Public health shutdown has harmed Hawaii healthcare providers

Businesses and workers throughout Hawaii have suffered huge financial losses over the last few months due to the state and county lockdowns intended to contain the coronavirus pandemic. 

As it turns out, the state’s hospitals and healthcare system have not been insulated from this economic destruction. 

In the early stages of the crisis, there were concerns that the state’s hospitals would quickly run out of beds if there were a surge in coronavirus patients.[1] Therefore, in late March, many Hawaii hospitals closed clinics and reduced outpatient services. And in order to free up resources for potential COVID cases and to prevent the spread of the infection, the governor ordered hospitals to cancel elective and nonemergency surgeries.[2]

Furthermore, as fears of the virus spreading mounted, the U.S. Army Corps of Engineers began surveying locations to build extra care facilities in case the hospitals ran out of beds.[3] The Hawai‘i Convention Center was selected as one of the possible locations for such emergency facilities. 

But as it turned out, the hospitals were never overwhelmed; their hospital bed capacity was never exceeded. According to data released by the state Department of Health, even at the height of the emergency,[4] from the end of March to mid-April, hospital bed use never surpassed 50% of its capacity,[5] ICU unit occupation never surpassed 40%[6] and ventilator usage never surpassed 15%.[7] 

And by mid-April, the same Convention Center that was poised to be converted into extra hospital facilities was instead turned into a phone bank facility to handle the influx of unemployment claims. [8] 

As the number of daily new COVID cases began to approach zero by May, many hospitals reopened their clinics and resumed so-called nonessential surgeries.[9] By that time, however, hospitals had already lost a large portion of their revenue due to reduced operations during the lockdown.  

Jason Chang, president of The Queen’s Health System, revealed in early May that the Queen’s group hospitals had lost approximately $40 to $45 million due to a 58% reduction in elective surgeries.[10] Likewise, Hilo Medical Center saw a nearly 40% reduction in patient visits and an estimated $26 million dollars in lost revenue through the end of the year.[11]

Other smaller operations that rely on in-person visits for revenue, such as West Hawaii Community Center, are also feeling the consequences of a 25% drop in patient visits.[12] 

“None of us as nonprofits have the cash reserves to sustain a long-term effort,” said Richard Taaffe, CEO of West Hawaii Community Center. 

“We are the safety net providers in the community and we want to do our job,” he told Honolulu Civil Beat, “but we don’t have the financial reserves.”[13]

Ideally, hospitals should prioritize the community’s well-being over financial gain. But what if public health suffers along with the hospitals’ finances? That is precisely what has happened. Not only have the hospitals suffered from the shutdown, so has the wider community. 

Many healthcare networks aggressively shifted their appointments to online “virtual care.” And some networks such as Kaiser Permanente were successful using this approach, handling the majority of its appointments online.[14] 

However, not all systems were equipped with the same capabilities, nor did the communities that they assisted have ready access to technology. Hospitals, particularly in more rural areas, struggle to adjust to virtual care. Locations such as Hana Health in rural Maui saw an 80% drop in patient visits.[15] Similarly, about 40% of patients stopped visiting the Waimanalo Health Center. 

Nationwide, outpatient and diagnostic care have declined by 60%.[16] This trend of people deciding against seeking healthcare applies to urgent care as well. Some Hawaii hospitals estimate that stroke cases fell by nearly a third.[17] In the month of April, 911 calls for chest pain, often associated with heart attacks, were also down by more than 50%. 

It’s not as if patients suddenly stopped needing non-COVID-related emergency care once the virus began to spread. Instead, due to widespread urging by the government and healthcare industry itself against overwhelming the state’s hospitals, many patients simply decided to stay home, even if they felt sick or needed treatment.

While the shutdown may have been well-intentioned, the consequences of such prolonged lockdown measures harmed an industry – healthcare services – that typically we assume will always be available.

In this time of emergency, it is necessary to keep in mind that there are health threats to our community beyond the coronavirus itself.

[1]   Kristen Consillio, “Surge of coronavirus patients could cripple Oahu hospitals,” Honolulu Star-Advertiser, March 18, 2020,

[2]  Gov. David Ige, “Executive Order No. 20-05,” April 16, 2020.

[3] Hawaii Updates: Cases stand at 106; Convention Center, Blaisdell eyed for care sites,” Hawaii Public Radio, March 26, 2020.

[4] “Virus Tracker,” Honolulu Civil Beat, 2020.

[5] Hawaii COVID-19 Joint Information Center Daily News Digest,” State of Hawaii, April 14, 2020.

[6] Hawaii COVID-19 Joint Information Center Daily News Digest,” State of Hawaii, March 30, 2020.

[7] Hawaii COVID-19 Joint Information Center Daily News Digest,” State of Hawaii, April 6, 2020. 

[8] Lynn Kawano, “State further expands phone bank set up for unemployment claims,” Hawaii News Now, April 24, 2020.

[9] Olivia Peterkin, “Queen’s reopens clinics, outpatient services as Island Covid cases dwindle,” Pacific Business News, May 21, 2020.

[10] Mahealani Richardson, “In positive sign, Queen’s Medical Center takes down triage tent set up to screen for COVID-19,” Hawaii News Now, May 4, 2020.

[11] Stephanie Salmons, “Fewer patients, less revenue: COVID-19 crisis suppresses visits to Big Isle hospitals, clinics,” Hawaii Tribune-Herald, May 18, 2020.

[12]  Ibid.

[13] Eleni Gill, “COVID-19 Is Taking A Big Toll On Other Types Of Health Care,” Honolulu Civil Beat, March 31, 2020.

[14] Ibid.

[15] Eleni Gill, “Queen’s, Hawaii Pacific Health Get Big Chunk Of Federal Health Care Bailout,” Honolulu Civil Beat, May 30, 2020

[16] Ateev Mohrotra, “The impact of the COVID-19 pandemic on outpatient visits: A rebound emerges,” The Commonwealth Fund, May 19, 2020.

[17] Jim Mendoza, “Fearing COVID-19, patients are delaying urgent care and putting their health at risk, hospitals say,” Hawaii News Now, May 27, 2020.

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