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Column: A plan to defeat COVID-19 in Hawaii — and we must deploy it now

JAMM AQUINO / JAQUINO@STARADVERTISER.COM
                                A family listens to instructions on a self-administered COVID-19 test in their vehicle during the first day of COVID-19 testing put on by the city on Aug. 26 in Kaneohe.
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JAMM AQUINO / JAQUINO@STARADVERTISER.COM

A family listens to instructions on a self-administered COVID-19 test in their vehicle during the first day of COVID-19 testing put on by the city on Aug. 26 in Kaneohe.

We must defeat COVID in Hawaii, and we must do it now.

For the sake of our vulnerable kupuna who face its lethal threat, for our loved ones with underlying health conditions who may not know they are at risk, for our patients with other medical emergencies who will need life-saving beds in our hospitals, for Hawaii’s children who need the education and socialization our schools provide, and for the economic health of our state, we have no choice — we must stop the spread of coronavirus now.

For five months this year from February through June, Hawaii’s COVID response was seen as a success around the world. Our geographic isolation, a 99% reduction in travelers to our state, and a statewide stay-at-home order resulted in almost no spread of the virus, but at great economic and social sacrifice by our people. During those 150 days, we had a total of 926 coronavirus cases and 18 fatalities, both the lowest in the nation.

Our apparent success started to crumble around July 4, after our local economy reopened and people began gathering in large numbers again with the belief that the threat was over. Over the next 30 days, Hawaii’s cases more than doubled to 2,200 and by Sept. 1, COVID had exploded to a total of 8,653 cases, with 5,945 active cases and 70 deaths.

Hawaii now faces a COVID crisis that threatens the health and safety of our people and the future of our economy.

This crisis has happened for two primary reasons:

1) As a society, we failed to protect ourselves adequately by consistently wearing masks and socially distancing to prevent virus spread; and

2) The leadership at the Department of Health failed to build effective COVID testing and contact tracing capacity to monitor and contain new outbreaks. These two failures have cost us enormously, both in terms of unnecessary human suffering and loss of life, and in economic losses, which may ultimately total over $2 billion.

In order to stop the spread of COVID, prevent unnecessary deaths, and begin to restore our economy, we must take the following steps now, putting them into effect immediately during the current stay-at-home order:

>> Everyone in Hawaii must wear a mask over their nose and mouth at all times when not at home, with clear and consistent enforcement of masking along with responsible social distancing in all public places and other effective hygienic measures.

>> As quickly as possible, we must increase our statewide testing capacity to 10,000 tests per day so we can see spikes in COVID spread before they get out of control, and we can aggressively and proactively test all symptomatic people, high-risk groups that have seen spikes in infection rates, those in high risk professions such as health-care workers, and every close contact of those who have tested positive, followed by quickly isolating every infected person until they recover.

>> Hawaii must immediately employ 500 full-time contact tracers and implement a rapid, thorough and comprehensive program of tracing and testing everyone who has come in contact with someone who has tested positive for COVID, using every available resource and technology to support, coordinate and strengthen an effective tracing effort.

>> We must increase hospital staffing statewide by at least 300 nurses and 100 beds for COVID this month, and prepare to launch our 150 emergency mobile hospital beds, staffing them with a mix of National Guard and private sector health-care professionals.

>> We must be publicly transparent with COVID data, publishing updated and accurate information to the people of Hawaii daily, including the number and location of cases, number of people tested and contacts traced, number of people in quarantine, and number of new cases. This will ensure that our COVID response is accountable to the people for protecting and informing them, and for producing the results and success we must achieve.

If we implement this plan immediately, we can quickly slow the spread of the virus and identify outbreaks as they occur so we can fight it even more effectively. It will also allow us to avoid future lockdowns with their painful social and economic consequences, so we can focus on other important public decisions, such as how to safely reopen our schools and restore our economy.

If we can limit new COVID cases to under 150 per day by implementing these measures, Hawaii’s hospitals will continue to function well and provide the level of care we need. This number translates to 4,500 cases and 500 hospitalizations per month, which our health-care system and our economy can sustain without collapsing. The better we do at prevention of virus spread, comprehensive testing and thorough contact tracing, the fewer cases we will have.

Schools could then open as planned after fall break at the end of the first quarter, on Oct. 13. Parents with children could return to work. We could provide rapid tests and appropriate protection our students and teachers need to attend school safely, which we will be able to fund through the CARES Act.

We could also resume safe outdoor activity and exercise if we practice consistent, society-wide masking and social distancing, and if we all remain committed to practicing and enforcing these safety measures.

Travel from the mainland with a negative COVID pre-test could begin by Oct. 1, to help restore our economy by the end of the year and prevent high unemployment during the holidays. Opening to travel and restoring a measure of normal economic activity are being done safely by governments around the world with successful COVID policies and, if we implement the plan outlined here, we can do it in Hawaii.

From now until the end of the year, the state must fund all legitimate requests for unemployment benefits, and do everything possible to prevent evictions of those affected by the economic crisis. Small business grants should be expedited to prevent further closures, and all health-care needs should be funded through the end of the year, otherwise we will lose these federal CARE Act funds. We can and must help families and small business survive this crisis.

This plan includes the only measures that we know for sure will stop the spread of COVID: an initial stay-at-home order, universal masking, social distancing, effective hygienic measures, and an effective program of testing, tracing, and isolating of positive cases with public accountability and transparency. Every government on Earth that has been successful in controlling the spread of COVID has used a combination of these measures in a coordinated, society-wide effort.

This is the way forward for Hawaii, through the COVID crisis and to the daylight on the other side — with our people spared the worst ravages of the virus, our social fabric and our values intact, and our economy still able to recover relatively quickly after the pandemic ends.

There is simply too much at stake for us to fail to learn from our mistakes or repeat them, to hesitate and not act swiftly with all of our strength and resources, or worst of all, to surrender in our fight against the coronavirus.

We must defeat COVID in Hawaii now.

I know that we can, and I have faith that we will.


Josh Green, M.D., is lieutenant governor of Hawaii.


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