The departures of top leaders from the state Department of Health follow disclosures of major shortcomings in the state’s response to COVID-19. These events have diminished public confidence in what officials say. However, trust is crucial in maintaining the public’s health.
Community leaders have observed the dwindling public trust in state government after a series of failed responses to COVID-19:
“We must restore the public confidence,” said Hawaii Pacific Health President Ray Vara.
“They need to build public confidence at this point, that is what is lacking,” said state House of Representatives Speaker Scott Saiki.
“The actions speak a lot louder than words, and what we've seen is not good,” said University of Hawaii Economist Carl Bonham.
Comments like these reflect a sharp turn in perception: state received high marks early in the pandemic when COVID-19 cases were low and Hawaii received praise for taking the right steps to keep the virus at bay.
But failed contact tracing, poor communications and unending days of triple-digit COVID cases have created an environment of public distrust in the state government’s ability to handle the pandemic.
“The messengers and the champions of the different risk preventions, they need to be credible, and if they've lost credibility, that's going to be a huge barrier,” said Alice Payne Merritt, a team leader for the breakthrough action project on COVID-19 at Johns Hopkins University School of Public Health.
Merritt noted while there’s no timeline for how long it takes to regain public trust, it starts with transparency.
“People of all ages in all cultures appreciate transparency. I've seen this in the different countries we're working in,” she said.
“If people feel that they're not being leveled with, they become skeptical. You have to achieve that transparency. You have to regain that confidence. It’s good to do it quickly.”
Statements from state health officials that the state’s contact tracing was robust, that Hawaii was conducting enough testing, that it was communicating with those most impacted by COVID turned out to be less than true.
When reporters, including those at HPR, asked for information, they were often denied, ignored or put off. Even lawmakers were stone-walled.
House Speaker Saiki sought more COVID-19 information from the health department than legislators were given. He wanted to know how cases were transmitted, what were the individuals doing when they became infected, were they wearing masks, and were they asymptomatic?
He said he received little if any answers from the health department.
“My fear is that the health department has not been collecting this data over the past five months and that's why they could not respond to this request,” said Saiki.
The DOH released more information late Friday that included modes of COVID transmission, numbers of contact tracers and isolation facility capacity. Other data were labeled as “coming soon.”
Parts of the new website designed to be interactive were not. The new data dashboard was labeled as “prototype.”
A DOH spokeswoman said the data on the dashboard are official numbers, but will temporarily be presented as static images and updated daily. The department “is still working on the coding and other issues to make the interactive page live,” she said.
The DOH spokeswoman says she is handling media requests from at least 25 reporters from about 10 local news outlets, plus various inquiries from international and national news media.
Suspending transparency laws
One critical move that impacted transparency was Gov. David Ige’s decision to suspend the state’s open meetings and open records laws, giving the public and the press fewer ways to check on how state and county agencies were performing during the pandemic.
The suspension of the records law, the Uniform Information Practices Act, since the initial state lockdown in March, allowed government agencies to delay information requests and not meet mandated deadlines.
However, the state agencies will be required to respond eventually, when the suspension is lifted, explained Brian Black, the executive director at the Civil Beat Law Center for Public Interest.
“If we start to see that agencies are fully operational and there's really no further need for the suspension, then I think a question could start to be raised as to why would the proclamation in this suspension of the public records law still be in place.”
Black said credibility in an emergency hinges on public cooperation.
“When you have an epidemic like this a lot of it depends on the public doing the right thing,” he said.
“If you want them to do the right thing, they have to understand what it is that they're being told. You can't just rely on, ‘Trust me, this is the right thing to do.’
"That may hold for the short term, but when you've got something like this, it's stretching on for months. People need to have faith in the sense that they can understand that justifies action.”
The Office of Information Practices is urging government agencies to continue to respond to requests in a timely manner even with the suspension.
It also warned agencies against using the 1996 health privacy law known as HIPAA, as a blanket reason to withhold information. It advised departments to remove identifiable information and release what it can to, “allay public fear and combat misinformation.”
Cultural change to restore trust
But Hawaii Pacific Health’s Vara says the lack of public trust goes beyond the lack of data.
While the retirement next week of Health Director Bruce Anderson is a step in the right direction, he said it is the culture in state government that needs to adjust. He listed what is missing:
“It's a culture of leadership. It’s a culture of action orientation. It's a culture of accountability. It's a culture of transparency,” Vara said. “Unless we see significant change in that entire culture beyond just individuals providing leadership, I think we're still going to struggle.”
Last week's departure on paid leave of state Epidemiologist Sarah Park captured the chaos that has marked the state response in recent months.
Park, whose management of the contact tracing program came under fire after workers disclosed heavy workoads that prevented them from fully doing their jobs, was replaced by Emily Roberson. Roberson then took leave, citing chain of command issues, a reference to Park's interference in her job.
When Park left, Robertson returned to work.
UH economist Bonham noted that COVID-19 has shown everyone the cost of a dysfunctional government culture.
“It's not just at the very top, although you do have to establish that leadership, but it goes all the way deep down into these departments,” he said.
“It’s the culture and the community, and the culture in our bureaucracies. We failed at all levels from the very top, all the way down to you people who are deciding to gather for lunch in the lunchroom. That's what we have to change. We have to change it at all levels.”
Change depends on the state's ability to convince the public to behave in ways that it advises.
The state’s credibility, however, appears at a low point and may only return if transparency is restored, the way officials conduct business improves and the public sees COVID cases decline and fewer people added to the death toll.