Pandemic planning involves isle hotels

Site conversion into makeshift hospitals may happen if more beds are needed

Health care officials in Hawaii may have to transform some hotels into makeshift hospitals to care for a surge in patients if an influenza pandemic erupts.

Doctors and nurses would pull out disposable bed sheets, hand towels, and other supplies currently being stockpiled for that worst-case, said Toby Clairmont, chairman of the emergency management committee of the Healthcare Association of Hawaii.

"Be bold, be prepared for anything. That's sort of our thinking right now," Clairmont said. An influenza pandemic is "probably not going to happen. But if it did, it would be really bad. I mean really bad," he said.

Hawaii, like other states, has been getting ready for the next influenza pandemic, which experts say could kill millions around the world and hundreds in the islands.

State officials are storing the anti-flu drug Tamiflu and practicing vaccinating elementary school children. On some islands, health care workers have held mock clinics.

Hospital contingency plans are among the most important.

There are about 3,000 beds in hospitals across the state, about 90 percent of which are occupied at any one time.

But Hawaii will likely need almost double that in a pandemic, Clairmont said, forcing doctors and nurses to turn to hotels, shopping malls and other facilities for space to treat the sick.

Hotels are particularly suited for the task because they come ready with rooms and toilets. But they're run by private companies, and already have guests staying in them, complicating their use as emergency treatment centers.

"None of them are really enthusiastic about the idea. That's probably the best way to say it," Clairmont said. "They're afraid they're going to be designated a site. And they want the risk to be evenly shared."

Clairmont stressed medical professionals would only take over hotels if the governor declared a public health emergency and invoked special powers to order such a move.

Murray Towill, president of the Hawaii Hotel & Lodging Association, said he expects hotels and public health officials to talk about the possibilities as pandemic planning progresses. To date, there hasn't been much concrete discussion, he said.

"The devil's in the details, obviously," Towill said. "And those are decisions that ultimately would have to be made by the individual companies involved."

The Healthcare Association of Hawaii, a group representing island hospitals, nursing homes, and other health care providers, has been working on surge capacity plans since the 1995 terrorist bombing of the federal building in Oklahoma City.

But the prospect of a global influenza pandemic -- something experts have grown increasingly worried about as a deadly strain of flu has killed more than a hundred people in Asia and Africa since 2003 -- has made such planning more critical.

The state Department of Health forecasts a fourth of Hawaii's population would catch the virus and need treatment in a pandemic.

Hospitals would be reserved for the most seriously ill, turning them into "big intensive-care units," Clairmont said.

Most people falling ill would be asked to stay at home and nurse themselves. Hospitals would provide advice and direction by telephone.

The association also has readied mobile tents that could be delivered to wherever the virus starts to spread.

"We don't know where the outbreak is going to start. It could start with a visitor flying in to Kona, and people starting to get sick over there," Clairmont said. "Or it could happen here on Oahu where we get so much international travel."

The largest of the tent hospitals fits 50 beds and is being stored on Oahu.

Three others that can fit 20 beds are on the neighbor islands. The association expects to receive two more by June.