According to the Merriam-Webster dictionary, resiliency is defined as the ability of something to return to its original size and shape, and as we begin to define Hawaii’s resiliency we must clearly understand what we’ve been through and why.

The impact of the COVID-19 pandemic was of a size and magnitude never seen or felt before in modern times. For most folks, getting back to how things were sounds very good. We wonder if, because of our shared experience, we all feel this way to some degree: that getting back to how things were is good enough.

As the pandemic unfolded, cracks within the public health system, hiding beneath the surface unnoticed, began to manifest in ways we were unprepared for. It also became increasingly clear that our poorest communities were being impacted most.

Frontline health care providers closest to the pandemic struggled to gain access to lifesaving personal protective equipment. Basic medical supplies were suddenly scarce and rationed. Ongoing confusion and conflict among leaders was on display.

People get outside for fresh air and exercise with face masks at Magic Island in Honolulu, HI, Saturday, April 25, 2020. (Ronen Zilberman photo Civil Beat)
People get outside for fresh air and exercise with face masks at Magic Island on May 11. COVID-19 is a clarion call to overhaul Hawaii’s health care infrastructure. Ronen Zilberman/Civil Beat/2020

There was a maddening rush to determine how, exactly, to tweak regulations to enable providers to adequately respond to the pandemic.

Hawaii’s Community Health Centers are on the frontline of the pandemic response, and care for over 160,000 people on all islands, making them the second-largest provider of primary care and an essential tool of prevention.

They offer comprehensive services to anyone, including those who lose their health insurance due to job loss, and have provided a wide array of medical, dental, and social services to communities across our state for more than thirty years.

Yet, during a major health crisis, the important role of community health centers was dismissed.

Stewards Of Communities

Despite the cracks in the system, CHCs worked diligently to partner with community organizations and other nonprofits to ensure that patients continued to have access to medical services, and were at the forefront of efforts to provide meals to keiki and kupuna, as well as drive-through testing sites across the islands.

We are forever grateful to the many volunteers who sewed masks for providers, to the businesses who pivoted to manufacturing face shields, and to the community organizations that found ways to obtain PPE for our providers.

As stewards of our communities, we have long advocated for a more holistic, integrated approach to policy, which recognizes that the social determinants of health — where a person lives, what kind of education they receive, what access to social supports they have — create lasting effects on the strength and resiliency of our islands, particularly neighbor island and rural areas.

Supporting essential providers like health care centers will heal our communities upstream, long before the problems become too large to manage. The time to strengthen our public health system, to better prepare our entire state for the next wave of the pandemic, is now.

As we plan to reopen the state and recover from the economic disaster wrought by the pandemic, we must do a better job of ensuring that local supplies of PPE are immediately available for providers across all communities.

We must invest in our infrastructure so that residents in communities across the state don’t die simply because they are too poor to have a computer, smartphone, or broadband internet that allows them to access tele-health. We must resist the temptation to roll back tele-health regulations to pre-emergency levels, because as we see from the global data, this won’t end anytime soon.

Finally, we must ensure that access to rapid, broad-based testing is widely available in all communities across the state as tourists begin arriving again from all over the world, potentially seeding new infection hotspots.

We must do a better job of ensuring that local supplies of PPE are immediately available.

We’ve all witnessed what’s possible when our people and communities work together, when we recognize that both our fragility and our strength rest in our interconnectedness.

Thankfully, we avoided a cataclysmic meltdown of our health care system, but it also came at great social and financial cost. We may not be as fortunate the next time. Our resiliency will depend on our ability to leave our silos, put zip codes aside, and work together toward a better Hawaii, not just aim for good enough.

We encourage government and business leaders planning the state’s recovery to come together and make the smart, strategic decisions that strengthen our essential primary health care infrastructure, ensuring that our response to the next crisis is decisive as well as inclusive.

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