Kaua‘i’s Community-Driven COVID-19 Response

by Tommy A. Noyes

In recognition of National Public Health Week in April 2022, Mayor Derek Kawakami (center) presented a proclamation to the Kaua‘i District Health Office, represented by (left to right) John Kolman, Environmental Health Section Head; Rhiannon Ako, Acting Epidemiological Specialist; Janet Berreman, Kaua‘i District Health Officer; Madeleine Hiraga-Nuccio, Clinical Director of Kaua‘i Family Guidance Center; and Lauren Guest, Deputy District Health Officer. Contributed photo

For the past few years, the COVID-19 pandemic has influenced and taken lives around the world in unforgettable and tragic ways. Communities and countries have responded to the disease’s continuing threats in various ways which are still evolving.

A few jurisdictions deserve recognition for their successes in preventing serious illnesses, minimizing the number of pandemic-related deaths, and managing economic impacts. Valuable lessons may be drawn from those communities.

Nationally, the State of Hawai‘i was awarded one of the top rankings for pandemic response and healthcare outcomes. As a county, Kaua‘i consistently scored better on COVID-19 response and healthcare outcomes than the other counties.  (https://www.commonwealthfund.org/publications/scorecard/2022/jun/2022-scorecard-state-health-system-performance)

“It is a privilege to be part of the team leading Kaua‘i through the difficult pandemic years,” Kaua‘i District Health Officer Janet Berreman said. “Most of all, mahalo to the Kaua‘i community for its patience and resilience. None of us could have done this alone.”

Evidence gathered on Kaua‘i and recently published online makes the case that our community’s response ranks among the best in the nation in mounting effective and appropriate measures to combat the pandemic.

By recounting how the community came together with the same strength of spirit shown in response to Hurricane Iniki and the 2018 floods, this article credits Kaua‘i’s ordinary residents with stepping up and managing through adversity, as they have done before.

The detailed account of Kaua‘i’s rapidly coordinated public health response is available to subscribing public health professionals online or by request to Kaua‘i Path. Health Security provides insight into the experiences of local, county or state health professionals on the frontlines of health emergencies. Titled Effective Pandemic Response: Lessons from Kaua‘i, the article in Health Security was written by Kaua‘i residents Janet Berreman and Lauren Guest. Subscribers may access the article at https://www.liebertpub.com/doi/10.1089/hs.2022.0097, others will need to reach out to news@KauaiPath.org.

“Since the beginning of COVID, our island has been kept safe through the incredible effort of the Kaua‘i District Health Office, the Incident Management Team, and the resilience of our community,” Mayor Derek Kawakami said. “We applaud the published work by Dr. Berreman and Lauren Guest that illustrates in great detail the effectiveness of our pandemic response, and thank them for their leadership and service to Kaua‘i.”

Berreman and Guest’s paper recounts assembling local leaders, compiling the most relevant public health information available, and reaching consensus decisions on how to implement appropriate local pandemic countermeasures.

Saving lives was paramount in the team’s broad array of initiatives. In the paper’s introduction the authors write, “Response successes include implementation of unified command, coordinated public messaging, early protective measures, effective disease control and outbreak response, attention to secondary impacts of the pandemic, free community testing, mass vaccination, and mobile vaccinations and testing. The value of local health departments engaging regularly and authentically with partners and communities cannot be overstated. It has saved lives on Kaua‘i. Local health jurisdictions should focus on all-hazards and all-staff endeavors to enhance their disaster response effectiveness.”

Guest said that in a country where the COVID-19 response tended to be contentious at every level of government, she was enormously grateful to have been part of such a collaborative effort on Kaua‘i. commented Deputy District Health Officer Lauren T. Guest.

“Our Incident Management Team was comprised of county and state representatives who each brought their own expertise and perspective to the table. We definitely didn’t always agree, but we were always able to reach a consensus and to make the best decision we could at the time with the information we had available to us — and to course correct when new information warranted it. I can’t say thank you enough to Mayor Kawakami and his administration for their continuous support and willingness to make difficult — and at times unpopular — decisions in order to protect our community. I would also like to thank the Kauai District Health Office staff for their tireless efforts during the past three years. It’s an honor to be part of such a dedicated team,” Guest said.

There are volunteering opportunities with the Kaua‘i Medical Reserve Corps and American Red Cross for community members willing to be a part of future responses to whatever new threat comes to our shores. Interested individuals can sign up with the Kaua‘i Medical Reserve Corps  at https://www.nlk.doh.hawaii.gov/ , or contact Tommy Noyes at

• Tommy Noyes is Kaua‘i Path’s executive director, a League of American Bicyclists Certified Instructor and active with the Kaua‘i Medical Reserve Corps.