Hawaii hospitals are making “hard decisions” due to COVID surge and limited resources


Nicole Pasia


The COVID-19 case surge from the Delta variant has kept Hawaii weeks away from reaching a “crisis point.” Leaders from the Department of Health and Healthcare Association of Hawaii said the state is relying on resources from the mainland, such as oxygen tanks and additional health care personnel, to keep up with cases. 


Stay one step ahead. Join our email list for the latest news.



Although COVID cases have decreased over the last few weeks, according to state data, they remain higher than any previous surge the state has faced during the pandemic.

According to data from the U.S. Department of Health and Human Services (HHS), 26 Hawaii hospitals are collectively operating at 78.26% capacity, with about 11.48% of inpatient beds being used to treat COVID patients. However, ICU beds in these hospitals are filling up. About 85.78% are in use, with 29.78% in use for COVID. 

If hospital numbers continue to rise, it would put further strain on staff and limited resources, according to Dr. Douglas Kuntzweiler, Chief Medical Director at Mountain-Pacific Quality Health, which has partners across the Western U.S. and Hawaii. 

“Unfortunately hard decisions are being made concerning how best to utilize limited health care resources. Those resources are not infinite and must go to the patients most likely to benefit. Underlying medical conditions are the determinant of likelihood to benefit. A person’s age is a very relevant part of their underlying medical condition and therefore must unfortunately figure into the decision of whether or not to treat any given person.”

On Sept. 15, the state updated its Crisis Standards of Care Triage Allocation Plan, which hospitals, nursing homes, and other facilities would use to determine where to allocate treatment “in the event that medical treatment resources are scarce, and a State of Emergency is declared.” 

The plan indicates that age may be used as a determining factor for receiving treatment, which raised ethical concerns among some experts and advocates. 

Members of the plan’s core development team, including Hawaii Pacific Health and the John A. Burns School of Medicine, did not respond to State of Reform’s request for comment. 

Dr. Kuntzweiler said this issue could be avoided with higher vaccination rates. State data says there have been 6,038 vaccinations in Hawaii since Sept. 22. However, 141,728 eligible people remain unvaccinated, which accounts for approximately 10% of the state population.