The coronavirus has now reached every county in the United States – even a remote Hawaiian outpost that was the last remaining holdout.

Until recently, Kalawao County, which has fewer than 100 residents and was used as a leper colony for decades, was the only county in the nation that hadn’t reported a single COVID-19 case. But even though it’s so isolated from the rest of the world that basic supplies have to be brought in by barge once a year, as the Wall Street Journal reported on Thursday, the virus still managed to make its way there.

According to Hawaii health officials, a resident who had traveled outside the community tested positive after flying home in December, ending Kalawao County’s impressive run. What could have been a disastrous outbreak was narrowly avoided, because that individual followed the county’s self-quarantine guidelines upon arrival – as did the other passengers they had close contact with during the flight.

The fact that Kalawao County remained virus-free for so long can partially be attributed to geography. Located on the small island of Molokai, its single town, Kalaupapa, can only be reached by hiking down 1,600-foot cliffs, catching a rare flight on a small plane or making an arduous three-mile trek by mule. That seclusion also explains its painful history: In 1865, Hawaii decided that anyone diagnosed with leprosy – now known as Hansen’s disease – would be exiled there for life.

Thousands of patients were never allowed to leave the tiny settlement, and could only interact with visiting family members through a chicken-wire screen. Though some ended up marrying fellow patients and doing their best to live normal lives, parents often had their newborn babies taken away to a nursery out of fear that the disease could be transmitted to the child.

In 1969, after a cure for Hansen’s disease was introduced, Hawaii finally overturned the mandatory quarantine policy. But some patients opted to stay on the island because they’d grown accustomed to the lifestyle and feared the stigma that they might face elsewhere. Though most of the Kalawao County is now a national park, roughly a dozen survivors still live there today, in the care of the state.


“Our patients are, on average, 86 years old. They all have other health issues, so they’re at extreme high risk for covid mortality,” Baron Chan, the branch chief for Hansen’s disease at the Hawaii Department of Health, told KHON in October.

Before the pandemic, Kalawao County had roughly 100 residents, including National Park Service employees and health workers, Chan told the station. But as many as half that number have left since early March, when state health officials took aggressive measures to protect the remaining residents who were once Hansen’s disease patients. Visitors from outside the county were barred, and residents who left for other parts of the island or the state were told they would have to quarantine for two weeks upon returning.

As the nationwide death toll from the coronavirus reached staggering heights, many in Kalawao County came to appreciate those restrictions. “I don’t want to go Honolulu! You know, I don’t want to go to the other islands at this point,” Sister Alicia Damien Lau, a resident, told KHON in October. “You just get so paranoid.”

In fact, Kalawao was already so committed to following public health guidelines that the discovery of the first coronavirus case didn’t make much of an impact, locals told the Maui News. People had started wearing masks long before they were mandatory statewide, and the county was already effectively under lockdown, with most nonessential tasks put on hold.

“I don’t think there is any fear,” Father Patrick Killilea, a pastor at Kalawao County’s sole Catholic church, told the paper. “The rest of us just have to be careful as usual.”

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