From ocean-minded to COVID-19-minded community

In my dual role as an ER doctor and as president of the Kaua‘i Lifeguard Association, I have some observations and comments to share.

First, Kaua‘i has so far avoided the exponential take-off of COVID-19. It may well be premature to offer thanks to certain people for this, but I nevertheless have to start out by thanking Mayor Kawakami and District Health Officer Dr. Janet Berreman for their great, proactive leadership in guiding us Kauaians to the public-health measures that may give us a chance to not “go exponential.”

The mayor is obviously listening to Dr. Berreman and her epidemiology colleagues across the nation, and Kaua‘i is fortunate to have Dr. Berreman’s knowledge and communication skills that have allowed for this strong collaboration. Dr. Lee Evslin has been doing a nice coaching job as well.

In regards to the Wilcox Hospital ER and to Wilcox Hospital in general, I myself am an aging Wilcox ER warrior and it’s been very inspiring to see our younger doctors come forward with great knowledge and leadership. Dr. Brock Tulley and Dr. Allon Amatai were driving forces in getting the “COVID” tent set up outside the ER front entrance, and it’s here that any patients with cold symptoms (i.e. possible COVID) are evaluated. This has served to keep the “inner ER” relatively free from exposure to viruses, COVID or otherwise, and so far we have been able to treat people with heart attacks, injuries, and other non-viral illnesses in a relatively COVID-free environment. This, of course, could all change, as it has in NYC and other hospitals.

Other young ER doctors such as Dr. Ryan McMorries and our ER Department Chief Dr. Spencer Smith have done wonderful work interacting with our administrators and with other departments in order to maximize the hospital’s preparedness and continued functioning. And our wonderful nurses, clinical assistants, clerks, housekeepers, adminstrators and other ancillary staff have been, as always, the forces that keep the engine running.

So far we really haven’t been put to the “COVID-19 test,” for reasons I’ve already alluded to. If and when we are, it will be day-to day-in regards to seeing how our resources and preparedness hold up and need to be adjusted. I’m happy to be able to report that we are in good hands if worst-case scenarios do, God-forbid, start to unfold here on Kaua‘i.

In tandem with most all of Kaua‘i’s businesses large and small, the hospital’s preparedness measures have come at a massive economic cost. Wilcox Hospital and Hawai‘i Pacific Health, in canceling all elective surgeries along with taking on many other COVID-related measures, have shot themselves in the foot, or maybe even in the chest, economically. I have no understanding of how this economic beat-down will play out. My heart aches for us all, especially for our “economically vulnerable” families which have made their monthly rent payments by holding down two or even three hospitality industry-related jobs, jobs that have disappeared.

In regards to lifeguards and the Kaua‘i Lifeguard Association, obviously there have been huge changes, just as there have been across the Kaua‘i landcape. Lifeguards are still at their posts, with their main duty now being to help park rangers and police officers as they guide people to be responsible about “social distancing.” Lifeguards don’t have enforcement as part of their job description, and they certainly don’t carry guns. But they have communication skills and awareness training under their belt, and they are being counted on to help carry out the mayor’s policies. Also, like athletes who have been laid off, part of their job is to stay in shape for when life starts to normalize and beaches again become populated.

The Kauai Lifeguard Association went into 2010 with an ambitious and carefully thought-out agenda towards continuing lifeguard/Ocean Safety Bureau support, expanding public awareness about water hazards, and continuing our quest for “an ocean-minded community.” Well, we are now a COVID-minded community. What is our role now? What are our goals now? Our fundraising and fundspending and marketing strategies are all out the proverbial window.

Thankfully, through all this the Hawai‘i Tourism Authority has continued to partner with us for strong financial support of our lifeguards and the OSB, and we therefore will be able to continue with this part of our work. Additionally, our redoubtable KLA board member Andy Melamed has been very helpful in helping us re-think our role and our revamped messaging goals. At this time, KLA’s publicity role won’t be based on the “When in doubt, don’t go out” jingle that we try to get across to our often ocean-clueless visitors in particular.

Rather, our role will now be to support the mayor with his “When in doubt, don’t hang out,” social-distancing message.

I end with a thank you not only to our hospital front-line workers, but also to our firefighters, our lifeguards, our paramedics, our police officers (who are REALLY, REALLY on the front lines), and all our other front-line workers such as supermarket employees, gas-station attendants, highway workers who are still clearing storm debris, and many others who keep essential wheels turning. Be careful. We will cry salt tears if any of these people succumb to COVID-19. Godspeed to all of you, and Godspeed again to our economically vulnerable families because of whom I have been having restless attempts at sleep.

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Monty Downs, M.D., is an emergency room doctor at Wilcox Medical Center and president of the Kaua‘i Lifeguard Association.