope of COVID-19 infections and could plunge off an economic and public health cliff in the next month if it continues to see daily triple-digit cases.
“At this current trajectory we’ll have 5,000 cases by Sept. 1,” said Lt. Gov. Josh Green, an emergency room physician on Hawaii island, who estimates that at the current rate of infection, hospitals will soon be full of COVID-19 patients.
He projects 90 more coronavirus patients will be hospitalized over the next few weeks, and at an average of 100 cases per day, there could be 3,000 new cases in the next month alone, about 11% of them severe enough to require inpatient care.
The state recorded 87 new confirmed COVID-19 cases Saturday, all on Oahu, after triple-digit increases for each of the three previous days: 123 on Friday, just one shy of Thursday’s record high of 124, and 109 on Wednesday.
Also Saturday, the Honolulu Emergency Services Department announced an employee who works in Liliha tested positive for COVID-19 and is in isolation. It was the first positive case for the department, which said it has treated and transported more than 90 patients infected with the new coronavirus.
The statewide total number of infections since the start of the outbreak is now at 2,197, with cases more than doubling since the beginning of July.
As a result, state and county leaders have called for reinstating rules limiting gatherings to no more than 10 people, shutting down bars for three weeks on Oahu and tightening other restrictions on activities that might encourage the spread of the virus.
“That’s a modest effort to get the numbers under control. If we don’t get it under control, there will certainly be statewide calls for closures and for a shutdown,” Green said. “The alternative is a gigantic surge that could very well overwhelm several of our hospitals.”
Since the start of the outbreak, 194 patients testing positive have required hospitalization. As of Saturday, there were 75 confirmed and suspected COVID-19 patients in the hospital, including 15 in intensive care units and 10 on ventilators, Green said.
The state has a total of 244 ICU beds, with about 100 of them at any given time filled with individuals suffering from heart attacks, strokes, cancer and other serious conditions.
At the current hospitalization rate, that means 350 individuals could be hospitalized in August, which would be “a devastating surge” that might exceed the number of ICU beds and ventilators, of which there are 459. The average hospital stay for COVID-19 patients is 10.5 days, which means there could be less room for other patients with life-threatening conditions, Green said.
Public health authorities caution that though the state’s coronavirus death toll remains at 26, that could easily change. The nationwide COVID-19 death count has surpassed 150,000.
“We can stop it. It doesn’t require anything but the lowest technology — a piece of cloth. We can stop this with only human cooperation that respects other humans … it’s called the aloha mask,” said DeWolfe Miller, an epidemiologist, University of Hawaii professor and fellow in the American College of Epidemiology. “It’s not high-tech, you don’t have to change the batteries, you don’t have to reboot it, you just have to wear the damn thing.”
Miller said restrictions aimed at curbing the spread of the disease have exposed a “me first” culture in the country of people who lack empathy or a sense of social responsibility. These individuals don’t care if they infect others if it means a minor inconvenience to themselves, he said.
“We’ve got knowledge, we’ve got intellect, teachers, technology, we’ve got the rules of law — there’s no excuse for it,” Miller said. “We have the ability to do something and we’re not doing it.
“I’m out of my wits, I’m beside myself with concern. They’re not just idiots, they’re really dangerous zombies. They’re people who have education, read and write and do know what’s going on and have decided not to take consideration of other people. There is no aloha.”
Miller’s wife, Dr. Jennifer Frank, is a family medicine practitioner who works at The Queen’s Medical Center. She said there needs to be more outreach to specific groups, particularly Micronesians, who are “filling up the hospital beds.” They represent 34% of coronavirus cases and only 4% of the state population, according to Miller’s research.
“They’re not the only ones; there’s lots of others,” she said.
The answer to the crisis the community is facing is obvious, she said: Follow public health advice to wear masks and social distance.
“We know what to do, the logical answer is so clear, but we’re dealing with human beings,” Frank said. “We all have to do this for each other. We can say all the right things then somebody has to come along and knock all the knuckleheads on the head.”
Before Hawaii reaches the thousands of cases predicted and state and county governments are forced to further curtail economic activity, Miller said individuals must choose to take the right actions for their health, the health of others and for the state’s economy.
“We’re in really big trouble. It won’t take very long before you’ll have so many cases you can’t do contact tracing. It’ll just be overwhelming,” Miller said, adding that even if people survive COVID-19, their life expectancy could significantly shrink due to damaged lung tissue and other repercussions.
“You can achieve a reduction in transmission without a lockdown. I don’t want to crush the economy any more than we already have. It’s sort of like an extreme last-ditch effort.”