VOICES: Hawai‘i doctors endorse Kahele’s 10-point COVID plan

On Jan. 19, U.S. Congressman Kai Kahele (representing rural O‘ahu and the neighbor islands) delivered a powerful message to the people of Hawai‘i.

He gave this message as a record number of new COVID cases — greater than 6,000 — were reported in a single day in Hawai‘i, and The New York Times reports that our state is one of the states with the highest number of cases per 100,000 people.

Kahele minced no words in his concise, seven-minute speech. His basic message is that there was a time in this pandemic when Hawai‘i was doing very well compared to the rest of the U.S.

We received almost $3 billion in federal funds, and we had an opportunity based on our unique geography to remain extremely safe.

He believes “that indecisiveness, the lack of a statewide strategic plan, and failure…to prepare for a resurgence… have cost us all greatly.”

The problems include “decisions to relax entry requirements, abandonment of robust testing, failure to procure…proper masks, and inadequate planning for our public schools.”

Kahele states that the current omicron wave demonstrates that COVID-19 remains a serious problem, and we need both immediate and long-term solutions. He proposed a 10-point plan.

The doctors listed below are in support of the concepts presented in his 10 points. State leadership needs to be much more proactive. The best way to appreciate Kahele’s passion and clear thinking is to listen to his video: https://tgilinks.com/3qXpbae.

We present below a shortened version of his points.

First, the state needs to modify its entry requirements for all trans-Pacific, international and cruise-ship passengers to require a pre-entry COVID-19 test and a post-arrival test regardless of vaccination status;

Second, the definition of “fully vaccinated” needs to change to require an additional vaccine dose or “booster,” if eligible, and this requirement must be in place for all indoor events, including indoor dining;

Third, the state needs to require and provide high-quality masks, like N95 or KN95 masks, or at the very least, single-use medical-grade masks, to prevent community spread. Cloth masks should not be allowed unless over a high-quality mask. This policy should be mandatory in all schools, and high-quality masks should be provided for free by the state;

Fourth, the state needs to invest in a digital, secure health passport that will allow each individual to have an electronic vaccination certificate as well as report and track testing status in real-time;

Fifth, the AlohaSafe Alert needs to be updated to be more effective. Residents need the ability to confidently rely on the state reporting system to provide them accurate notice of a close contact in real-time;

Sixth, to keep schools open, the state must implement a testing strategy in all public schools that, first and foremost, keeps our teachers and students safe. We also need to provide every classroom in the state with the necessary ventilation upgrades and air-filtration systems to improve air quality, mitigating the risk of airborne spread;

Seventh, if we are ever to achieve herd immunity, state, county, health-care and community leaders must continue to provide a strong, unified message and robust education about vaccination effectiveness and availability for all eligible residents, with the goal of fully vaccinating (including booster shots) 80% of the eligible population by the summer. In order to accomplish this, the state must work with the business community and private sector to provide paid sick leave and time off so residents can plan for when to get vaccinated or boosted;

Eighth, in the event that someone does test positive, the state must provide clear public-health isolation guidance and require two negative antigen tests commencing on the fifth day of isolation…to allow isolation to end and return to normal life. These tests should be secured by the state and given to each resident when they test positive to help people come out of isolation;

Ninth, the state must procure the resources needed to respond to the next variant. The state must ensure that all our families have free access to at-home, rapid tests, and that there is an adequate supply to meet our needs. Every family should be ordering tests from covidtests.gov, but our state still needs its own strategic stockpile ready to serve our residents’ needs;

Tenth, the state must work with county officials to increase the number of quarantine facilities across the state. Many of our residents are sharing crowded apartments or living with multiple generations under one roof where isolation at home is not possible. We must provide these facilities to reduce the chance of spread and keep our residents safe.

He further states that “these 10 steps are absolutely critical in building resilience that allows residents and visitors to be safe. We must strengthen our hospitals, health-care systems and public-health institutions. We need to stop burning out our health-care workers and instead give them the resources they need to do their jobs effectively.

People are scared. People are demoralized. People are frustrated. It cannot and must not stay this way. I implore my former colleagues in the state Legislature to act decisively. We need to do better.”

We, the doctors listed below, recognize that because the current “omicron surge” is predicted to wane in the coming weeks, there is little hope that all the components of the 10-point plan will be implemented in time to have a decisive impact. If we have learned nothing else over the past two years, it is that Hawai‘i is uniquely positioned to protect its citizens against future outbreaks.

Now is the time to incorporate Kahele’s 10-point plan into a “pandemic-preparedness” strategy that ensures that resources and policies are established and ready to be rolled out before the next wave of infections arrives at our shores. In combination with immunizations and the ever-increasing natural immunities from infection, we have the ability to finally bring an end to this pandemic.

We applaud the congressman’s call for decisive and specific improvements in our state’s approach to ending the threat to the state posed by the coronavirus and any future wave of illness.


This submission came from the following: Martin Albert, M.D., Lee Altenberg, Ph.D., Kapono Chong-Hanssen, M.D., Jonathan Dworkin, M.D., Lee Evslin, M.D., Darragh O’Carroll, M.D., Mary Pixler, M.D., Michael Schwartz, M.D., Linda Weiner, M.D., Robert Weiner, M.D.


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