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Hospital: Current 28-case surge different than previous outbreak

MMMC, Hale Makua each discuss their responses to uptick

Maui Memorial Medical Center is shown in a photo taken in April. Maui Health System, operator of the hospital, said Monday that the Maui Memorial increase in COVID-19 cases includes 17 staff members and 11 patients and is a reflection of the surge in Hawaii with many cases tied to community spread. The Maui News / MATTHEW THAYER photo

Maui Memorial Medical Center officials assured residents that the current surge in COVID-19 cases at the hospital — 28 as of Monday — is different from a 50-case outbreak that began in March.

Maui Health System, operator of the hospital, said Monday that the Maui Memorial increase includes 17 staff members and 11 patients and is a reflection of the surge in Hawaii with many cases tied to community spread.

The hospital outlined additional measures to mitigate the spread of the virus, including postponing surgeries that are not urgent and widespread testing of patients, providers and staff.

Meanwhile, Hale Makua Health Services reported two new cases Monday, triggering testing of nearly 70 employees and two dozen Kahului nursing home residents, along with a temporary ban on new admissions. 

“Over the recent months, we’ve been really nervous because of what’s been going on in the state,” Hale Makua Health Services CEO Wesley Lo told The Maui News on Monday night. “This thing doesn’t discriminate, it can happen to anyone, at any place and any time.”

During a Monday evening Maui County news conference, Dr. Michael Shea, Maui Health Systems ICU medical director, noted the “big surge” in new virus cases recently in Hawaii. Oahu has seen triple-digit cases over recent weeks, with Maui logging a handful of double-digit days over the last week.

“Our hospital community is a reflection of our county, our community, so we have seen an uptick in our numbers recently,” Shea said. 

Unlike the hospital cluster this spring, many of the current cases are tied to community spread, Maui Health spokeswoman Tracy Dallarda said. She added that Maui Health has been expecting and preparing for a rise in cases.

A hospital cluster in mid-March grew to 38 health care workers and 14 patients before it was deemed closed by state health officials in mid-May. The origin was traced to a patient who came to the hospital with the virus and infected a health care worker, Dallarda said Monday.

Shea said that the hospital is taking “decisive actions” to reduce the risk of spread. All patients in the hospital will be tested in the next 48 to 72 hours, and all employees and providers will be tested over the next week.

“We are calling this a point in prevalence study,” he said. “We want to know how much COVID-19 is in our community.”

The ICU medical director said a lot of patients from the community are presenting without symptoms, and the hospital’s usual screening involves looking for symptoms. 

“Folks are in an incubation period when tested the first time and become symptomatic later,” he said. 

Shea added that the hospital is increasing personal protection equipment usage, including N95 masks, eye protection, gowns, gloves and shoe covers over the next week for clinicians and staff participating in procedures that aerosol the virus. He said the measures “go well above CDC (Centers for Disease Control and Prevention) and DOH guidelines.”

Elective and non-urgent surgeries are being postponed, he said. Hospital staff will be evaluating when it’s safe to proceed with those surgeries again.

“I really want to urge that anyone who requires urgent or emergent surgery, the operating rooms are open and functioning; they are safe. So if you need surgery, it’s OK to come get surgery,” Shea said. “If your surgery can wait, we will be postponing it.”

Hale Makua’s recent cases include one Kahului nursing home resident and one home health patient. The resident, recently admitted from the hospital, is currently asymptomatic and being cared for in isolation, a news release said. The home patient is receiving care at the hospital.

The nursing home has halted admissions until Hale Makua officials learn more about the recent surge in cases, Lo said. 

Crediting his staff, which has a “sixth sense” about preparing for potentially positive COVID-19 cases, Lo said that the nursing home continues to follow measures that meet and exceed state and federal standards.

“This staff here is just incredible,” he said. “When we got wind that there may be some cases out there, staff actually set up our isolation unit. A lot of our decisions over the last several months, they haven’t been easy, but they are helping us now.”

Hale Makua COVID-19 measures include: screening staff and vendors for respiratory symptoms and fever before entering facilities since early March; sending new admissions since March 23 to a separate area for 14-day monitoring; requiring PPE protocols since April; prohibiting visitors except under certain circumstances; and sanitizing and educational measures.

Hale Makua Kahului previously had one asymptomatic patient who tested positive after being admitted to the facility in April. After a full recovery and rehabilitation, the patient was able to be released and returned home to Kona in June.

Lo said watching the virus surge on Oahu and seeing its impact on nursing homes there is worrisome. 

“We’ve been nervous when we see what’s been going on in nursing homes on Oahu. We know those operators, and they’re good operators,” he said. “You’re going, ‘wow.’ It’s dodging bullets, and you hope you don’t get one. Some are testing negative, then they’re testing positive.

“You just don’t know. We are staying vigilant and on high alert.”

* Kehaulani Cerizo can be reached at kcerizo@mauinews.com.

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