The lieutenant governor wants more healthcare resources, not rationed supplies


Hawaii Lt. Gov. Josh Green urges the federal government to help states avoid medical care rationing during the pandemic – a policy that has preoccupied many older adults and their families.

Green, also an emergency doctor on the island of Hawaii, said he was encouraged that the state’s hospital admissions numbers are declining but is concerned about the “Crisis Standards of Care: Triage Allocation Framework,” updated by the Hawaiian Department of Health last week.

If an increase in hospitalized critical patients led to a prioritization of medical care, the crisis care standards could be implemented.

“What I know is that they put it together – they are great people – but they put it together at a very different time than when we faced a different scenario,” said Green. “First of all, we’ve now vaccinated a lot more of our people and have an opportunity to stop the virus from spreading.”

Green said Hawaii also has the ability to expand medical services with mobile hospitals, increase medical staff, and use monoclonal antibodies that were not available when the framework was first released in August 2020.

“All of these different scenarios make it possible for us now to get far, far away from rationing supplies. I think it’s as bad as an idea that you can only imagine right now, “he told Hawaii Public Radio.

According to the document, a patient’s age is only a factor in a “tie-break” situation, not a primary criterion.

“Evidence from several countries, including the US, shows that age> 65 is an indicator of a poor prognosis for COVID-19 patients,” read the crisis standards of care. “If the triage score is the same between two people, the Triage Officer / Review Committee should consider that a patient over 65 who is also COVID positive is less likely to benefit from the scarce resource.”

Hawaii’s COVID-19 positivity rate is 5.8%, much lower than the 25% in Idaho, where hospitals are overcrowded, Green said.

“I know that they played out worst-case scenarios. But we are 30% below our high, we were hospitalized at 448 on September 3rd, yesterday morning we are at 327, and this morning we are silent. “he said.” So there is no reason in the world to invoke this crisis standard of due diligence, not only because it scares people but could also have other consequences. “

Green said he reached out to the U.S. surgeon general this weekend for more assistance.

“I ask the surgeon, President Biden, to consider assisting any state that would otherwise consider rationing supplies to save,” he said. “I think they should go to places like Texas and Idaho and Alabama and South Carolina and they should provide additional services, additional nurses, additional facilities, and whatever resources necessary to keep people alive because I think that is about it would help unite the country. “

Last week, the Hawaii AARP executive director said she appreciated the state preparing for a worst-case scenario by updating the triage allocation framework, but she also had concerns.

“The truth is that people can have many different prejudices. We are all human. And we believe that age shouldn’t be one of them, ”Lopez told HPR The Conversation. “The federal government recently issued some of its guidelines – so we hope the Ministry of Health will investigate this – saying that age shouldn’t matter.”

Read the updated Hawaii Crisis Standards of Care: Triage Allocation Framework in the box below or click here.

This interview aired on The Conversation on September 20, 2021.

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