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Covid-19 Live Updates: Hawaii Struggles With Oxygen Shortage During Surge

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Outside the emergency room at The Queen’s Medical Center in Honolulu last week.
Credit…Caleb Jones/Associated Press

The authorities in Hawaii are struggling to transport tanks of oxygen from the mainland as the state’s hospitals grow increasingly strained by new coronavirus infections.

Medical authorities are asking people to postpone elective surgeries and the state’s 223 I.C.U. beds have dwindled to 16 available, said Hilton R. Raethel, the president and chief executive of the Healthcare Association of Hawaii.

“The most critical point for Hawaii that we’ve experienced during this entire pandemic is right now,” he said.

Since July 1, Hawaii has been battling its highest surge in virus infections and hospitalizations, with the seven-day average of reported cases reaching 884 on Tuesday, according to a New York Times database. The seven-day hospitalization average peaked at 427 on Monday. Health experts say the surge is driven by the highly contagious Delta variant and low vaccination rates.

Though Hawaii has seen droves of tourists coming to the islands — so many that the state’s governor last week asked them to stay away — Mr. Raethel said that around 95 percent of hospitalized patients are unvaccinated residents, not tourists.

These hospitalized patients are also largely the reason for a huge surge in requests for medical oxygen. The demand is up 250 percent since August began, the association said in a statement. The state authorities turned to the mainland for help, but encountered challenges.

An international shortage has limited the number of liquid oxygen tanks that the state can order, Mr. Raethel said. It also takes up to a month to ship the tanks in boats across the Pacific. (Liquid oxygen is highly flammable and dangerous to transport by plane.)

“If New York runs out of oxygen, you ship it in from New Jersey or put it on a truck,” he said. “Even Alaska can drive it across the border from Canada or Washington.”

The state currently has 10 tanks, Mr. Raethel said, and each carries up to 3,500 gallons of liquid oxygen.

The state authorities have requested assistance from the Federal Emergency Management Agency, U.S. Department of Health and Human Services and other agencies as it tries to increase its oxygen supply, the association said.

Mr. Raethel said he believes the state will weather the crisis without running out of oxygen. In addition to canceling elective surgeries, FEMA has approved the purchase of three oxygen generators, the authorities have asked shipping companies to speed up deliveries and the state has identified a few tanks that can carry liquid oxygen instead of other gases.

“Living in Hawaii is wonderful when things are going well,” he said. “But it’s really challenging when you have logistical concerns.”

In hospitals, I.C.U.s are equipped with specialized equipment and trained staff who can treat critically ill patients. Experts say maintaining existing standards of care for the sickest patients may be difficult or impossible at hospitals with more than 95 percent I.C.U. occupancy, and throughout the pandemic, hospitals have been forced to improvise solutions when I.C.U. space and staffing have dwindled.

President Biden during a tour of a Pfizer manufacturing site, in February, in Kalamazoo, Mich.
Credit…Doug Mills/The New York Times

The White House, under pressure to do more to address the global coronavirus pandemic, announced Thursday that it will invest nearly $3 billion to ramp up domestic production of critical vaccine components as part of President Biden’s push to make the United States the “arsenal of vaccines for the world.”

The money, $2.7 billion, will go to firms doing business in the United States that make supplies necessary for vaccine production, including lipids, bioreactor bags, tubing, needles and syringes, officials said. It will come from funds appropriated by Congress through the American Rescue Plan, the $1.9 trillion economic stimulus package Mr. Biden signed into law in March.

“This new investment will further expand domestic vaccine manufacturing capacity, helping the U.S. deliver on its commitment to be the arsenal of vaccines for the world and preparing America for future vaccination efforts,” said Jeffrey D. Zients, Mr. Biden’s coronavirus response coordinator, who announced the effort during a briefing with reporters.

Details, however, were scant. The Department of Health and Human Services is in the “final stages” of awarding contracts for the work, and will make announcements in the coming weeks, according to a White House official who was not authorized to speak publicly about the investment. Neither the official or Mr. Zients could provide an estimate of how many doses the investment would yield.

But Mr. Zients said that investing in the supply chain would also “create thousands of good paying American jobs.”

Mr. Biden has already either donated or pledged about 600 million vaccine doses to other countries — a small fraction of the 11 billion that experts say are needed to slow the spread of the virus worldwide. His administration has also taken steps to expand coronavirus vaccine manufacturing in the United States and India, and is supporting production in South Africa and Senegal to expand access to locally produced vaccines in Africa.

But the president has come under increasing criticism in recent weeks from global health advocates and experts who say he is nowhere near fulfilling his “arsenal” promise. Their outrage grew after the administration announced last month that it was recommending booster doses for all Americans — even before the Food and Drug Administration has had a chance to weigh in on whether such doses are necessary.

Worldwide, 81 percent of shots that have been administered have been in high- and upper-middle-income countries, according to the Our World in Data project at the University of Oxford. Only 0.4 percent of doses have been administered in low-income countries.

Activists have been calling for the Biden administration to ramp up vaccine manufacturing around the world as well as in the United States. They also want the administration to press major vaccine makers to share their recipes and technical know-how with other companies — a process known as “tech transfer,” which Thursday’s announcement did not address.

“Major investments in urgent vaccine manufacturing are desperately needed, and after today’s announcement, still far more is needed to make the billions of doses lacking to end the pandemic,” said Peter Maybarduk of the consumer advocacy group Public Citizen, which has proposed a $25 billion investment to retrofit manufacturing facilities around the world, with the goal of making 8 billion doses of mRNA vaccine in one year.

Congress put a total of $16.05 billion in the American Rescue Plan this year, in two separate tranches, that could be used to procure and manufacture treatments,…

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