Ka‘ū News Briefs, Friday, May 8, 2020

     As the last cars made it to the front of the line, Suisan employees cheered and rewarded patient customers with shouts of, "You made it!" Punaluʻu Bakery manager Connie Koi and staff gave a free pack of Punaluʻu sweetbread rolls to those in each vehicle.

     Suisan sold frozen food packs that included fryer chicken, pork butt, butter, New York steaks and bags of fries. Add-ons included mayonnaise, pork loins, pork link sausages, chicken nuggets, and onion rings. Suisan brought two large refrigerated trucks of food but supplies dwindled before all customers could buy. However, Suisan continued to alter packs and prices based on the remaining inventory, so that long-waiting customers could still receive a good deal on food. A Suisan representative said the crew will return to Nā'ālehu in the future.

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HAWAI`I'S FARMERS AND FOOD DISTRIBUTORS WILL RECEIVE $5.2 MILLION in federal funding from the U.S. Department of Agriculture to provide food to families in need. Sen. Mazie Hirono announced today that the funding, distributed under the Farmers to Families Food Box Program, is part of the Coronavirus Food Assistance Program that Congress established in the second coronavirus relief legislation that passed the Senate in March.

Suisan, known for its fish and local foods market, is also a wholesale food distributor and will receive more than $600,000 to help feed the needy on this island. Photo from Suisan

     Hirono said, "Like so many places across the country, the COVID-19 pandemic is driving unprecedented demand for food assistance in Hawaiʻi. The harrowing images we've seen of families lining up for hours to receive food demonstrate the urgency to direct more federal resources to assist those in need. This funding, provided through the Coronavirus Food Assistance Program, will facilitate the delivery of assistance to food banks and other social service organizations across our state. It will also support the ongoing efforts of our farmers and distributors who have worked hard to adapt to feed individuals and families in our community. I will continue to advocate for this program and other crucial initiatives to assist Hawaiʻi families in need."
     The funding to Hawaiʻi-based companies under this program goes to: Suisan Company Limited receives $621,813. Ham Produce and Seafood Inc. receives $3,584,000. Hawaiʻi Foodservice Alliance receives $313,500. ʻĀina Hoʻokupu O Kīlauea receives $468,000. Mālama Kauaʻi receives $235,200.

"STAMP IT OUT AND KEEP IT OUT!" is the advice of West Kaʻū's member of the state House of Representatives. Physician and Rep. Richard Creagan issued this opinion piece today. It takes a look back at history:

     As we experience this horrible COVID-19 pandemic and search for a strategy that will make Hawaiʻi a paradise again, we should first look to the past. The 1918-20 Spanish Flu pandemic killed over 50 million people worldwide, but one island group was spared. American Samoa had zero deaths from that pandemic.

     The reasons were that it was very isolated and, as the flu pandemic started during WWI, American Samoa was under a military governor who banned all visitors. There was no testing, just a complete ban. Contrast that with what happened in Western Samoa with an identical ethnic group. Western Samoa was under the British Commonwealth. A ship from New Zealand brought in the flu and 22 percent of the ethnic Samoans died – one of the highest mortalities in the world. The entire United States lost less than one percent of its population.

While women in Japan wore gauze masks during the 19117-1918 pandemic, a ship took the disease to Western Samoa, where 20 percent of the people died. American Samoa kept out everyone and suffered zero deaths.

    In Hawaiʻi, we are the most geographically isolated island group in the world. That could work to our favor in dealing with an infectious disease pandemic. Unfortunately, we are no longer functionally isolated and so COVID-19 swept in here, but we reacted quickly. We took a number of steps to limit further cases coming in, and will be increasing that restriction until readily available immediate and reliable testing can let us screen all incoming visitors and returning residents. Because of our extreme physical isolation, we can more easily than most countries, and all our other states, reestablish a protective functional isolation.

     We are doing well from a public health standpoint. Our hospitals have not been overwhelmed. We have, compared to most states, has a relatively low number of cases and a small number of hospitalization and deaths, mostly on Oʻahu. But our economy and our people are suffering greatly.

     We can and must do better. We need to stamp out this disease and we need to keep it out. We need to become the only COVID-free state in the United States. That will not be easy, but it is doable, and the benefits will be remarkable.

     China did it and is continuing to do it. We hear talk of "mitigation" and "bending the curve." That is the best the other states can probably do. It will keep the number of cases per unit of time down. If successful, it will avoid overwhelming the health care systems, but will not decrease the number of cases, and many deaths will occur over the several years that will pass until herd immunity is achieved or a vaccine is developed. Our country's economy has been and will be further severely impacted by the economic and social shutdown necessary for this mitigation.

     However, what China aimed for and achieved is "suppression" with the goal not being to minimize deaths to "acceptable" levels but to eradicate the virus. Their goal was to recover their society as a largely COVID-free country. They did it, New Zealand is trying it – and we can do it here.

The 1917-1918 Spanish Flu pandemic killed 50 million people worldwide.

     It will take will and hard work, but when it is done, we will have a thriving, healthy, and safe economy again. Don't throw away a chance for a total victory for short term economic gain.

     We are not only isolated as a state, but each of our islands is substantially isolated from the other islands, and we can stamp it out in each individual island first before tackling the larger problem of Oʻahu, where most of our population, cases, and deaths are found.

     We have emulated much of the social distancing and closing down tactics which limited the spread of the virus, but there are aspects of China's strategy that we should emulate to truly "stamp it out."

     The most important thing that China did is to isolate all COVID-19 positive cases, even if mild, either in existing hospitals that were designated as COVID hospitals or in their "pop-up" hospitals, which consisted mainly of a bunch of beds in large spaces with sanitation, food and water, some oxygen, but no advanced treatment. This is where the mild cases were kept, so they could be observed and moved to more advanced facilities as needed, but that strategy kept these infected patients from spreading the disease further to their families or neighbors.

     It should be noted that they kept some hospitals – such as trauma and cardiac centers – as COVID-free as possible. We should emulate that approach as well, and keep all our neighbor island hospitals and some Oʻahu hospitals COVID-free. We should also concentrate our younger and less vulnerable health care providers at these COVID hospitals. We do not want to wipe out much of a generation of older health care workers.

We have no need to create these temporary buildings, lacking in comfort and privacy.

     The massive slow down in tourism and the mandatory 14-day quarantine limited new cases coming in but also freed up our hotels to be used in dealing with the COVID-19 cases and their care givers. Hotels are almost ideal hospitals, with privacy, ability for individual isolation, bathrooms, food service, security, communication, robust electrical systems, big elevators, multiple isolatable floors, and individual air handling for most rooms. The Army Corps of Engineers has plans to readily and quickly convert hotels for effective isolation, quarantine, and treatment of mild to moderate cases not needing critical care or ventilators. There would also be plenty of room to house health care workers so they would not bring COVID-19 home.

     Letting people self-quarantine at home does not work if you want to eradicate. New York found 100s of people dead who were self-isolating. Had they spread the disease before they died? Could they have been saved? Many of those self-isolated patients had other family members who unnecessarily got the disease. Television news anchor Chris Cuomo "self-isolated" in his basement but gave it to his wife and then they gave it to his 14-year-old son. That pattern will continue here in Hawaiʻi and prevent eradication – if we do not alter it.

     Our neighbor island hospitals need to be preserved to take care of the regular medical problems which they were already struggling to deal with before COVID. Trauma, cardiac care, delivering babies, surgery, cancer care, etc. are functions that are compromised if COVID patients are treated in neighbor island hospitals.

     Mild cases can become very severe very quickly and should be kept in at least a health provider-staffed COVID hotel/hospital, ideally near regular hospitals that can provide advanced treatment. I would argue that, with the decrease in the threat of overwhelming our Oʻahu hospitals, that treatment of COVID patients should be there. It moves the risk of COVID transmission out of the neighbor islands, preserves our critically needed neighbor island hospitals and health care providers, and protects their families and communities

   Since infected patients are isolated because of their disease, they cannot be visited by family anyway, so having them on Oʻahu makes medical sense and social sense. The neighbor islands do not have enough specialists needed to take care of critical and complicated patients, and some patients that might survive on Oʻahu will likely perish.

     One example of treatment that is not readily available at hospitals on the neighbor islands is renal dialysis for renal failure, which developed in about a third of critical patients in New York. Kona Hospital does not have any dialysis units. While Hilo does, those units could be needed by existing non-COVID patients. Many patients in New York died because of the limited availability of dialysis.

     New York is reporting severe strokes in their young and middle aged COVID patients, which could be reversed by interventional neurologists that are not available on the neighbor islands – certainly not on the Big Island. Cardiac complications are not easily treated on the neighbor islands. Patients that require hospitalization cannot be visited so there is little benefit to keep them near their families and with the superior treatment available on Oʻahu they are more likely to be able to return home as functional and healthy individuals.

     The Air National Guard or perhaps unused Hawaiian Airlines planes could be used to fly the patients to Oʻahu.

     Read more on Creagan's outlook in tomorrow's Kaʻū News Briefs.

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A healthy coral reef. NOAA photo

     Case said coral reefs are vital natural infrastructure that safeguard our coastal and island communities. Healthy, resilient coral reefs buffer against severe weather, shoreline erosion, and flooding, and serve as natural breakwaters for maritime ports and harbors. "Coral reefs also support countless American jobs in the tourism, hospitality, boating, recreation, and fishing industries," he said. "In particular, coral reefs are integral to commercial and recreational sport fisheries across the United States and in our nation's Exclusive Economic Zone.
     "As coral reefs provide a rich habitat for a variety of marine life, the loss of coral reef ecosystems is having very serious consequences for coastal communities and economies, the health of fish and other marine wildlife, biodiversity, and the overall marine environment. In fact, such loss is accelerating rapidly, for various reasons. Warmer-than-normal ocean temperatures combined with widespread pollution are threatening their health and causing mass bleaching events. Bleaching events cause corals to be more susceptible to disease and increase their chances of dying."
     Case explained that his Coral Reef Conservation Reauthorization Act would:
     Strengthen the federal responses to coral reef emergencies, including bleaching, vessel groundings, harmful algal blooms, coral disease/invasive species outbreaks, and unexploded ordnance underwater;
     Expand federal grant-making for local coral reef conservation projects, including research on coral biodiversity, propagation, and resiliency;

An example of coral bleaching. NOAA photo

     Authorize the U.S. Coral Reef Task Force and the Coral Reef Management Fellowship; and
     Authorize the U.S. Department of the Interior to research and conserve coral resources, including coral reefs within national parks, national wildlife refuges, and national monuments.
     "Coral reefs represent the planet's greatest source of biodiversity," said Case. "Coral reefs cover less than 1 percent of the ocean floor but are home to some 25 percent of all known marine species." Coral reef ecosystems also support upwards of 12 percent of global fisheries and an estimated 25 percent of all known fish species. "It is critical to life as we know it that we accelerate our efforts to preserve these invaluable and indispensable elements of our natural world."
     Case said co-sponsors of his measure include: Rep. Tulsi Gabbard from Hawaiʻi and other members of Congress from coastal regions.