The COVID-19 pandemic took hold across the globe five years ago this month.
The virus is still in our community, and people continue to die from COVID-19 in our hospitals, though the death rate is quite low because of the availability of antiviral medicines. The state Health Department's COVID-19 dashboard still shows the latest number of cases.
At the height of the pandemic, Hawaiʻi's positivity rate was more than 20%, and we saw over 2,000 deaths in the islands. The nation as a whole experienced 1.2 million COVID-19 fatalities.
Former East-West Center epidemiologist Tim Brown shared that the number of cases has recently been low on the islands — typically fewer than 100 cases per week diagnosed on Oʻahu.
Brown added that he thinks there is a "collective amnesia" in the country about what everyone went through during the first year of the virus.
"We had doctors and nurses who were shell-shocked from the amount of death that they were dealing with on a daily basis. We had hospitals that were overflowing. We had semis parked outside of hospitals as makeshift morgues because so many people were dying that they overwhelmed the hospital morgues. We were dealing with almost a constant state of fear because we didn't know much about how it was transmitted. We were still learning about the virus — we knew there was asymptomatic transmission, but we didn't know how much," he said.
"In general, we were getting some frankly pretty bad advice from a lot of our public health agencies at that point, CDC (Centers for Disease Control and Prevention) and WHO (World Health Organization) were both telling us not to mask. But Asian countries, right from the very start, as soon as the virus was diagnosed in Wuhan, were already issuing masks to people and encouraging people to use masking. Those of us who worked in Asia knew that they worked, but here in the U.S., because of shortages of the proper equipment, people were basically avoiding masking or even being advised not to mask, which was actually very bad advice," he continued.
Brown said that the height of the pandemic in Hawaiʻi occurred during the Omicron variant — over 6,000 cases a day were being diagnosed. In the early days of the pandemic, Hawaiʻi's case numbers stayed low due to early masking requirements and lockdowns.
"We cut off tourism for an extended period, and economically that was very damaging to Hawaiʻi, of course, but it did keep our numbers extremely low. To this day, I think we have the lowest or the second lowest death rate in the United States," he said.
Brown said that the Delta and Omicron variants pushed Hawaiʻi's hospitals to the limits. He added that throughout the pandemic, there were a couple of close calls, but Hawaiʻi never got to the point where capacity was completely overwhelmed, compared to other places like New York.
"We got to the point where there were so many people that our hospital capacity was exhausted. And in fact, we were already starting to talk about setting up triage sites outside of the hospitals, but we never got to the point where we needed to do that. But we did need to import a lot of nurses from the mainland, basically, to deal with the large number of patients that we were handling with COVID," he said.
Vaccination rates were high in Hawaiʻi, but Brown shared that herd immunity turned out not to be possible with COVID-19.
"One of the requirements for herd immunity is basically that once vaccinated or once infected and then 'immune,' people can no longer be infected. And with COVID, we know that's not true, like the other common cold coronaviruses — if you get COVID, then six months to a year later, you can still get COVID again," he said.
Brown said the vaccines in the early days were about 95% protective against severe illness and death. Now, theyʻre only about 40% to 50%.
"So that means that your immunity tends to wane and that means that herd immunity really can't occur, because there's always new people becoming more susceptible, either because their infection was far enough in the past, or their vaccination was far enough in the past that they no longer have significant immunity against infection," he said.
He emphasized that the coronavirus is still affecting people and causing damage.
"We're still dealing with, you know, especially for people who are older or people with immunocompromised or any of a number of different conditions like heart disease or high blood pressure or obesity, they are still at higher risk of severe illness and even potentially death from COVID if they're not properly diagnosed and treated. So yes, it is still very much with us," Brown told HPR.
This interview aired on The Conversation on March 13, 2025. The Conversation airs weekdays at 11 a.m. HPR's Tori DeJournett adapted this story for the web.
