Hawaii is near top of the rankings for keeping residents alive during the COVID-19 pandemic, according to a study in the medical journal The Lancet, as one of three states with the best performance in this regard. In fact, Hawaii had the lowest COVID-19 death rate in the nation, at 147 per 100,000, when age and underlying illnesses were taken into account.

Hawaii was a top performer in building public trust, leading to public buy-in on its mask mandates and restrictions on gatherings. This cut infection rates, but did come at a heavy price: The state’s economic health plummeted during the pandemic, and Hawaii ranked last in employment.