Across the mainland, it’s apparent that COVID-19 is particularly life-threatening in nursing homes and long-term care facilities. The virus can spread easily through enclosed settings that house residents with underlying health conditions, and where workers move from room to room.

According to a recent analysis, 11% of coronavirus cases nationwide are in these settings, along with an outsized fatality rate of roughly 35% — more than 34,000 deaths. In more than one dozen states, the category of long-term care accounts for more than half of all COVID-19 deaths.

Hawaii, fortunately, is included in a small group of states in which long-term care has so far been almost entirely spared. To date, there has been no outbreak of COVID-19 in local nursing homes, according to the state Department of Health (DOH). However, with the islands slowly reopening public life, it’s clear that risk levels tied to virus spread will rise.

In response, Hawaii must maintain and expand its stepped-up state vigilance of nursing homes and all other licensed care facilities, which have a combined capacity to support nearly 12,900 people.

For months now, the DOH’s standing guidance for facility operators — based, in part, on recommendations issued by federal agencies as well as the experience of other states — has created a social-distancing bubble by restricting visitors, limiting activities within facilities, and regularly checking health-care workers and residents for fever and other symptoms.

To avoid a puncture of the kupuna bubble, state officials must continue to work in tandem with facility operators and others to assess ongoing needs for personal protective equipment (PPE) and testing for COVID-19 infection — and prep for the possibility of a sudden surge in cases.

Moving forward, the state is right to stress measures such as steady access to masks, gloves and other supplies, given the ongoing shortage of clinically-acceptable PPE nationwide. While some small-scale care operations here scrambled to secure PPE gear when the virus threat surfaced, the state has responded with go-to supply channels now in place.

In regard to testing for infection, the DOH has so far had success with a prioritized testing approach — and has regarded the idea of establishing frequent testing of long-term care residents and workers as impractical and unwarranted. But at the nation’s Capitol, U.S. Sen. Brian Schatz (D-Hawaii) sees the matter differently.

Earlier this month, in a letter to Gov. David Ige, Schatz asserted that while Hawaii’s comparatively low count of cases is encouraging, “additional steps, including dramatically expanded testing, are necessary to continue to protect these vulnerable residents and the workers of these facilities.”

Some other states have launched new protection steps. In New York, which ranks among the hardest hit by COVID-19, there are recently issued requirements for twice-weekly testing of nursing home workers. With each step Hawaii takes toward reopening our economy, there should be another step that further safeguards public health.

Right now, conducting thousands and thousands of tests every day at long-term care facilities does seem excessive and overly invasive — especially in cases of frail kupuna residents. However, given the COVID-19 ravage on the mainland, and the health threat tied to reviving Hawaii’s community life and tourism, more needs to be done to keep the kupuna bubble intact.

Schatz has asked the governor to provide an update on strategies to prevent virus transmission, including the status of testing. Indeed, the public needs to hear about these. Among the tactics should be a plan to establish at least a low level of routine testing at these facilities, with ability to ramp up quickly should a coronavirus outbreak occur.