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Health care workers in Hawaii say a lack of government action is worsening an already crippling wave of coronavirus cases in the islands, and without effective policy changes, the state’s limited hospitals could face serious crisis.
“Soon we’re going to find ourselves in a situation where we’re going to ration health care,” said Dr. Jonathan Dworkin, an infectious disease specialist in Hawaii.
Dworkin said that while the mandates may be unpopular, the rationing of Hawaii’s limited health resources “is going to be a lot uglier.”
“It involves making decisions about who lives and dies,” he said. “I hate the idea of having to make a decision about who is going to get oxygen.”
Another stay-at-home order might be needed, Dworkin said.
“I don’t like the idea of doing this, but we’re in a situation where hospitals are very strained, where non-COVID patient care becomes very difficult, where we are in danger of running out of oxygen. “
Doctors statewide have made recommendations they believe could help Hawaii curb the spread of the delta variant.
They say the state failed to implement various measures agreed to by officials last year, including speeding up rapid tests, installing better air filtration systems in schools and businesses. and improving contact tracing.
Some believe that a more robust screening process for travelers that includes two tests, one before travel and one after arrival, could also help slow the spread of the disease.
“For an island state not to take border control seriously is, in my mind, an epidemiological crime,” Dworkin added. However, “the best impact for tight border control would have been a few months ago.”
Prior to July, Hawaii reported a seven-day average of 46 daily cases. Today that number stood at 881.
And even as hospitals fill up and mortuaries bring in portable containers for bodies, leaders have hardly made any major policy changes.
The state recently announced that groups of more than 10 people inside and 25 outside could not assemble, but a group of more than 300 people that was dispersed by police on a beach over the week -end last took place without any citation for COVID-19 violation.
A vaccine pass for restaurants, bars, and other businesses has been announced for Oahu, but that program won’t begin for several weeks, and the incentive vaccine payouts could be months away.
The governor recently suggested that people stop traveling to Hawaii until the end of October, but he hasn’t changed any official travel rules.
Governor David Ige did not immediately respond to a message Thursday from The Associated Press about the concerns of healthcare workers.
The governor posted a video on social media imploring people to act responsibly over the holiday weekend.
“The state of Hawaii is grappling with an unprecedented and catastrophic increase in COVID-19 cases,” Ige said. “Our hospitals are being pushed to the limit.”
Ige asked travelers to test voluntarily after arriving at the islands and for people to establish their own nighttime curfews, avoid crowds and wear masks.
The governor also quietly signed an order this week that frees healthcare workers and hospitals from liability during the outbreak.
Hospitals and health workers “will be immune from civil liability for any death or injury … which may have been caused by an act or omission on the part of the health care establishment,” the health care establishment said. order, with legal reservations, including fault and negligence.
Authorities say only a small fraction of cases have been directly linked to tourists.
But hundreds of thousands of visitors and residents began traveling in July when travel rules were relaxed. Hotels and beaches were full, local families gathered for birthdays and reunions, and tourists crowded into luaus and restaurants.
“Travel started to increase and we started to see our cases increase,” said Dr Kapono Chong-Hanssen, medical director of the Kauai Community Health Center. “And from there, you know, you’ve really just seen this skyrocketing cases.”
State Department of Health director Dr Libby Char said there were likely missing cases among visitors who might not get tested while on vacation.
“Do we underestimate the travelers who arrive or become ill afterwards? Yeah, probably we are, ”Char said. “If they don’t test, then it’s very difficult to identify these people.”
And now the delta variant has torn Hawaii’s unvaccinated residents apart. Even though the state has one of the highest vaccination rates in the country, the outbreak has repeatedly set records for the highest number of cases and deaths since the start of the pandemic. About 75% of Hawaii residents eligible for the vaccine are fully immunized, according to the state’s dashboard. Children 11 and under cannot register yet.
Hawaii had one of the lowest infection, death and hospitalization rates in the country before the Delta epidemic.
On the island of Kauai, where authorities have enacted strict rules including a two-test screening process, the virus was virtually non-existent before travel resumed.
Dr Janet Berreman, state Department of Health official for Kauai, said contact tracing on the island has proven that travel sows local epidemics, and this is true for visitors and residents alike. .
“When residents travel and return home, they often live in multigenerational households. They go to work, they go to school, they see their friends. So a lot, a lot, a lot of transmission from one or two people in the household, ”Berreman said.
Another issue for hospitals is that now that hotels are full of tourists, the state has ended a program to provide rooms for patients requiring quarantine.
“We were able to help coordinate the departure to hotel rooms where they could safely quarantine themselves until the end of their quarantine period so that the risk of transmission, risk of infection and disease in their family members is significantly reduced, ”said Jennifer Tucker, a nurse practitioner at one of the state’s largest hospitals. “We no longer have that option. We send people home.
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