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The tropical paradise of Hawaii, with its pristine beaches, lush rainforests, and vibrant culture, seems like an ideal escape from the trials of the COVID-19 pandemic. However, the coronavirus has impacted even this remote island chain.

If you’re short on time, here’s a quick answer to your question: While Hawaii has fared better than most US states, it has still suffered major effects from COVID-19 such as economic hardship in the tourism industry, periodic spikes in cases and hospitalizations, and almost 1,500 deaths.

In this comprehensive article, we will analyze the full effects of the COVID-19 pandemic across Hawaii’s islands. We examine case rates, death tolls, hospital capacity, lockdown measures, travel restrictions, economic impacts, and more. Read on for the full story of how bad COVID truly is in Hawaii.

Case Numbers and Death Tolls in Hawaii

Total Cases and Deaths

As of December 2022, Hawaii has reported over 400,000 confirmed COVID-19 cases since the start of the pandemic, with over 1,600 deaths attributed to the virus. The state has seen several major waves of infections, including during the initial outbreak in early 2020, the Delta variant surge in summer 2021, and the Omicron wave in late 2021/early 2022.

New Cases Over Time

After seeing relatively low case numbers in the first half of 2022, Hawaii experienced an uptick in infections in late summer and fall. While still far below previous peaks, the 7-day average of new daily cases reached over 350 in November before declining again in December.

  • Highest 7-day case average: 3,290 cases per day (January 2022)
  • Lowest 7-day case average: 34 cases per day (June 2022)

Positivity rates and hospitalizations have also increased slightly but remain much improved compared to earlier surges. Health officials continue monitoring for new variants that could spark another wave.

Comparison to Other States

Compared to other U.S. states, Hawaii has reported fewer COVID-19 cases and deaths adjusted for population size. For example, Hawaii’s cumulative death rate of 115 deaths per 100,000 residents is well below the overall U.S. rate of 330 deaths per 100,000 as of December 2022.

State Cumulative Cases Per 100k Cumulative Deaths Per 100k
Hawaii 28,097 115
California 31,863 233
U.S. Overall 42,903 330

Hawaii’s lower relative impact from COVID-19 can likely be attributed to rapid response measures, strict travel rules limiting outside infections, and high vaccination rates. However, the state remains vigilant against complacency as the pandemic continues evolving globally.

Strain on Hawaii’s Healthcare System

Hospital and ICU Capacity

The COVID-19 pandemic has put immense strain on Hawaii’s healthcare system. Hospitals across the islands have struggled with limited capacity in both general hospital beds and intensive care units (ICUs).

At the peak of the Omicron wave in January 2022, Hawaii’s hospital bed occupancy rate reached nearly 80%, with only about 180 ICU beds available statewide. Several hospitals were forced to set up temporary patient care areas and divert patients to other facilities.

Staffing shortages added to the burden on already overwhelmed hospitals.

Though hospitalizations have declined significantly since last winter, capacity constraints remain an issue. As of November 2022, 76% of Hawaii’s 279 ICU beds were filled. Public health experts warn that a substantial flu season or potential new COVID-19 wave could again push hospitals to the brink.

Staffing Shortages

Hawaii has faced critical healthcare staffing shortages throughout the pandemic. Hospital administrators report severe nursing shortages, estimating a deficit of around 1,200 nurses statewide as of mid-2022.

Difficulty recruiting traveling nurses has compounded Hawaii’s longstanding lack of medical professionals. The state’s remote island geography makes it less attractive for temporary nursing assignments. And Hawaii’s high cost of living has deterred some full-time candidates.

These shortages have required increased workloads for existing clinical staff, leading to fatigue and burnout. Nearly 20% of nurses left their positions in 2021 – double the typical turnover rate. Addressing wage gaps and improving working conditions will be key to rebuilding Hawaii’s depleted nursing workforce.

Government Lockdowns and Restrictions in Hawaii

Stay-at-Home Orders

In March 2020, Hawaii became one of the first states to issue a statewide stay-at-home order in response to rising COVID-19 cases. The order closed non-essential businesses, urged residents to work from home when possible, and restricted gatherings and visitors.

However, Hawaii did not issue any statewide stay-at-home orders in 2021 or 2022 as vaccines became widely available.

Travel Restrictions

Hawaii has maintained some of the strictest travel restrictions in the U.S. throughout much of the pandemic. From March 2020 through October 2022, anyone arriving in Hawaii was required to either quarantine for 5-10 days or show proof of a negative COVID-19 test taken within 72 hours of departure.

In November 2022, Hawaii ended testing/quarantine requirements for domestic travelers who showed proof of vaccination. International travelers must still adhere to federal testing requirements. These stringent measures likely helped limit the spread of COVID in Hawaii.

Vaccine and Mask Mandates

Hawaii was the only state that did not implement any broad indoor mask mandates during the Omicron surge in early 2022. However, individual counties did implement varying mask rules. Hawaii also initially announced one of the strictest employee vaccine mandates in the country in August 2021, requiring all state and county workers to get vaccinated or face termination.

But the state later backed down and allowed weekly testing as an alternative after facing lawsuits. Vaccine mandates vary by county and industry.

Economic Impacts on Hawaii’s Tourism Industry

Declines in Tourism Revenue

The COVID-19 pandemic devastated Hawaii’s tourism industry, which is the economic backbone of the state. In 2020, visitor arrivals to Hawaii dropped dramatically by over 75% compared to 2019. This resulted in a staggering decline of $17 billion in tourism revenue for Hawaii in 2020.

The ripple effects of the tourism decline were felt throughout Hawaii’s economy. Over 100 hotels temporarily closed, airlines cut flights to Hawaii by two-thirds, and major attractions like Pearl Harbor and Volcanoes National Park shut down for months.

Unemployment in Hospitality Sector

With tourism at a near standstill, Hawaii’s unemployment rate skyrocketed from 2.7% in February 2020 to 23.8% in April 2020. The accommodation and food services sector was hit the hardest, with a staggering 45% unemployment rate.

Tens of thousands of hotel, restaurant and transportation workers were laid off or furloughed. The situation became so dire that food bank lines stretched over a mile long in some communities.

Small Business Closures

The economic fallout from COVID-19 proved too much for many mom-and-pop shops and other small businesses in Hawaii to withstand. Over 11% of Hawaii’s small businesses closed in 2020 alone, according to a sobering University of Hawaii study.

Retail stores, restaurants, tour operators and other tourism-dependent small businesses were especially hard hit. Even long-time Honolulu staples like the 60-year old Me BBQ restaurant and Cinnamon’s Restaurant, beloved by locals, shuttered for good.

Outlook Going Forward for Hawaii

Potential Future Waves

While COVID cases have declined recently in Hawaii, experts warn that new variants or future waves remain a possibility. As of December 2022, the 7-day average of daily cases in Hawaii was around 100, down from over 6,500 in January 2022.

However, the winter months often see an uptick in respiratory viruses. According to the state epidemiologist Dr. Sarah Kemble, “The pandemic is not over and we need to remain vigilant.” She notes that only 68% of Hawaii’s population is up to date on COVID vaccinations as of November 2022.

Increased vaccination coverage could help mitigate potential new waves. Experts also stress the importance of continuing common sense precautions like masking in crowded indoor areas.

Gradual Tourism Recovery

Hawaii’s tourism-dependent economy was decimated by border closures and travel restrictions earlier in the pandemic. After two very difficult years, Hawaii’s tourism industry is finally starting to rebound.

While 2021 saw only 2.9 million tourist arrivals, 2022 is projected to welcome around 7.9 million visitors – the most since 2019. This gradual recovery is expected to continue into 2023 and 2024.

According to Hawaii’s Tourism Authority, increased flights and relaxed travel protocols have restored visitor volumes. For example, in November 2022 passenger counts increased +28% from 2021. Tourism industry leaders are now focused on managing this growth in a sustainable way – promoting cultural values and environmental stewardship alongside economic recovery.

Long-Term Societal Impacts

The COVID-19 pandemic has indelibly shaped Hawaii’s society and culture. Extended lockdowns and border closures led to increased depression and isolation but also strengthened local community ties. Hawaii’s public health infrastructure underwent dramatic upgrades after significant deficiencies were exposed early in the pandemic.

Telehealth and remote work opportunities expanded greatly out of necessity and will likely persist post-pandemic. House prices have skyrocketed over 50% as remote mainland workers flocked to the islands.

While Native Hawaiians faced disproportionate COVID infection and mortality rates, the broader public awakening around longstanding healthcare inequities has sparked real dialogue and action around better supporting this community.

Overall, Hawaii’s “ohana spirit” has helped its people navigate the immense challenges of the past three years with resilience, solidarity, and aloha.


In the end, while Hawaii has certainly suffered major effects from the COVID-19 pandemic with high deaths, economic blows, and societal disruption, it has objectively fared far better than most other US states over the last three years.

With its isolation and natural beauty still largely intact, Hawaii remains well-positioned for tourism to eventually rebound back to normal levels. For now, COVID precautions are still wise, but the tropical paradise should continue emerging from the worst impacts of this global crisis.

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