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<br />and Human Services (HHS) is one of the lead federal agencies that determines when a public health
<br />emergency exists. The first HHS Public Health Emergency Declaration, issued January 31, 2020, stated that “a
<br />public health emergency exists and has existed since January 27, 2020, nationwide”. At that time, there were
<br />108 confirmed cases in the U.S. and 93,090 cases worldwide. As of Feb. 28, 2023, the U.S. has had
<br />102,019,564 confirmed cases, 1,109,145 deaths, and 662,514,513 vaccines administered. (World Health
<br />Organization (WHO) website. Retrieved 3/2/23.) Worldwide, there have been 758,390,564 confirmed cases,
<br />6,859,093 deaths, and 13,266,873,459 vaccines administered. (WHO) The HHS 90-day Public Health
<br />Emergency Declarations have been reissued 14 times throughout the duration of the pandemic. The last
<br />declaration will expire on May 11, 2023. The federal government has determined that the number of COVID-
<br />19 cases and deaths have declined to an acceptable level and is not planning to issue future declarations of
<br />public health emergencies related to the COVID-19 virus. Hawaiʻi County’s Emergency Rule No. 20 was
<br />repealed effective February 28, 2022.
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<br />The reduction in cases and subsequent deaths can be attributed to the advent of COVID-19 vaccines, the
<br />prevalence of milder variants of 2019-nCoV, social distancing practices, the use of PPE’s (face coverings),
<br />sanitation efforts, and herd immunity, among others. Mitigation efforts included rather drastic measures
<br />that had a tremendous effect on the world and how people were able to live their daily lives. Mandated
<br />lockdowns, travel bans, stay-at-home orders, business and school closures, social distancing guidelines, and
<br />quarantining when sick changed how many people have lived from the beginning of the pandemic to today.
<br />COVID-19 mitigation levels of success vary greatly from state to state and country to country. Hawaiʻi’s inter-
<br />state and international travel ban helped keep COVID-19 cases and deaths to one of the lowest in rates the
<br />country. Other Pacific Island nations including New Zealand, Tonga, and Samoa had great success by issuing
<br />total travel bans as well.
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<br />Increased Risk for Severe COVID-19 Illness
<br />Those most at risk of severe outcomes of COVID-19, including hospitalization or death, are the elderly,
<br />people with underlying medical conditions, minorities, and people living in rural areas with limited access to
<br />healthcare (including testing and vaccines), among others. The pandemic brought to the forefront inequities
<br />in healthcare and access to services and resources. When determining the risk of severe COVID-19
<br />outcomes, providers consider a persons’ age, presence of underlying conditions, and other risk factors.
<br />Age
<br />The risk of severe outcomes from COVID-19 increases in people who are 50 years and older, with the risk
<br />increasing substantially at ages older than 65 years. The risk of developing dangerous symptoms increases
<br />with age, with those who are age 85 and older at the highest risk of serious symptoms. In the U.S., about
<br />81% of deaths from the disease have been in people age 65 and older. (www.mayoclinic.org/diseases-
<br />conditions/coronavirus/in-depth/coronavirus-who-is-at-risk/art-20483301. Retrieved 3/13/23) Residents of
<br />long-term care facilities are also at heightened risk of severe outcomes from COVID-19.
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<br />Race and Ethnicity
<br />People from racial and ethnic minority groups (Native Hawaiian, Pacific Islander, American Indian, Alaska
<br />Native, Asian, Black, and Hispanic/Latino) have been disproportionately affected by the COVID-19 pandemic.
<br />Compared to non-Hispanic whites, people from minority groups are more likely to be hospitalized and die
<br />from COVID-19 at younger ages. (CDC data: Risk for COVID-19 Infection, Hospitalization, and Death By
<br />Race/Ethnicity)
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