We have watched daily the sadness of COVID-19 at the Yukie Okutsu Veterans Home in Hilo. Many have wondered how could so many of the home’s residents be affected quickly and die in such large numbers.

Following COVID-19 news across the country, looking at the number of nursing home and senior care communities with outbreaks and large number of deaths, there was no doubt Hawaii’s senior communities would be just as vulnerable. Could our facilities have been better prepared, and what preparation can be done going forward?

Over my years in long-term care administration, I understand major infectious diseases such as SARS, H1N1, avian flu, annual influenza and norovirus. Yet, with COVID-19, our community’s response needs to be unlike all others due to the rapid worldwide spread of the contagion.

Little has been shared from our government officials and departments, as well as the facilities, on how senior-care residents and family members have been doing for the past six months.

No visitors, not seeing a loved one and only in-person communication with staff, have left many depressed.

For kupuna with Alzheimer’s disease and other dementias, cognition can be further complicated. What was previously stated as “this is a marathon,” is really not a marathon, because in a marathon, there is an end in sight.

COVID-19 is a worldwide pandemic. It is a disaster.

We have seen the Federal Emergency Management Agency (FEMA) support Hawaii recently. Under the leadership of Maj. Gen. Kenneth Hara (no relation), director of the Hawaii Emergency Management Agency (HI-EMA), we have seen National Guard men and women deployed to support our communities in a variety of ways. In other disasters, such as a hurricane, flooding or earthquake, HI-EMA responds as stated in its mission statement, “prepare for, respond to, and recover … ”

HI-EMA can apply the same mission principles to the COVID-19 response as soon as a single case arises in a nursing home or senior-care community, to assure the strongest infection control policies, procedures and practices are in place 24/7.

Its medics, nurses and physicians can augment care and assure all, especially the public, that the kupuna and staff are of importance.

HI-EMA can work in coordination with the facility’s own disaster preparedness plan and utilize the Incident Command System for solid response.

Okutsu Veterans Home’s management company, Avalon Health Care, based in Utah, was not reassuring with its textbook response and lack of aloha.

The Hawaii Department of Health’s Office of Healthcare Assurance can respond to these COVID-19 incidents immediately, conduct an inspection and, if necessary per federal nursing home regulations, direct management of care if warranted.

Hawaii County Mayor Harry Kim’s request for help was responded to with, “We will be there soon.” The response could have been with more malama.

As we enter the next six months of the pandemic, every senior-care facilities’ quality assurance teams can identify more “thinking out of the box” approaches to care to address the psycho-social needs of residents and family members.

Nurses, nurses’ aides, social workers and geriatric-medicine physicians can gather virtually and develop the ideas to improve care and activities for Hawaii’s vulnerable kupuna living in nursing homes, assisted living facilities, adult resident care homes and foster care homes.

The ongoing trauma to kupuna from COVID-19 needs to be addressed collectively. Life is precious.

Calvin M. Hara, of Kaimuki, is a licensed nursing home administra-tor with 30 years of long-term care experience in California and Hawaii; he volunteers with the Alzheimer’s Association Hawaii Chapter.