Hawaii has the highest number of Pacific Islanders per capita in the nation, but the state’s outreach efforts have been ineffective in helping curb the spread of the coronavirus, a doctor who serves the community said.

Pacific Islanders have been hardest hit by COVID-19 among island residents, contracting the virus out of proportion to their numbers in the overall population, Hawaii Public Radio reported Thursday.

Clusters in the community broke out as early as May, including in public housing projects where residents live in tight quarters.

Dr. David Derauf, executive director of Kokua Kalihi Valley Comprehensive Family Services, said there has been a lack of virus services directed toward Pacific Islanders.

Some messages disseminated by the state Department of Health also were not relevant to many people in the Pacific Islander community, Derauf said.

He cited advice from health officials to isolate at home in one’s own space with a private bathroom if possible.

“I think we all know what a luxury that is to have a private bedroom and bathroom, particularly for many of the communities we’re talking about here,” Derauf said.

Advocating to have more people in the community tested is difficult when there are is no support system in place afterward, Derauf said.

“When they find out they test positive, they don’t get so much as a phone call from someone. They’re not offered anything,” Derauf said. “All it means for them, in terms of their daily life, is a loss of income because they can’t go to work.”

Derauf stressed the need for the state to talk to Pacific Islander community leaders, determine what services are most needed and then quickly create and publicize those services.

Derauf also warned against stigmatizing the Pacific Islander community in communication campaigns and said information should be presented in the languages of the Pacific Islands, including Marshallese and Chuukese.