BREAKING: COVID-19 Cases at Maui Hospital Rise to Nine: Includes 4 Health Care Workers, 5 Patients

By Wendy Osher

The number of COVID-19 cases at the Maui Memorial Medical Center has risen to nine as of noon today.  Maui Health confirmed that there are four health care workers and five patients at Maui Memorial Medical Center who have tested positive for COVID-19.

The health care workers are in quarantine at home and the patients have been isolated in the hospital’s COVID-19 warm unit.

According to Maui Health, the Emergency Operations Center contact tracing team was initiated yesterday immediately after a health care worker test returned positive. The contact tracing team has been investigating potential patient and employee contact with the identified positive cases, and has continued with the notification, screening and testing of individuals identified through the contact tracing process.

“In an abundance of caution, Maui Memorial has converted the affected unit into a warm unit which is now the second of two warm units open in the hospital. The first unit is an ICU unit that has remained open as a warm unit since the pandemic began and has served as readily available isolation unit for any positives, or persons under investigation. When Maui Memorial was without any positive patients for over 80 days, the ICU warm unit remained open to isolate any patient who was awaiting test results as an additional safeguard to protect employees and other patients from potential exposure,” said Tracy Dallarda, Communications for Maui Health / Maui Memorial Medical Center.

Testing will resume throughout the two-week incubation period within the affected units, along with ongoing employee testing for high risk units, and surveillance testing for other potentially affected units as an additional precaution.

According to Dallarda,the ongoing testing includes travel nurses who are tested upon arrival to Maui and then again within 5-7 days.  She said none of those who tested positive to date are considered travel nurses.

“As communicated yesterday, we are committed to testing any individuals that may have been exposed to prevent any spread of the virus. All Maui Health employees have access to a dedicated medical professional – an Advanced Practice Provider – in the emergency department for 24/7 COVID-19 assessment and testing if they’re experiencing COVID symptoms or feel they have been exposed to the virus,” said Dallarda.

According to Maui Health, any employee who is experiencing symptoms and is required to stay home to await test results or quarantine can implement a special COVID-19 pay benefit so there is no loss of income.

“We are working collaboratively with the Department of Health to investigate the possibility of a community-acquired exposure as the source,” said Dallarda.

The three individuals initially identified yesterday included a health care worker and two patients that were in the Maui North medical surgical unit.  View Maui Now’s initial report published on Aug. 13, 2020.

In reference to the cases at the Maui hospital, Mayor Victorino said, “They are working very diligently right now to make sure we don’t have any reoccurrence of what happened the first time.  They learned a lot of valuable lessons.”

During the initial wave of infection, the cluster of individuals linked to the initial Maui Health outbreak totaled 52 including 38 health care workers and 14 patients who had tested positive, according to previous reports.  That cluster was declared “closed” on May 19, 2020.

According to Dallarda, the newly converted warm unit is a combination of private and semi-private rooms. “Whenever possible, patients
are kept in rooms alone,” she said, noting that air flow on the unit and throughout the hospital flows through air handlers with HEPA filters.

The unit is also closed off from the rest of the hospital with a barricaded entrance in which limited access is allowed. “This means that traffic is limited to medical staff and cleaning team. Medical supplies and meals from the cafeteria are delivered to the unit entrance but not delivered in individual rooms like regular units,” said Dallarda. She explained that COVID unit staff is instead delivering meals.

According to Maui Health, each of the rooms are outfitted with supplies of PPE and staff are not allowed to enter warm units without proper
PPE which, per CDC guidance, includes gown, goggles or face shield, N95, and gloves. “Staff are trained on proper donning (putting on PPE) and doffing (taking off PPE) protocol as per CDC guidance, and they ‘bundle’ their procedures so that they don’t have to enter and exit the rooms as often which reduces exposure. Each room has signage that staff can refer to as step-by-step guides for donning/doffing and we utilize staff “spotters” and/or mirrors so nurses can ensure that PPE is being appropriately used and fitted before entering a room,” said Dallarda.

Additionally, Maui Health notes that facility wide safeguards remain in place to protect employees, providers and patients. This includes:

• universal masking for all staff, providers and patients (masks provided to each person allowed to enter hospital),
• symptom, fever screening at hospital entrance (anyone with symptoms or fever are not allowed to enter),
• universal COVID testing for admitted patients and patients that are scheduled for an outpatient procedure/surgery,
• no-visitor policy (except OB and pediatrics, special needs -and end of life on a case-by–case basis ),
• enhanced cleaning/disinfecting of rooms, public areas, and offices,
• appropriate PPE for all employees and providers, and
• appropriately distanced furniture in waiting rooms, break rooms and other sitting areas.

Of the 206 cases in Maui County on Friday, at least 157 have been released from isolation, and 27 have required hospitalization.  Based on the current numbers, there are 43 active cases in Maui County.

With another triple digit record case count of new COVID-19 cases in Hawaiʻi, Governor David Ige on Thursday suggested that more restrictions could be necessary in order to get the situation under control, especially on Oʻahu where more than 96 percent of active cases are located.

“If things do not get better, we will have no choice but to look at more restrictions.  This could include going back to the stay-at-home orders, or other restrictive measures that we need to implement in order to stem the increase in the number of COVID cases.  It also means that we will be looking at a delay of the trans-Pacific pre-travel testing program.  I know that going backwards will cause further harm to our economy, but we have always said that the health and safety of our community will be the highest priority,” said Gov. Ige during an afternoon press conference yesterday.

There are currently more than 150 people hospitalized for COVID-19. Lt. Governor Josh Green said major and acute care hospitals on O‘ahu are already transferring patients and expanding ICU capacity.

“If we do have to go to a stay-at-home order, it will be to save lives, and ultimately stop the virus sooner rather than later.  I want to reassure people that we definitely have capacity in our hospitals right now, but it is getting closer–closer to the point that we will overflow our hospitals and not be able to give all of the services which all of our citizens deserve,” said Lt. Gov. Green on Thursday.