Sarina Erstad has had a tough year. In May, she found out she had breast cancer and spent three months going in and out of The Queen’s Medical Center for a barrage of tests and exams to figure out how bad it was.

She scheduled a mastectomy to remove her cancerous breast on Aug. 19. Then Covid-19 cases shot up in Hawaii, and with them, Covid hospitalizations.

As case counts swelled, Erstad found out that her surgery was rescheduled until Aug 24. Then she heard it was canceled. Then it was back on, but up in the air when.

On Wednesday, she heard it was canceled completely and might not be rescheduled for months. She might have to go on hormone therapy and chemotherapy to prevent the cancer from spreading.

Erstad is one of the casualties of the surge’s squeeze on hospitals, which had more than 300 coronavirus patients as of Wednesday.

Tent located outside the Straub Medical Center during surge in Covid-19 patients.
A tent located outside the Straub Medical Center is used for Covid-19 patients in Hawaii. Cory Lum/Civil Beat/2021

The combination of hundreds of Covid patients plus many non-Covid patients is pushing some Hawaii hospitals beyond their capacity.

Lt. Gov. Josh Green said Wednesday that he’s encouraged by Hawaii’s test positivity rate hovering around 7.5% and not rising to double digits like in some areas on the continent. But the stress on hospitals is worse than last year, as both Covid and non-Covid patients crowd facilities.

Most Hawaii hospitals are now limiting non-emergency procedures, according to the Healthcare Association of Hawaii. That’s forcing some patients who have scheduled procedures in limbo.

“It’s very stressful,” Erstad said. “It adds to the stress of already having a cancer diagnosis to just sit here and wait, not knowing.”

Exceeding Hospital Capacity

Officials from Straub Medical Center, which is part of Hawaii Pacific Health, told reporters Wednesday that the influx of Covid patients is putting the hospital at 100% to 125% of capacity.

Straub is activating emergency procedures to manage the bigger patient load that were drawn up last year during the pandemic but weren’t needed until now.

The hospital is using a negative-pressure tent that can accommodate up to six Covid patients to help prevent them from infecting others.

Straub is among the majority of Hawaii hospitals that are delaying elective procedures in response to the demand for caring for Covid patients.

The hospital is also among those that will be receiving extra staff from the mainland through a partnership between the state and FEMA that’s bringing more than 550 medical professionals to Hawaii hospitals.

The Queen’s Medical Center is another hospital that’s rescheduling non-emergency surgeries in response to the pandemic stress. On Wednesday, the intensive care unit at the hospital’s Punchbowl location was near capacity.

“We remain committed to providing care by constantly evaluating our operations to ensure our doors remain open to those in need of emergency care,” Jason Chang, president of The Queen’s Medical Center, said in a statement.

Anxiety And Uncertainty

The uncertainty over Erstad’s surgery isn’t just worrisome for health reasons. It brings up all sorts of practical questions for the 45-year-old resident of Oahu’s North Shore, who works as a marketing director and manages several staff.

In addition to her mastectomy, Erstad planned to do breast reconstruction surgery and expected to be out of the office for as long as six months.

But not knowing exactly when the surgery will happen means she’s not sure when to prepare her employees for her departure, when to go on disability leave or even when to stock up on groceries at home for her recovery.

“I don’t know what to do because I can’t plan anything,” she said. “I sit here and I’m stressed out which is not a good thing before a surgery.”

Sarina Erstad isn’t sure when she’ll have a mastectomy to address her breast cancer and is worried the cancer will spread. Courtesy: Sarina Erstad

She’s grateful for the support of her husband, her workplace and her medical team at Queen’s. But after learning Wednesday that the surgery might not happen for months, she’s now trying to see if she can have it done elsewhere.

In May, her oncologist told her that the surgery should preferably be completed within two to three months.

“Everyone knows how cancer spreads, so the sooner I can have the surgery the better,” she said.

She said she is vaccinated against Covid and wishes more people would get vaccinated, or if they choose not to, stay masked and take precautions to stop spreading the virus.

“Otherwise people will die and not just from Covid but from other medical issues,” she said.

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