COVID-19 deaths and cases in Hawaii nursing homes has fallen below the national average, according to the latest update of the AARP Nursing Home COVID-19 Dashboard, but they continue to suffer from personal protective equipment and staff shortages.

Between Oct. 19 and Dec. 6, Hawaii was the only state that saw a decrease in COVID-19 deaths and cases in nursing homes, according to AARP, a nonprofit that represents Americans older than 50 years.

In September, Hawaii was experiencing a high of 0.91 coronavirus deaths per 100 nursing home residents, but that has steadily dropped to zero deaths during over a course of three weeks ending on Dec. 6.

“The rise and fall in Hawaii death rates track the period over the summer and early fall when community transmission was rising, positive test results rose to over 5% and two large outbreaks on Hawaii island infected and killed dozens of residents,” AARP said in a news release. “Since then, positive test rates and community transmission have dropped, and the outbreaks were finally brought under control.”

However, during a four-week period ending on Nov. 15, AARP found that 27.5% of nursing homes did not have at least one week’s worth of PPE. On average, only 19.1% of nursing homes across the country were without a week of PPE during the same time period.

Also, during the same period 37.5% of the nursing homes reported staff shortages, which is also higher than the 29.2% national average.

“AARP Hawaii commends Hawaii nursing homes for taking steps to reduce cases and deaths, but the reports from nursing homes to the federal government indicate that there continues to be a problem with shortages of personal protective equipment and staffing,” said Keali`i Lopez, AARP Hawaii State Director, in a statement. “We know as coronavirus transmission rises in the general population, it is more likely to spread into long-term care facilities and when COVID-19 gets into nursing homes, it can spread quickly with deadly consequences. The state and long-term care facilities can’t rest. We need to prepare for the next outbreak by being more transparent about cases in long-term care facilities and making sure there is adequate PPE for all long-term care facilities, testing, and the ability to increase staffing during an outbreak.”

Lopez said the state needs to do more to inform the public about coronavirus cases in long-term facilities. She said it should be collecting and publishing its own data so people know what’s going on in real time.

AARP acknowledged that the state released comprehensive data in August but has not done so since.

It has also called on the state to prioritize regular COVID-19 testing and PPE for long-term facility staff, residents, inspectors and visitors and to provide more access for visitation, whether virtual or in-person.