COVID-19 found in Kona; Lt. Gov. tours Big Island hospitals

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Lt. Gov. Josh Green discusses COVID-19 preparation with Hilo Medical Center staff Friday in Hilo. (Courtesy photo/Special to West Hawaii Today)
Doctors Audrey McCandless and Scott Cassidy stand with Lt. Gov. Josh Green, right, and Rep. Richard Creagan, back, during a tour of Kona Community Hospital’s not-in-use triage tent on Friday. (Courtesy photo/Special to West Hawaii Today)
Lt. Gov. Josh Green, center, and Rep. Richard Creagan, right, talk with Kona Community Hospital spokeswoman Judy Donovan during a visit to the facility on Friday. (Courtesy photo/Special to West Hawaii Today)
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Two presumptive positive coronavirus cases were identified Friday afternoon at Kona Community Hospital, COVID-19 Task Force chief Lt. Gov. Josh Green said.

Both cases involve travelers, the practicing physician said, noting that officials were completing the verification process.

“They are not community spread, but they are cases,” said Green, who represented West Hawaii in the state Senate from 2009 to 2018 and state House of Representatives from 2005 to 2009.

If verified positive, the two cases will be added to the list, which as of the Health Department’s update on Friday stood at 37, up from 26 on Thursday.

Kona Community Hospital spokeswoman Judy Donovan confirmed the two presumptive positive cases in Kona, but said she couldn’t comment further.

“The Department of Health takes over from here,” she said, noting that the department will trace contacts, which will include some hospital staff. “We will obviously work with them on that. I really don’t know anything more than that at this point.”

Two of the 11 new COVID-19 cases in the state confirmed Friday by Department of Health Director Bruce Anderson had no recent travel history, indicating that the virus is now being transmitted via community members. Ten of these cases were confirmed in Honolulu and one on Kauai.

Anderson said during a conference call that this is the first time that a case has been confirmed in someone with no known exposure to someone who has traveled. He added that, with evidence of community transmission, he expects case numbers in the state to continue to rise.

“I would anticipate that, now that we’ve seen some community spread, it is going to continue to be a problem and continue to be occurring in increasing frequency as we go forward,” Anderson said.

The remaining nine new COVID-19 cases were from people with recent travel history, including one child.

Prior to the presumptive positive cases at Kona Community Hospital, the Big Island had only one confirmed case thus far.

“This is a day where we’re about to see some more disease,” Green said after visiting Kona Community Hospital and learning of the presumptive positive cases. “This is the beginning as the tests come back in.”

Green was on island Friday visiting Kona Community Hospital and Hilo Medical Center to assess capacity and operations as the coronavirus pandemic continues.

“They’re very well prepared to see patients,” he said. “They need more PPE — personal protective equipment — especially at Kona and we’d like to get extra supply for Hilo in advance of the surge.”

The COVID-19 Task Force chief urged those who have stockpiled or have extra personal protective equipment to consider donating the items, such as masks, gloves and eye gear.

“There are people who did buy excessive amounts of protective gear. If they have extra, they can volunteer it for the hospitals where they’ll need it,” Green said.

Green commended the Hawaii Health Systems Corp. facilities’ plans to work with The Queen’s Health System’s North Hawaii Community Hospital should the need arise.

“They’re being thoughtful about even partnering with North Hawaii (Community Hospital) if we do need to separate different classes of patients,” he said. “All of these things are very smart, and I think that it’s good that they’re doing this in advance of the crisis.”

At Kona Community Hospital, Green said he was pleased to see officials preparing the facility for a potential surge of patients with a triage set up and plans for expanding beds.

“I think they will be ready when the time comes,” Green said, noting additional isolation measures were being put in place at in the ER on Friday.

He did encourage the facility to consider increasing emergency room staff for at least two months — not only for a potential surge but the likelihood of patients coming to the facility for care for other maladies.

“A lot of outpatient practices and urgent cares are hitting the pause button and have closed temporarily,” Green said. “That unfortunately turns more people to the ER for basic things.”

Kona Community Hospital Friday afternoon announced restricted visitor access to minimize the risk of COVID-19 exposure. The protocol was implemented Thursday and was not related to the two presumptive positive cases identified Friday

“Hospital leaders, the KCH infection prevention department, and KCH medical staff have closed all patient units to visitors, until further notice,” the press release read. “This emergency measure is being taken to help minimize risk of potential COVID-19 exposure to patients, their loved ones, and hospital employees. There are limited exceptions for patients on the Obstetrics Unit, pediatric patients and compassionate care patients.”

Green visited the Hilo Medical Center earlier Friday, receiving a tour of the facility’s intensive care unit and emergency room. He also reviewed the hospital’s intake plan for addressing COVID-19.

“It’s very well-organized,” he said.

Further, he explained, the hospital is capable of increasing its bed count by 67% should the need arise with plans in place for using surgical wards and even outpatient facility to house patients.

“They’re very well-prepared,” Green said. “Hilo, so far, is one of the most prepared places I’ve been.”

The Big Island has 294 licensed hospital beds, 24 intensive care unit beds and 39 ventilators, not including surge potential, according to figures provided Friday by Green. Statewide, there are 3,069 licensed hospital beds, 340 ICU beds and 561 ventilators.

Also while in Hilo, Green met with Mayor Harry Kim and the county’s emergency response team.

“We discussed the challenges that we think we have, the state plan and what we need to do better,” Green said of the conversation he described as “very good.”

Both agreed “a lot more testing is needed,” he said.

“Only with testing will we know what the background disease state is — where we are as a people — and that’s very important,” Green explained. “We can’t model how many cases we expect to have in the hospital on ventilators until we know exactly what the background rate of disease is and how much spread there’s been.”

Testing began last week on the Big Island with Hilo Medical Center, Queen’s North Hawaii Community Hospital and other private testing sites, including West Hawaii Community Health Center, screening for COVID-19.

On Monday, a pop-up drive-through testing site will be in place at Old Kona Airport Park with no requirement of a physician’s order/referral. Lt. Gov. Josh Green’s COVID Task Force is undertaking the 8 a.m. to 3 p.m. effort with help from the Daniel R. Sayre Memorial Foundation and Ironman Foundation.

The task force and West Hawaii Community Health Center will be providing the swabs for those who meet criteria, with Clinical Labs and Diagnostic Laboratory Services testing samples. Results are expected within three days.