The Senate Special Committee on COVID-19 convened an informational briefing on Friday, September 3 to receive an update and assessment on the current pandemic situation from the Hawaiʻi Pandemic Applied Modeling (HiPAM) organization, the Department of the Attorney General, the Healthcare Association of Hawaiʻi (HAH) and the State Department of Health (DOH).
HiPAM: COVID-19 FORECAST MODELS
Director Victoria Fan, Thomas Blamey and Dr. Monique Chyba of Hawaiʻi Pandemic Applied Modeling (HiPAM) provided the committee with the current forecast on COVID-19 transmission and other relevant data.
As part of their finding, they reported that the County of Hawaiʻi, the County of Maui and the City and County of Honolulu are all experiencing an increase in test positivity and a decrease in the number of tests being administered. The average positivity rate statewide is 7.5% (8.3% on Oʻahu, 8.2% on Hawaiʻi Island, 7.0% in Maui County and 5.2% on Kauaʻi). Due to this situation, the forecast model indicates that there is likely a large underreporting of cases. The group emphasized to the committee the importance of continuing to promote mass testing.
Forecast models also indicated that hospitalization on Oʻahu for COVID-19 would surpass by 500 by September 13 (448 individuals were hospitalized as of Friday, September 3).
Thus, HiPAM warned the committee of potential emerging issues:
• There is a risk of a flu and COVID-19 co-occurring epidemic this fall.
• Waning vaccine efficacy and increased susceptible population will increase transmission of COVID-19.
• Impacts of the coronavirus on pregnant women and children can be long-lasting due to development impacts, not only of COVID-19 but also from co-occurring stress, economic and educational conditions.
• Risk of ongoing variants that are not preventable by vaccine.
o Avoid extremes (protocols vs. Laissez-faire) and continued need for the main pillars of prevention: testing, tracing and isolation/quarantine; and masking, social distancing and washing hands.
DEPARTMENT OF THE ATTORNEY GENERAL: ENFORCING COVID-19 VIOLATIONS
Attorney General Clare Conners provided the committee with information on her departments effort to enforce the current Safe Travel’s program for visitors, specifically focusing on the recent vaccination fraud attempts. Through the screening process at the airport and reports from the community, law enforcement officials with the Department of the Attorney General have arrested seven individuals who entered the state using fraudulent vaccination cards; and also arrested 60 individuals for violating Hawaiʻi’s quarantine rules.
She shared that the Department of the Attorney General has assisted county law enforcement officials in conducting over 4,000 compliance checks since the beginning of the pandemic. Attorney General Connors indicated that the recent passage of Act 185 will help to address the issue of the judicial backlog, due to the 60,000 emergency order violations that were issued on Oʻahu in 2020. Act 185 provides the Governor and the four county mayors with flexibility to implement lesser penalties for emergency order violations. This will help by increasing fairness and judicial efficiency while still providing a substantial deterrent to alleged violators.
Attorney General Connors also explained to the committee that the pre-travel testing requirement for visitors is legal because it does not restrict travel to Hawaiʻi; it only requires additional safety measures for visitors to follow while in the State that is based on public health guidance.
DEPARTMENT OF HEALTH AND HEALTHCARE ASSOCIATION OF HAWAIʻI: HOSPITAL CAPACITY AND OXYGEN
Hilton Raethel of the Health Care Association of Hawaiʻi (HAH) and Dr. Libby Char of the Department of the Health provided the committee with information regarding the State’s hospital capacity and the current medical oxygen situation.
Mr. Raethel shared with the committee that the Federal Emergency Management Agency (FEMA) is supporting Hawaiʻi’s healthcare partners by deploying 650 registered nurses, respiratory therapists and other technicians to healthcare facilities across the State. Most of these personnel will be in Hawaiʻi by mid-September.
He also shared that there is an increased need for post-acute care staffing. He indicated that there is a staffing shortage in long-term health (LTC) care facilities, assisted living facilities, home healthcare and hospice care. To address this issue, HAH presented a $10,628,000 proposal for an eight-week deployment of 242 post-acute personnel to increase capacity at various facilities statewide. HAH is currently seeking funding for the aforementioned proposal.
The committee learned that FEMA has tentatively approved a request from the State Department of Health (DOH) to provide six teams to support subcutaneous monoclonal antibody (MOAB) treatment at various facilities, including Queens Medical Center – West, a Hawaiʻi Pacific Health facility on Oʻahu, Maui Memorial Hospital, Hilo Hospital, Kaiser – Moanalua and Waiʻanae Coast Comprehensive Health Center. There are currently three monoclonal antibody products under Emergency Use Authorization (EUA) for the treatment of mild to moderate COVID-19 in adults and pediatric patients, who have tested positive for COVID-19 and who are at high risk for progression to severe COVID-19, including hospitalization or death This treatment will help to limit the number of hospitalizations for individuals with COVID-19.
Mr. Raethel also briefed the committee on the status of the liquid oxygen (LOX) supply in Hawaiʻi. The State’s two oxygen producers, Matheson and Air Gas Hawaiʻi are operating at maximum capacity and producing medical oxygen exclusively to help meet the healthcare demand. Demand for medical oxygen has increased significantly due to the number of individuals hospitalized with COVID-19.
Chief Medical Officers (CMO) at the various healthcare facilities statewide are working in collaboration with the University of Hawaiʻi School of Engineering to review oxygen conservation strategies and provide needed support. Oxygen conservation measures are being implemented statewide.
HAH is also searching for additional intermodal containers (ISOs) for lease or purchase to help with the interisland shipment of oxygen. Due to swift action by state and federal agencies, a crisis was averted and there is enough medical oxygen in the State to meet the demand should Hawaiʻi reach its peak of COVID-19 cases in the coming weeks.
As of September 3, 2021, 446 individuals are hospitalized with COVID-19; an increase of over 330% since August 1 (when 134 individuals were hospitalized). Of the 223 licensed adult intensive care unit (ICU) beds statewide, 224 adult patients are hospitalized in the ICU. Mr. Raethel notified the committee that Hilo Medical Center, Adventist Health Castle, Queens Hospital – Punchbowl, Wahiawa General Hospital, Pali Momi Medical Center, Straub Medical Center, Kuakini Medical Center are above their licensed ICU bed capacity. Every hospital on Oʻahu (except for Tripler Army Medical Center and Kapiʻolani Medical Center) are either at or above their licensed ICU bed capacity. Given this situation, Mr. Raethel expressed deep concern that hospitals are near the point where they may not be able to provide ICU care for all patients needing it; leaving patients with the possibility of not receiving the optimal level of care that they need.
Of the 224 adult patients in ICU statewide, 99 of those individuals are COVID-19 positive.
“The information provided to our committee is very alarming and indicative of the need for us as a State to curb the spread of COVID-19 in our communities,” said Senator Donovan Dela Cruz (District 22 - Mililani Mauka, Waipi‘o Acres, Wheeler, Wahiawa, Whitmore Village, portion of Poamoho), chair of the Senate Special Committee on COVID-19. “If we don’t take action now, our hospitals will continue to operate above maximum capacity and people in our community who need proper healthcare will suffer greatly.”
To view a rebroadcast of the 9/3/21 informational briefing, click here.