The outbreak of the novel coronavirus, which has spread from China to the rest of the world, demands a global, integrated response focused on vulnerable populations and containment.

We also need to develop plans right here, right now, in Hawaii. Our state faces some unusual challenges, such as our dependence on a tourism economy likely to be disrupted by the spread of the virus, and our isolation, which means we cannot depend on help from elsewhere. We may even have to reconsider, at least for now, how we express aloha.

While there are uncertainties and incomplete information on its origins, transmission, lethality, and treatments, we do know that it is highly infectious and can be life-threatening, especially for those with medical conditions or weakened immune systems. While other diseases are far more deadly, COVID-19 must be taken seriously. 

Individuals, families, and households need to take precautions to prevent illness and spread. This includes personal hygiene, sanitizing areas of potential contamination and reducing contact with sick people or those who may carry and spread the virus.

Staff at Kaiser Permanente Hawaii stage a coronavirus drill as the state gears up to deal with the outbreak. Courtesy: Kaiser Permanente/2020

Some people’s symptoms are so mild that they and those around them may not realize they are contagious. Because of the insidious nature of the disease, you should treat everyone as a potential carrier while avoiding stereotyping or discrimination.

This means reducing physical contact and promoting effective hygiene and creating germ-free spaces in which to live, work and play. Curtailing physical contact or increasing social distance may require adjustments in cultural practices and how we show aloha.

Firms and businesses need to support employees and create a culture of preparedness. This means making cleaning supplies, hand sanitizers, and other protective equipment available to workers, customers and vendors.

It means providing the necessary education, training, and support to enable all employees to practice safe behaviors. These include frequent hand-washing, encouraging people to report any symptoms or contact with those who’ve been infected, allowing workers to stay home and supporting medical treatment and hospitalization of sick employees. 

Government, at all levels, needs to be transparent in sharing data on the numbers of infected people, hospitalizations, fatalities, and efforts to monitor, track, and report on this disease.

Plan Now For Large-Scale Disruptions

We need more testing. Governments should establish clear thresholds for when to declare emergencies or implement voluntary and involuntary actions backed by public health laws, police powers, and the authority to restrict movements. These could include mandated testing and treatment and shutting down schools, businesses, government offices or transportation services, as well as calling off social and cultural events. 

We may have to encourage voluntary social distancing, curtailing non-essential activities and travel. How to do this effectively in Hawaii requires additional research and development. 

These actions will help us to build longer term resilience against future emerging infectious diseases and the many hazards and perils that threaten Hawaii.   

We need more up-to-date training.  Using the internet and communications technologies, individuals, businesses and governments can greatly reduce face-to-face contacts while still accomplishing what they need to. We should figure out how medicine, food and water will be delivered in an extreme lockdown.  And we need to consider worst-case scenarios affecting hospitals, treatment facilities, care homes and critical facilities.

An effective community-wide response requires the unfettered flow of information at all levels, from scientists to medical personnel to emergency responders to community leaders. Others also need to be part of this network, including businesses, social, cultural and religious organizations and neighborhood groups who understand our communities, vulnerabilities and assets.

As a state dependent on visitor spending for jobs, we are especially vulnerable to disruptions in tourism. We need to marshal intellectual and other resources to prepare for and effectively respond to this evolving crisis. 

Unlike other states that are part of larger continental land masses, we are isolated here in Hawaii.  We are not connected to other states by superhighways and rail lines. We lack the mutual aid, surge capacity, and supply chains to provide emergency personnel and vital goods and services. 

Moreover, because the COVID-19 virus could potentially have far-reaching impacts on the continent, other governments may not have the surplus capacity to help us out. For these reasons, we need to develop programs and partnerships now to manage the disease and its potential social and economic impacts on our community.

These actions will help us to build longer term resilience against future emerging infectious diseases and the many hazards and perils that threaten Hawaii.  

For the latest information, please consult the Hawaii Department of Health, the Centers for Disease Control and Prevention and John Hopkins University.

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