Molokaʻi currently has no confirmed cases of COVID-19, and local residents and businesses are taking precautions to keep it that way.
A coronavirus outbreak on Molokaʻi could severely strain the island’s health care system with just one hospital - Molokaʻi General Hospital - serving its more than 7,000 residents.
Molokaʻi residents may not have the consumer conveniences of urban centers to get them through this COVID-19 lockdown, things like all-hours stores or fast food drive-throughs. But that doesn’t mean they are at a disadvantage, says Hoʻolehua resident and long-time community activist Walter Ritte.
"We got one guy going around picking up food for everybody … You know, farmers that got extra stuff, they picking 'em all up. We know the fishermen. We know the hunters ... And we taking 'em and we sharing 'em with one another. Sharing is a HUGE thing over here," said Ritte.
The island’s rural lifestyle and remote location have created a brand of independence unique to Molokaʻi, says Rob Stephenson, who heads the Molokaʻi Chamber of Commerce.
"Because we are such a small community, because resources are limited, our physical separation from the rest of the state. The high cost of shipping, the high cost of groceries and things. Many of our residents tend to be generally prepared," said Stephenson.
For grocery store owner Kevin Misaki, this means keeping higher inventory. He owns one of only a handful of grocery stores on island -- Misakiʻs in Kaunakakai. His shelves are stocked with the basics like toilet paper but supply chains are running dry because of COVID-19.
"There are shortages on everything. Everybody has the same problem across the islands. Right now we gotta buy from whoever we can so our cost has risen," Misaki said.
Competition with bigger buyers has been a challenge says Misaki, as has been shipping. Goods aren't shipped directly to Moloka'i and have to go through either O'ahu or Maui, which can take time. For example, Misaki ordered plastic protective shields for his cashiers but the shipment will take another three to four weeks to arrive.
Businesses are scaling back operations while others temporarily shut down until the virus is contained. Restaurants like Kualapu'u Cookhouse and Paddlers Inn have transitioned to take-out. Makani Kai Airlines has announced its limiting service only for essential business on the island.
Michael Drew, general manager of Hotel Molokaʻi, said he would have been horrified if his business was responsible for bringing COVID-19 to the island. So even before the stay-at-home orders and quarantine mandates, Drew shut down his hotel through May 1.
"We wanted to do our part. Although it was a difficult decision, I strongly stand behind the decision, that it was the right decision," he said.
He estimates the hotel lost hundreds of thousands of dollars in revenue from canceled reservations and stands to lose a lot more over the next couple of months. But according to the head of the local Chamber of Commerce, it was the right choice.
"Once this is over, we can all get back to work. Once this over...we can always replace...items that we might have lost. But one thing that is very difficult to replace...are the relationships that we have with one another," he said.
Stephenson says by doing the right thing and not placing strain on those relationships, Molokaʻi will be able to better band together and move forward once this is all over.
Molokaʻi Representative Lynn DeCoite, who also represents Lānaʻi, has said a coronavirus outbreak could "literally cripple these islands." For Molokaʻi, the COVID-19 threat has exacerbated some of the vulnerabilities associated with services like health care in an isolated, rural community.
Molokaʻi General Hospital serves the islandʻs roughly 7,400 residents. Like many health care facilities in rural communities, Molokaʻi General has struggled to secure health care workers including doctors to run the 15-bed facility. At one point, the hospital was flying in an emergency room doctor every day.
Molokaʻi General is owned by the Queen's Health Systems. In response to questions about COVID-19 preparedness, Queen's sent a statement saying all physicians and staff "have been trained in the latest Centers for Disease Control and Prevention (CDC) protcols, and have all the safety precautions and necessary equipment in place to safety care for suspected or confirmed COVID-19 patients."
But some Moloka'i residents like Ritte say they don't have much confidence in the island's health care system. He says if he were to get sick, he'd rather fly to Oʻahu for care.
"It's just the way it is. We've accepted it. We all try to stay as healthy as we can. And now we have this pandemic. There's no way if the thing hits on Moloka'i that we're gnona have the same kinda care of any other islands," says Ritte, "So that's why we want t otake these drastic measures of trying to stop completely the carriers of this disease from coming to Moloka'i."
Federal, state, and county authorities are currently working on a plan to restrict interisland travel to the island. Rep. DeCoite expects the details to be revealed Monday afternoon.
"They are trying to come up wiht a solution to use the exemption forms so that youʻd have to call or email to get approval (to travel)," says Rep. DeCoite, "But you shouldnʻt be getting an approval if you donʻt live here on island."
DeCoite has been a critic of Governor David Igeʻs 14-day mandatory quarantine order because of its "honor system" method of enforcement. She has been urging a travel ban for non-residents, but wants to ensure exemptions be made available for Molokaʻi residents needing to fly off island.
"Theyʻre afraid that if we completely shut down, we might not be able to send people back out to Honolulu if they need to go to doctors," says Rep. DeCoite, "So I think with the exemption forms weʻll be able to help with that situation."