As hospitalizations soar, ‘unprecedented’ number of ERs are turning ambulances away

HONOLULU, Hawaii (HawaiiNewsNow) - The number of COVID-19 hospitalizations in Hawaii has nearly quadrupled since Aug. 1, leaving some Oahu hospitals so overwhelmed they’re turning ambulances away.

To underscore the problem, sources provided Hawaii News Now with a snapshot of the tracking system used by hospitals across the island. At about 6 p.m. Monday, it showed Kaiser, Kuakini, Pali Momi, Straub, Queen’s Punchbowl, Queen’s West and Wahiawa General hospitals all on “ambulance divert.”

It happens when an emergency room is so busy it stops taking in most patients. Those ambulances are then rerouted to other facilities, oftentimes much farther away.

“To see two or three on reroute is unusual,” said community physician Dr. Jim Ireland, who has helped broaden COVID-19 testing in Hawaii. “But to see five, six or seven on reroute is really unprecedented.”

During that 6 p.m. Monday timeframe, when so many hospitals were diverting patients, only three were accepting them: In Kailua, Kahuku and Waianae. While those facilities are a crucial part of Oahu’s healthcare system, Ireland says they’re limited in what they can do.

“Waianae Comprehensive, again very critical to the region of the island it’s on, but they’re not even a hospital,” he said. “They’re a free-standing emergency center. They will do life-saving stabilization but nobody can stay there.”

Lt. Gov. Josh Green said he’s never seen Hawaii’s hospital capacity this limited.

“Only a handful of times in the 20 years I’ve been a doctor have we had more than two places on divert,” he said. “When you exceed capacity at the hospitals, you get unnecessary deaths.”

Green says the new Oahu stay-at-home order set to go into effect on Thursday is meant to take some of the stress off the island’s healthcare system.

But he warns the situation will likely get worse before it gets better.

“We have 4,700 active cases,” he said. “When those individuals end up getting hospitalized in the next few weeks, it’s going to be very dire.”

Overall, COVID-19 patients make up only a fraction of the people who need care. The problem is that when someone needs hospitalization for COVID-19, their hospital stays tend to be long.

That fills hospital capacity.

"We still have all the other patients that normally need to go to the hospital for everything else," Ireland said, "Broken legs, asthma, pneumonia, heart attacks, strokes."

Many people on other islands also depend on Oahu for critical care.

“COVID is the emergency,” he said. “But there’s a rippling effect to other medical conditions and Neighbor Island patients across the state.”

Ireland says there are rules that allow ambulances to transport serious trauma and critically ill patients to the nearest hospital even if it’s on divert.

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