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Hospital at 90 percent capacity — which is the norm

Maui Memorial has ability to expand nearly 100 beds

The 90 percent capacity at Maui Memorial Medical Center reported last week by a top hospital official “is a normal census,” even when tourists were around, an official for the facility operator said Thursday.

Tracy Dallarda, spokeswoman for hospital operator Maui Health System, also discussed Maui Memorial capacity issues and measures to deal with a surge in COVID-19 cases and possible overcapacity.

Members in the community have expressed concern on social media about hospital capacity, especially in the context of reopening to tourism and potential COVID-19 patients. Maui Health CEO Michael Rembis told Hawaii News Now last week that the hospital was at 90 percent capacity, had ICU bed space available and was not close to putting up temporary facilities or relying on other hospitals.

Dallarda said the 90 percent bed capacity is normal for the hospital, even in the days before the pandemic. The hospital has a total of 219 licensed beds and 29 ICU beds.

The hospital can expand to 300 beds and can add a medical tent, which can handle another 10 beds, she said.

“Our surge plan does include the staffing component, and if additional staffing is needed, there are contingency workers identified to assist,” Dallarda said.

When asked at what point hospital officials would be sounding alarms, she said that “there is no specific number, as it is dependent on many factors:  what is our staffing needs, acuity of patients needing care (stable or critical care, as examples), what types of beds are needed, and what areas have capacity.”

“This is a dynamic situation that we deal with every day, even without a pandemic,” Dallarda added.

The plan for dealing with a surge of patients would be to increase beds incrementally up to the 300 beds, she said.

“As we approached that capacity, we would prepare to use our hospital medical tent,” Dallarda said. “At this point, we would also be looking to use other areas outside the hospital to house patients.”

She noted that The Queen’s Medical Center on Oahu is not one of the outside hospitals in the surge plan because Queen’s is currently managing a major surge.

Maui Memorial was caring for 23 COVID-19 positive patients with one patient in the ICU on a ventilator, she said.

Some medical professionals were concerned about the recent increase in COVID-19 cases on Maui and Hawaii island, which could signal an Oahu-type surge. Lt. Gov. Josh Green said last week that “both counties (Hawaii and Maui) are at the risk of tipping into a cautionary yellow phase of spread.”

Communities are considered to be in the yellow phase of virus spread when more than 5 percent of tests start coming back as positive, Civil Beat reported last week. Maui County reached 4.1 percent in mid-August, according to the report.

“We are carefully monitoring the current community outbreaks and remain prepared if some of those residents were to need hospital care,” Dallarda said. “There is clear evidence of community spread, and we are seeing cases from the community being admitted to the hospital.

“The future is in the hands of our community — if they practice appropriate physical distancing, are wearing masks anytime they are outside the home or around anyone they don’t live with, and wash their hands frequently, we can get control of this wave of the pandemic, just as we did with the first wave.”

This is important advice given the three-day Labor Day holiday beginning Saturday.

“If we are not careful, we will experience what Oahu is experiencing in the near future,” she said.

Local health officials have said that, unlike Hawaii island, most of Maui’s surge is related to an outbreak at the hospital and elderly care facilities. The Big Island cases are connected to large gatherings without masks and social distancing.

The Maui Memorial outbreak had grown to 31 patients, 35 staff last week. Dallarda said Thursday that the hospital numbers have “remained relatively flat.” She attributed that to mass testing and expanded protocols, including additional testing of all patients in the hospital.

Maui Memorial continues to test patients upon admission but has expanded to test them on day three and day six of a patient’s stay.

“This is to identify the patients that may be in the early stages of infection and may not have enough viral load to show a positive result,” she said. “By staggering the testing, we hope to identify those individuals and further prevent the spread.”

Dallarda also reported the completion Thursday of testing of all Kula Hospital residents and employees; the results all came back negative. Kula Hospital, also under Maui Health’s umbrella, is a long-term care facility with limited urgent and rural emergency care.

* Lee Imada can be reached at leeimada@mauinews.com.

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