The Hawai‘i COVID Collaborative: Winning Hearts, Saving Lives

We have all learned that telling others how they should think and feel about COVID-19 vaccinations is not easy.

Na‘alehu Anthony, director of the Hawai‘i COVID Collaborative, knows this all too well.

Like many Native Hawaiians, Anthony, a Ka‘a‘awa resident, lives in a multi-generational household. This communal lifestyle is one of the factors that contributes to disproportionately high numbers of COVID-19 cases among Native Hawaiians.

Challenging Circumstances
Anthony offered his insight into some of the circumstances Native Hawaiians may encounter in their homes:

“There are those who are vaccinated and unvaccinated living together, some have experienced generational trauma and have a distrust of government, others have no PCP (personal care provider) and some do not use their health insurance (to access care),” he said.

“Some in the home are going out every day to work and this creates a dangerous risk quotient,” he continued. “And there are those with co-morbidities such as diabetes, hypertension and obesity, which add to the risk of COVID.”

Touching Hearts
While some may write off these types of situations as hopeless, Anthony has been working to break through these challenges. The consummate storyteller and filmmaker, Anthony has leveraged his understanding of real-life experiences from his own family and from others in the community to effectively touch the hearts of the hard-to-reach in culturally sensitive ways that lead to life-changing decisions. This has been especially important to those who may have grown weary and hardened by being told over and over to get vaccinated but still had unanswered questions.

He believes questions are a natural part of the understanding process that gives others the room to learn. Now that COVID-19 vaccinations have been approved for children ages 5 and older, Anthony admits even he has reservations: “It’s one thing to get vaccinated myself, but I would have questions about my children. I have a 20-year-old, so it’s different story, but if I had a 5- or 6-year-old, I would want to know more.”

Empathetic Outreach
Even as Hawai’i’s vaccination rate continues to climb — about 74.8% of the state’s population is fully vaccinated as of Jan. 7, 2022 — engaging with others and allowing them to ask questions will be key to supporting those who have not been vaccinated. That’s why Anthony believes personalized, empathetic outreach is key to increasing Hawaii’s vaccination rate.

“Showing up and talking with people is important in this age of social media,” Anthony said. “Meeting in person brings back civility. A face-to-face meeting changes the tenor of meetings.”

Anthony has also seen many positive examples of care and aloha in the community.

“It’s amazing to see the kind of rallying where healthcare workers who have been working seven days a week for months come out to support the community,” he said.

“I’m going to Kahaluu for a vaccination clinic and the healthcare workers who have been doing 12-hour shifts show up with their best selves. I see the humanity baked into the community. The aloha spirit is there,” he said. “I feed off their energy.”

The Power of Storytelling
“Early in the pandemic, we were given facts. A 60- to 69-year-old man died from COVID,” he said, “But I wanted to work around the HIPAA (Health Insurance Portability and Accountability Act) issues so that people would say, ‘That could be my dad, my grandpa or my uncle.’ ”

“We see ourselves in storytelling,” Anthony said, noting that one story that he likes to share is about how at one time ali‘i mandated vaccinations to protect people from smallpox, which allows people to rethink their positions on vaccinations and mandates.

In one afternoon, he filmed his sister Kaiwipunikauikawēkiu Punihei Lipe, Native Hawaiian Affairs Program Officer at the University of Hawaiʻi at Mānoa, sharing her journey as a parent to understand vaccinations and how she came to the conclusion to have herself and her children vaccinated. The short video simply invites viewers to think about vaccinations and decide for themselves what they should do, and intentionally avoids a hard call to action that demands people to be vaccinated.

Gateway to Vaccinations
Anthony said that being accessible to talk story and answer questions has had positive results. He said Chantelle “Tellie” Matagi, with the Hawai‘i Department of Health, told him that COVID-19 testing has been a gateway to vaccinations. When families come to be tested for COVID-19, there are people available to share information about vaccinations and some family members end up getting the vaccine.

The Collaborative’s Track Record
The Hawai‘i COVID Collaborative was formed by businesses and healthcare organizations in August 2020 and grew out of the House Select Committee on COVID-19 Economic and Financial Preparedness. In his self-effacing way, Anthony jokes that he was selected to lead the group because he was the only member of the collaborative not running a multi-million-dollar organization.

The collaborative members continue to meet on a regular basis, but their focus has evolved over time. Pre-vaccination, the collaborative focused on data monitoring and policy to bring back tourism as soon as possible to boost our local economy. After COVID-19 vaccinations became available, the collaborative focused on making vaccinations more accepted and accessible.

Next Challenges
Anthony would like to see a more robust focus on the economic challenges ahead for Hawai’i, especially to support those who are or will become unemployed and a return to a focus on other health issues besides COVID-19, including mental health issues that may be caused by social isolation.

“We need to find the balance between reopening as we gather together. We need to gather again,” he said. “And find out how to tell uncle with the cap standing in the corner to wear a face mask!”