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Honolulu City Council leaders are calling on Mayor Rick Blangiardi’s administration to increase the number of rooms for Covid-19 patients who need to isolate and quarantine.

Council Chair Tommy Waters and Vice Chair Esther Kiaʻāina authored the resolution that calls for a report on plans to expand available rooms.

Waters and Kiaʻāina want the city administration to identify available city properties or other sites to use for isolating Covid patients.

“The Council finds that the need for adequate isolation and quarantine facilities is greater now than at any point in the ongoing and worsening COVID-19 pandemic,” says their resolution introduced last week and up for consideration Tuesday.

The proposal comes at a critical time in Hawaii’s pandemic. On Monday, 409 coronavirus patients were hospitalized in Hawaii, more than any other time since the pandemic began early last year. The Covid-19 positivity rate in Honolulu is approaching 10%.

At a press conference Monday, Blangiardi said that the city hasn’t increased the number of quarantine and isolation facilities available for Oahu residents.

“We have not done that yet,” he said. “But obviously we’re going to do anything and everything we can to deal with the circumstances.”

Hirokazu Toiya, director of the , cited tourism and the highly contagious nature of the delta variant as reasons for not adding more rooms.

“We’re in a totally different environment now than we were before, where the hotels are full of visitors that are paying customers for those hotels,” Toiya said at Monday’s press conference.

He said by the time a coronavirus patient exhibits symptoms and tests positive for Covid, they’d likely have infected their entire household. An estimated 93% of Hawaii Covid cases are the delta variant, which is far more transmissible than last year’s strain of coronavirus.

“As an intervention we don’t believe this is effective anymore to actually separate out households,” Toiya said.

He said the city is focusing on isolating people who live in “congregate” settings, which include homeless shelters.

But that doesn’t mean those people always get access to needed rooms. Darrah Kauhane of Project Vision Hawaii knows of people in homeless shelters or in crowded households who tested positive and weren’t able to get into city isolation facilities.

She’s often called to do in-home testing or in-home vaccination for households of 15 to 20 people living in two or three bedrooms.

“There’s no way you can safely isolate if there’s only one bathroom,” she said.

Less Funding This Year

Civil Beat reported on Aug. 10 that Oahu had just 64 quarantine rooms with a waitlist of 30 coronavirus patients. A year ago there were over 300 quarantine rooms.

Meanwhile, Honolulu’s over the week preceding Aug. 17 was the second highest in the nation, according to data from the Dartmouth Atlas of Health Care.

The Department of Health confirmed Monday that there are still 64 total quarantine and isolation rooms on Oahu. They are part of two city facilities, Toiya said, adding that previous contracts with hotels to provide hundreds of additional rooms for Covid patients have lapsed.

He cited conversations with state Department of Health officials about the lack of the effectiveness of publicly funded isolation rooms, which require not only space but staff to provide transportation and patient support.

“As the delta surge was emerging we really had deep discussions about where do we go with this program,” he said. “It doesn’t really work all that well for most populations.”

The exception, he said, is people who live in congregate facilities like homeless shelters. Last year, former Mayor Kirk Caldwell, frustrated at the time with how the state was handling the pandemic, secured hundreds of isolation rooms for Covid patients.

Toiya, who led the emergency management department under Caldwell, said one difference was the availability of federal funds.

“We were flush with CARES Act dollars and we were able to take a lot more chances and take a lot of financial risks and respond even more aggressively than we are now,” he said.

Less federal money is available this year, and Toiya said the city is now supporting the Department of Health’s efforts to expand isolation and quarantine rooms rather than taking the lead.

“Ultimately we see this as a Department of Health function and we provide as much funding as we can,” he said.

Letting DOH Lead

Toiya said he understands that even with limiting access to isolation facilities to only patients from congregate living situations, there’s still a need for more units.

“We haven’t just thrown up our hands,” he said. “We do recognize the need for more.”

Kauhane also wishes for more support for the state’s CARES line, which last year helped place patients in isolation rooms quickly.

Last year, the Health Department encouraged people who needed to isolate to call the 24/7 phone number. Now, the Health Department is discouraging the general public from calling with Covid questions.

The resolution noted that Hawaii has the largest average household size in the nation and said there’s still $10 million in untapped federal money available for pandemic help.

“We were able to do it during the first wave and we saw how many people utilized the service,” Kauhane said of the quarantine rooms. “I think it’s naive to think that we don’t need the same resources now, if not more.”