As new COVID-19 cases outpace the ability of Hawaii hospitals and health workers to handle them, hospital administrators are asking the federal government for help in the form of hundreds of nurses, officials with the Healthcare Association of Hawaii said Monday.

Hawaii is asking for 152 specialized nursing staff including medical-surgical telemetry nurses as well as respiratory therapists to care for the critically ill, HAH President and CEO Hilton Raethel said.

Hawaii has already exhausted its other options which include activating approximately 80 Hawaii Army National Guard doctors and other personnel, hiring other medical workers from national registries such as travel nurses, and transferring patients to other hospitals or other settings, he said. Those actions are required to meet the criteria that justify a federal request.

“We’ve already been working with this surge and this over-capacity issue for the past couple of weeks,” Raethel said. “We’re now at the point where we cannot continue to take care of the patients coming in unless we bring in additional resources from the mainland.”

Tripler Hospital. Military in Hawaii. 16 june 2015. photograph Cory Lum/Civil Beat

Tripler Army Medical Center has the space to care for COVID-19 patient overflow, Hawaii just needs federal approval and is submitting a plea for help during the COVID-19 pandemic.

Cory Lum/Civil Beat

If approved, the nurses would be deployed to Oahu and Maui to staff 60 beds on Oahu and 10 beds on Maui for about two months. Hawaii is also requesting that the federal government allow Tripler Army Medical Center to free up approximately 30 beds for civilian patients — patients the hospital does not normally tend to and needs federal approval before admitting them.

Tripler would serve as a bridge to “relieve stress on hospitals” until more nurses arrive from the mainland, Raethel said.

“In many states struggling with COVID, the Department of Defense is doing reasonably well because they deal with a younger, healthier population on average, so they’re not being overwhelmed like our other hospitals are being overwhelmed right now,” Raethel said.

HAH is the private nonprofit trade association for hospitals and other health care organizations, and planned to finalize its request Monday evening. The paperwork will be sent to the Department of Health, then to the Hawaii Emergency Management Agency which sends it directly to the Federal Emergency Management Agency.

“The shortage we have is essentially a statewide shortage particularly on Maui and Oahu. Activating local National Guard members is not going to help,” Raethel said. “They already have jobs in health care and we need them to stay in those jobs which is why we need to supplement more resources.”

HI-EMA and Gov. David Ige’s office did not respond to an inquiry Monday evening.

“It’s been clear for about two weeks that there was no way we’d avoid surging to our capacity, which is also why we have to be more serious about our prevention measures,” said Lt. Gov. Josh Green, the state COVID-19 medical liaison who tracks hospital and intensive care unit space daily.

Approximately 4,500 people have an active infection and are being monitored by the state, Green said, noting about 5% to 11% of all COVID-19 patients end up being hospitalized.

The surge in cases throughout August has strained hospitals for weeks. Last week, Gov. David Ige said he was in early communication with FEMA, and Raethel stated publicly for the first time that Hawaii did not have enough medical staff to tend to all COVID-19 patients in need.

Hilton Raethel, President and CEO of Healthcare Association of Hawaii.

Hilton Raethel, President and CEO of the Healthcare Association of Hawaii said it could take some time for federal medical staff to arrive in the islands.

Cory Lum

As the pandemic continues to affect medical supplies, personnel and other resources in other states, Hawaii does not have a guarantee that its request will be fulfilled in its entirety, he said.

If it ever becomes necessary, the state could consider creating an alternative facility to care for COVID-19 patients, which could include beds at the Hawaii Convention Center, according to Green.

Hawaii has not reached that point, according to Raethel, but hospitals have already been transferring patients to deal with new COVID-19 patients, which have been reported at a record rate throughout August.

A spokeswoman with The Queen’s Health Systems confirmed Friday that the hospital network has transferred at least 25 COVID-19 patients to other hospitals, but would not name which hospitals.

Those transfers were a signal Hawaii needs help, Green said. Requesting assistance from Tripler is “historic,” he said, although the Army’s medical center already has an ongoing relationship with Queen’s to care for trauma patients and has admitted veterans or other Department of Defense personnel in the past.

“Once it became evident that we actually needed to transfer patients from our largest hospital, no one could deny anymore that we needed some assistance,” Green said. “This has got to be all hands on deck.”

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