As COVID-19 vaccines became widely available through the first half of 2021, hospitals, nursing homes, prisons and jails throughout the country began reopening their facilities to in-person visitation, helping ease the isolation and loneliness that had gripped many since the start of the pandemic. But the Hawaii State Hospital, which houses mentally ill patients referred by the courts, has continued to bar visitors.

On Feb. 3, officials with the Hawaii Department of Health, which operates the hospital, told the Honolulu Star-Advertiser that once the latest surge of COVID-19 cases fueled by the omicron variant subsided, it would allow patients to reunite with family and friends. But the latest surge had plummeted by mid-February and state health officials still haven’t reopened the hospital to visitors.

On Wednesday, DOH would only say that the department’s Adult Mental Health Division is reviewing the visitation policy. “We will keep the public informed of any changes,” said DOH spokeswoman Kaitlin Arita-Chang.

Taurean Getzen, whose girlfriend has been a patient at the Hawaii State Hospital since December, said the lack of contact has been hard on his family, particularly the 14-year-old daughter he shares with his girlfriend.

“It is really messing with my daughter,” he said. “It is just sad to see my daughter the way she is because she can’t see her mama.”

He questioned how the lack of contact could be good for his girlfriend’s mental health.

While the hospital allows for video calls, Getzen said that they have been difficult to arrange with staff. Getzen said their two children have only been able to speak with their mother twice in the three and a half months since she was committed.

While state health officials have defended the no-visitation policy, saying it’s been in place to keep staff and patients safe, Sen. Jarrett Keohokalole, who chairs the Senate Health Committee and represents Kaneohe, said that continuing to bar visitors doesn’t make sense, particularly as Gov. David Ige ends his emergency proclamation and reopens the state. On Saturday, Hawaii will drop its indoor mask mandate, the last state to do so.

“If the reason for being closed is for COVID, that reason is no longer valid,” Keohokalole said.

The U.S. Centers for Disease Control and Prevention’s pandemic guidance cautions against restricting in-person visitation in detention facilities, particularly when COVID-19 cases are low, citing the harm this has on mental health.

Overcrowding

Most patients at the Hawaii State Hospital are suffering from severe mental illness and were ordered there by the courts after being charged with minor or serious crimes. Many are homeless and awaiting evaluations on whether they are fit to stand trial. The patients also have high levels of physical health problems, such as diabetes, cancer and asthma, that have put them at particular risk of severe illness during the pandemic, according to state health officials.

The state hospital has also been overcrowded for years. But the hospital was remarkably successful throughout the pandemic until the highly transmissible omicron variant caused a widespread outbreak at the beginning of the year. Relatively high vaccination rates helped protect patients against severe illness. During the surge, 78% of patients were vaccinated and 58% had received booster shots, said Run Heidelberg, the administrator at the Hawaii State Hospital, during an interview in early February.

“Everything we do is for the safety of our patients and our staff and their families,” he said when asked about the no-visitation policy. Heidelberg said there were no visiting rooms where social distancing could be implemented, while also citing liability concerns and the potential for visitors to pass on contraband to patients.

“It is definitely hard on all of us and it is definitely hard on them,” he said. “Especially this population, it is hard to say you can’t hug someone or give them a kiss. But the worst thing I would hate to see is if one of them gets really, really sick.”

Amy Curtis, chief administrator of DOH’s Adult Mental Health Division, said that the department had looked at reopening visitation several times during the pandemic only for the state to be hit by another wave of infections.

The Star-Advertiser asked to tour the hospital in early February, but DOH denied the request citing high COVID-19 transmission rates. The newspaper asked again in early March when case counts declined, but DOH has not responded to the request.

DOH spokesman Brooks Baehr at the time cautioned that COVID-19 cases could rise again.

“I know a lot of people seem to think the pandemic is over. Wouldn’t that be nice. But it is not over,” said Baehr by email. “And we’ve seen this before. We dropped to double digit daily case counts after the Delta surge only to be slammed by Omicron. We are wary about what may be lurking around the next corner.”

Building sits empty

The Hawaii State Hospital has been plagued by overcrowding, dilapidated conditions and security problems for years, prompting state officials to finally concede that the hospital was in crisis and in need of a new building. Nearly a year ago, construction was completed on a new $160 million, state-of-the-art building on the Kaneohe campus. The facility includes single rooms for patients with high-risk behavioral problems, which have their own bathrooms, large communal spaces, secure outdoor areas and rooms for counseling.

The new space would have been much safer for patients and staff to weather the pandemic, and made it easier to safely host visitors. But the facility has sat vacant for nearly half of the pandemic and state officials haven’t provided a set date on when it will open. During a tour of the new facility in May 2021, the Star-Advertiser was told it was slated to begin accepting patients in August. But that date has been pushed back as state officials say they are still trying to finalize new policies and fix potential fire and safety hazards that arose during inspections.

Keohokalole said that the delays in opening the facility are troubling and that he has scheduled a legislative hearing on the matter for Wednesday.