As the economic burden of the coronavirus shutdown grows unbearable, Hawaii, like other states, has begun looking for ways to reopen for business.

The process is fraught with risk. In the absence of a vaccine or effective treatments, prematurely lifting social distancing and stay-at-home orders could trigger a resurgence of the virus in our communities, with devastating consequences.

Health experts generally agree that one key to a safe (meaning gradual) lifting of restrictions lies in the ability to quickly, effectively identify and treat cases as they arise, to ensure the virus doesn’t come roaring back.

It starts with a solid flow of data. Like many states, Hawaii is not there yet. The state needs to build up its testing capability, contact tracing and sentinel surveillance programs to provide a more reliable picture of the virus’ spread statewide.

Down the road, certified antibody tests can be used expansively, with rapid results, to identify people already exposed to the virus so may have immunity.

On the positive side, the number of new cases seems to be stabilizing even as the number of tests has risen. The longer the trend holds, “the more reassured I am that we’re not missing cases,” said Bruce Anderson, the state’s health director.

Still, it can take a week or more to get tests results from the mainland, and rapid response is critical. Hawaii needs to cut the lag time by increasing its ability to test samples locally.

Anderson said that in the early days of the outbreak, most of the cases were related to travel, and that Gov. David Ige’s 14-day quarantine on incoming travelers “has been huge for us” in flattening the curve. The number of cases is manageable, fortunately, and hospitals are not overwhelmed with COVID-19 patients.

But now locally transmitted cases are the focus, and while community spread seems to be low — thanks to those strict stay-at-home orders and closed businesses — not everyone with symptoms is being tested, so there are still unknowns.

One way to reach more at-risk people efficiently is through extensive contact tracing. Investigators track down and gather information from those who came into close contact to an infected person while he or she was contagious. Those contacts are advised to self-quarantine for 14 days and are monitored for signs of coronavirus infection.

This is a crucial but labor-intensive process. Anderson said the state Health Department has about 30 volunteers — student nurses and others with some medical training — who are making the calls. But it’s not sustainable; Anderson wants eventually to hire as many as 50 specially trained people to increase the department’s ability to track the coronavirus and other infectious diseases.

It would be a good investment for the future.

“Some think (the virus) will burn itself out,” Anderson said. “I don’t see that happening. It’s something we’ll need to live with for many years.”

Anderson also said the Health Department wants to expand sentinel surveillance, the process of testing a representative sampling of specimens from people with respiratory symptoms who tested negative for influenza. Between March 1 and April 4, the department tested 925 specimens; 17 were positive for COVID-19.

Pressure on states to reopen is building. President Donald Trump on Thursday released “a phased and deliberate approach” for states to follow in restoring normal activity. The guidelines call for a drop in cases for 14 days, a standard Hawaii has not yet met. When we reach that threshold — and we will — we must be able to trust the numbers.

Anderson said that even when we can go out again, we’ll need to to keep some of our physical distancing habits, whether in a restaurant or social gathering. The virus will still be lurking out there.

“But if our health care system is sound,” he said, “we can certainly live with it.”