Tough Decisions Need Better Data And Inclusive Voices


About the Authors

Victoria Fan

Victoria Fan, ScD is faculty at the University of Hawaii Manoa and a member of the Hawaii Pandemic Applied Modeling Work Group, a voluntary brain trust to help confront the challenges of COVID-19 via the use of data and models.

Nick Redding

Nick Redding Ph.D. is executive director of the Hawaii Data Collaborative. He is a member of the Hawaii Pandemic Applied Modeling Work Group, a voluntary brain trust to help confront the challenges of COVID-19 via the use of data and models.


Writer Laurie Garrett once wrote, “Public health is a negative. When it is at its best, nothing happens: There are no epidemics.”

Public health advocates have long been faced with a communication challenge – how can we communicate the seriousness of acting when “nothing happens”?

COVID-19 was temporarily subdued by the decisive action of Gov. David Ige to shut down the state and restrict inbound travelers with a 14-day quarantine. After three months, Hawaii briefly returned to this stage of “nothing happening” with only a handful of cases each day.

That is, of course, before the most recent spike. Something appears to be happening.

Meanwhile, our tourist-dependent economy has been devastated, our state is in dire financial straits. The lines for unemployment services, food, health insurance, mental health services, and all kinds of assistance stretch on. People are suffering.

Volunteers were kept busy performing COVID-19 testing at the Waipi'o Peninsula Soccer Complex Saturday, June 27, 2020. Dr. Scott Miskovich continues to lead the Premier Medical Group Hawaiʻi in COVID testing as the State is experiencing a recent rise in positive cases. (Ronen Zilberman photo Civil Beat)

As a community, we know better than others who we are and what we do. While we seek support from outside the state, only we can make the best decisions for ourselves.

Ronen Zilberman/Civil Beat

Let’s be clear. This state had no other choice but to go with the mass shutdown and quarantine measures because cases were skyrocketing back in March. At a wildfire spread, our hospitals could have been overwhelmed with cases. Fortunately, we live in an island state where shutdown lends to a natural extinguishing of the virus.

Now, we again face a critical juncture. What should the state do in light of the recent spikes of double-digit cases? How quickly should the state lift the shutdown measures? Are we adequately reinforcing our most important tool in our Epidemic Prevention Toolkit: Testing-Contact Tracing-Quarantine strategy?

This latter strategy is what Taiwan has called its “precision” epidemic prevention tool – as opposed to a medieval “mass shutdown” tool, effective but painfully costly to our state. Will our state avoid another shutdown? What are the trade offs between COVID-19 care and other health care, between human lives and economic recovery?

These kinds of questions prompted us to form the Hawaii Pandemic Applied Modeling (HiPAM) Work Group. We are a group of applied epidemiologists, data scientists, and health professionals who want to help the state tackle these tough questions – which have only bad or worse outcomes, no good ones.

We face a new virus and our understanding of its biological features is constantly changing. No one expert or authority can presume to have complete expertise. We must draw on a broad base of thoughts and ideas but also thoughtfully use “data” and “evidence” in the face of many known unknowns and unknown unknowns.

As a community, we know better than others who we are and what we do. While we seek support from outside the state, only we can make the best decisions for ourselves. To do that, we need to come together in an inclusive and unified way – bringing everyone to the table and channeling our collective knowledge and mana‘o. Such an approach creates transparency and accountability, one that can be strengthened with mutual gratitude, respect, and trust.

We cannot dismiss others’ knowledge. We must welcome and include other voices to the table in order to be more effective.


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About the Authors

Victoria Fan

Victoria Fan, ScD is faculty at the University of Hawaii Manoa and a member of the Hawaii Pandemic Applied Modeling Work Group, a voluntary brain trust to help confront the challenges of COVID-19 via the use of data and models.

Nick Redding

Nick Redding Ph.D. is executive director of the Hawaii Data Collaborative. He is a member of the Hawaii Pandemic Applied Modeling Work Group, a voluntary brain trust to help confront the challenges of COVID-19 via the use of data and models.


Latest Comments (0)

While it's good to have these groups that have cross-subject participants, they have to be willing to include input of the public, or they will just be talking to themselves.  Yes, they don't like to do it.  But when you include the public (and not just public meetings, which only seem to bring out the loudest), you can hear their questions and know where you might have to tweak your information to make it easier to be understood beyond the "science bubble." Doing public outreach should be an element of every government worker job description, because the importance of communication is so important but sadly, very lacking. Hawaii has really paid the price and will continue to do so unless something changes. Really, it's not that hard.

fiona · 1 week ago

I totally support more, rather than less, data & analysis w/ this state of things we find ourselves in.The title of the article as a hook for readers seems intriguing; it made me click on it. But the same phrasing and lack of context was still missing. Yes, there was a spike. Of course there would be. And there will be even bigger spikes in the future. We all know this.What we don't get is context. Were the recent "cases" actual cases, or were they as a result of testing that was started weeks ago and only now the results have been returned? Did any of the cases result in "sick" or "death" or admission to hospitals? Kind of important to know in order to get closer to a "true" read on the data. Were any of the "cases" deemed as a "case" because of the new categorization of infection? I think probably so. There are reports that people going to the hospital for some other reason were tested and now are considered a "case"...but went in for a broken finger.

Ranger_MC · 1 week ago

Great idea that multiple disciplines can have a discussion of the merits, trade-offs, and risks of the various choices in dealing with the situation.  The past extreme shut down is not long sustainable in economic terms, nor is unrestricted activity sustainable in health care resources.  We desperately need some middle choice.  May I suggest addition of economists such as UHERO to provide insight to the economic impact of choices.

B_Skelton · 1 week ago

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