Hawaii’s top state health official, who has been widely criticized for his failure to keep COVID-19 infections under control, is leaving his post, along with the head of the state’s prison system, the scene of one of the largest outbreaks of the disease.

State Health Director Bruce Anderson and Public Safety Department Director Nolan Espinda are out as frustration mounts over the state’s handling of the pandemic.

Anderson has been under attack for failing to build up the state’s COVID-19 testing resources and its contact tracing capability. He was criticized for withholding, or not collecting, information on positive cases that could help the public understand how the disease is spreading.

Anderson’s departure “is probably a good start, for no other reason than to restore public confidence,” said Ray Vara, president and CEO of Hawaii Pacific Health. “But we also know that it goes deeper than that.

“It’s a cultural issue. It’s a culture of leadership. It’s a culture of action orientation. It’s a culture of accountability, and it’s a culture of (lack of) transparency. Unless we see significant change in that entire culture beyond just individuals providing leadership, I think we’re still going to struggle. So we’ll continue to press that issue, continue to call for those immediate changes.”

U.S. Rep. Tulsi Gabbard first called for Anderson’s resignation on April 8, saying he was “putting the lives of ourselves and our loved ones in grave danger … by failing to take necessary actions to protect us from coronavirus. Latest example is their continued refusal to carry out most basic and effective policies to prevent spread of coronavirus: contact tracing, testing and isolation.”

Gabbard renewed her call for Anderson to leave on Aug. 11, telling Gov. David Ige, “Your health director is keeping hundreds of trained contact tracers ‘on the bench’ because he doesn’t think they’re needed. Meanwhile, we have the highest infection rate in the nation. This is gross negligence.”

Ige said during a media briefing Monday that he did not “lose confidence” in Anderson and Espinda.

“I did not approach them. They did come and talk to me about retirement and I accepted their retirements,” Ige said.

The exits of Anderson and Espinda followed the departures of the heads of three other state departments since July — Tax, Human Services and Labor and Industrial Relations.

Dr. Libby Char, an emergency room physician, has been appointed as interim director of the state Department of Health effective Sept. 16, following Anderson’s Sept. 15 retirement.

Espinda’s retirement is effective Oct. 1.

Ige announced that Maria Cook, the DPS deputy director for administration, will be temporarily assigned and has been granted signatory authority while Espinda is on personal leave through September. Ige said he will announce an interim appointment to lead the department in the coming weeks.

Last week, the United Public Workers union called for Espinda’s immediate removal, citing “months of inaction by the state” to stop the spread of COVID-19 at Oahu Community Correctional Center.

UPW was joined by the Hawaii Government Employees Association, which called for an immediate leadership change, along with safety protocol improvements at OCCC, the Honolulu District Court Cellblock, Hawaii Paroling Authority and Daniel K. Inouye International Airport.

On Monday, OCCC was reporting 81 active inmate cases and 49 active staff cases. So far, 208 inmates and 14 staff members have recovered.

The outbreak got so bad that the Hawaii Supreme Court ordered the release of certain inmates and detainees — a move that’s been unpopular with community critics who thought the step could have been avoided if Espinda had been more proactive.

HGEA also had been among the critics calling for changes at the Health Department. The union filed a grievance in early August alleging that there were are only 15 epidemiological specialists on Oahu and three on the neighbor islands to perform contact tracing for thousands of potential COVID-19 cases.

National recommendations vary, but based on population, some experts have estimated that Hawaii should have between 420 and 564 contact tracers responding to the pandemic.

Lt. Gov. Josh Green said he was pleased with Char’s selection.

“She’s good. I tried to hire her when I became lieutenant governor for my team,” Green said. “She’s very smart and very stoic.”

Other Hawaii health care providers and politicians also are supporting the change.

Dr. Jonathan Dworkin, an infectious diseases doctor who has been highly critical of DOH’s COVID-19 response, said, “Dr. Char would be a good choice for a bigger role. She’s bright, she’s ethical, and she’s no-nonsense.”

“We are experiencing a major leadership failure at the state level now. We actually have the resources to implement a competent public health response in Hawaii, but we have chosen not to,” Dworkin said. “To fix that we need to clear a lot of bureaucratic driftwood. We need to hold people accountable for outcomes, and in particular for building a better integrated system of test-trace-quarantine. There’s no way that’s going to happen without leadership changes.”

Rep. John M. Mizuno, chair of the House Health Committee, said DOH’s credibility was hurt because it did not set up robust COVID-19 testing or an adequate contact tracing program.

“If the Department implemented these two points, we would have contained the virus and Hawaii would only have double digits reported daily of new COVID-19 cases, not the hundreds we have today,” Mizuno said in a statement. “Moving forward if interim Director Libby Char and the department can collaborate with the Legislature, the National Guard, the county mayors, the medical community, and the Department of Transportation (COVID-19 screening) and be extremely transparent and honest to the public, then I think the changing of the guard will be good for Hawaii.”

Sen. Rosalyn Baker, head of the Senate Committee on Commerce, Consumer Protection, and Health, said she’s confident that Ige made the right decision in choosing Char.

“Dr. Char understands the importance of collaboration, funding of essential services, and the necessity to maintain our critical health care infrastructure throughout the entire state,” Baker said. “She also has the experience needed to help hospitals, care facilities and community health centers work together to carry out the state’s COVID-19 response efforts.”

Char graduated from the University of Hawaii at Manoa John A. Burns School of Medicine.

After a residency in California, she returned to Hawaii, where she joined the clinical practice of emergency medicine at The Queen’s Medical Center. She’s previously served as the state EMS District Medical Director for Oahu. She still provides medical direction for several EMS, fire and ocean safety agencies statewide and is the chairwoman of the state’s EMS Advisory Committee.

Star-Advertiser reporter Dan Nakaso contributed to this story.