(BIVN) – Members of the Hawaiʻi medical community are urging Governor David Ige to immediately take more decisive action to limit the spread of COVID-19, including closing all non-essential businesses and asking everyone to stay home.

94 doctors and health professionals co-signed a letter to the governor, and shared it with the media. The release joint release was originated by the Hawaiʻi Children’s Action Network, a nonprofit working to create “a unified voice for Hawaiʻi’s children”, that “strives to ensure that all keiki are safe, healthy, and ready to learn,” as well as the Hawaiʻi Public Health Institute, whose “mission is to advance the health and wellness of the people” of Hawaiʻi.

“Our Governor’s actions yesterday were a start, but not enough,” said Deborah Zysman, Executive Director of Hawaiʻi Children’s Action Network. “Governor Ige must mandate extreme social distancing measures before the spread worsens.”

According to Jessica Yamauchi, Executive Director of the Hawaiʻi Public Health Institute, “Hawai‘i is fortunate to have a relatively small number of patients right now, but this number will continue to increase. We recently saw our first confirmed case of community spread; if we wait to act until the situation gets worse, it will be too late.”

Extreme social distancing measures must be put in place before the spread worsens, the group says. The health and medical community’s recommendations include:

• For families: Everyone should stay home. Travel and social events should be postponed or canceled.
• For workers and businesses: All non-essential businesses should be closed. All non-essential government employees should also be sent home. Only take-out should be allowed from restaurants; bars and other entertainment venues should close. Those who cannot go to work should be able to receive paid leave or Unemployment Insurance.
• For visitors: Everyone entering the state should be screened. The state should develop protocols for those exhibiting symptoms and provide hand sanitizer to passengers. The same restrictions for local families should apply to visitors.
• For the medical community: The state should ensure it has adequate facilities for those affected by COVID-19. Testing should be free and easier to access by waiving the requirement for a primary care physician order.

During a Tuesday press conference, Governor Ige announced various new directives in alignment with a “15 Days to Slow the Spread” approach, to include limiting social gatherings to groups of 10 people or less, closing bars and clubs, suspending services and activities in places of worship, and avoiding any discretionary travel. A few hours later, Hawaiʻi County Mayor Harry Kim issued a civil defense message, saying that Big Island restaurants, bars, and places of worship may make their own decision about whether or not to close. 

Here is the full text of the letter to the governor, which can be found on the HIPHI website (including signatories). 

Public Health Must Come First:

A public request to enact stronger measures of social distancing across Hawaiʻi

As public health and medical professionals living and working in Hawaiʻi, we are alarmed by the state’s response to the COVID-19 pandemic. Our Governor must take more decisive action, and he must do so immediately. Yesterday’s actions were a start, but they are not enough.

Time is of the essence, so we need to act quickly. Extreme social distancing measures need to be put in place BEFORE the spread worsens. The health and safety of our most vulnerable residents must come first, which is why we are asking that necessary steps be taken to protect our communities.

Unless we act immediately, the United States is set to follow in the footsteps of other countries, including Italy, Spain, France, and Germany. The current data shows our outbreak is in line with theirs — meaning tens of thousands will experience infection in an exponential trajectory, lasting for months. Hawaiʻi’s healthcare system does not have the capacity or resources to accommodate the flow of patients that will be needing care. Other state and city leaders from across the country have already issued comprehensive restrictions to help slow the spread of COVID-19 and protect the public; Hawaii’s leaders can — and must — do the same.

We have a very narrow window to act: Hawai‘i is fortunate to have a relatively small number of patients right now. However, this number will continue to increase, and we already have our first case of community spread; if we wait to act until the situation gets worse, it will be too late.

Recommended State Efforts to Protect Hawai‘i Residents

For Hawaiʻi’s workers and businesses:

1.) All non-essential work and businesses, public and private, should be closed if they are unable to work remotely. All non-essential state and local employees should be ordered to stay home; those who can work remotely should do so, effective immediately. Essential businesses may include but are not limited to: grocery stores, gas stations, pharmacies, healthcare facilities, government facilities, food processing and shipping, utilities, and mass transit.

2.) A clear mandate to limit restaurants, bars, and coffee shops to food take-out or delivery only. Non-essential businesses such as bars, clubs, movie theaters, fitness facilities, hair and nail salons, and entertainment venues must all close. We commend businesses that have done the right thing by closing their doors to protect public health, but it cannot be voluntary.

3.) Close childcare except for emergency/essential personnel.

4.) Ensure that workers who are ill or caring for an ill or quarantined family member with COVID-19 receive paid leave.

5.) Allow those who have lost a job or have had hours reduced for reasons related to COVID-19 to receive Unemployment Insurance to be used for temporary leave. Expand Unemployment Insurance eligibility, per federal guidelines, to include workers whose employers temporarily shut down due to COVID-19, workers who are quarantined, and workers who leave their jobs due to risk of infection or to care for family members. Federal law does not require workers to quit to receive benefits due to COVID-19.

For Hawaiʻi’s Families:

1.) Everyone must stay home. We have seen other states take bold action and close restaurants and bars, prohibit large gatherings (CDC recommends no more than 10), and essentially shut down their states in an attempt to stop the spread of COVID-19. Hawai‘i must do the same.

2.) Cancel all travel, events, parties and so on. We must care for our families and elderly population without putting them at risk of COVID-19.

3.) Work with the state and counties to provide a plan and allow for the operation of emergency child and youth care centers for children of front line health care workers and workers who are unable to work from home, especially our low-income families.

4.) Work with state agencies and community organizations to establish distribution sites for free meals during school closure for all children and youth.

For Hawaiʻi’s Visitors:

1.) Issue an advisory on travel restrictions, making recommendations for non-essential travel to and from the state and neighbor islands.

2.) Anyone entering the state, whether at the airports or by cruise ships, should be screened.

3.) Airports and ports should have protocol in place to address individual passengers exhibiting COVID-19 symptoms and notify the state health department.

4.) Make hand sanitizers available to all passengers.

5.) The same restrictions applying to Hawaiʻiʻs locals should apply to visitors: practice social distancing and donʻt put others at risk. Any visitors experiencing symptoms should notify hotel management.

6.) Hotels should prevent guests congregating in common areas or dining rooms. Meals should be shifted to room service; if this cannot be adhered to, meal times should be staggered so as to observe recommendations for gatherings of 10 people or less, and appropriate distancing.

For Hawaiʻi’s Medical Community:

1.) The state needs to have the ability to secure the necessary facilities to accommodate quarantine, isolation, or medical treatment of individuals testing positive for or exposed to COVID-19.

2.) Waive the requirement that primary care physician (PCP) orders are necessary to receive any kind of COVID-19 test such that testing can be expanded without overwhelming our providers. Allow health administrators to use their own discretion to allow individuals without health insurance or access to a PCP to get tested.

3.) Testing sites need to be able to 1) assess clinically, 2) conduct the test, and 3) provide this service without charge to the patient.

We, the public health and medical community, respectfully submit this written statement and we ask — please, let us rise to the challenge facing our state and take all action necessary without a second of delay. We stand ready to work with our state and congressional leaders in the weeks and months ahead and support our communities through this and to successfully navigate this public health crisis.