Thursday, July 2, 2020

From the Garden Island Newspaper: The best Advice



 Group wants double testing 

LIHU‘E — A committee of doctors and community leaders is considering a proposal to Gov. David Ige to test a tourist-entry system that would require visitors to Kauai to be tested for COVID-19 before they depart and again after they arrive, with a five- or six-day quarantine in between.

The Kauai-specific system would differ from a protocol announced by Ige last week under which visitors can produce evidence they have tested negative for the virus within 72 hours of arrival in Hawaii or undergo a 14-day quarantine.
Ige announced that the new approach, intended to safely resume Hawaii tourism, will go into effect Aug. 1. Currently, visitors must agree to a 14-day quarantine, but there is no testing requirement.
The two-test, Kauai-specific procedure emerged Wednesday from a Zoom meeting of members of the Kauai COVID-19 Discussion Group and Lt. Gov. Josh Green. The different protocol for Kauai, said Dr. Lee Evslin, an organizer of the committee, would assure tourists that their Hawaii destination would be more certainly COVID-free than the rest of the state in return for accepting the need for the two tests and a week in quarantine.
The COVID committee originally proposed a statewide two-test system in a report released June 18.
The meeting of the committee with Green came the morning after Evslin revealed new figures showing that Alaska, which introduced a one-test option like Ige’s on June 5, has seen exponential growth in new cases in the days since. It is not clear, however, whether Alaska’s caseload spike has been caused by increased numbers of tourists or brought on by behavior of local residents after statewide shutdown provisions were ended.

Meanwhile, Mayor Derek S.K. Kawakami said Wednesday that planning to reopen Hawaii began several weeks ago, “when our COVID situation across the state and nation was stabilizing.” Recent developments, Kawakami said, mean that “the situation on the mainland has shifted. It would be prudent for all of us to consider the increased risk of trans-Pacific travel under current circumstances.”

A spokesperson for the mayor did not respond to a request to clarify whether Kawakami was urging Ige to reconsider his decision. Kawakami said he was unaware of the meeting of Green and the COVID committee but that “first and foremost, I appreciate the passion and effort of the Kauai COVID group.”
The Kauai-specific test and quarantine system, which has not yet been presented to Ige, has little chance of being adopted. But it underscores the concern inong the medical community over trends in many states of ever-increasing caseloads which have led to renewed restaurant, bar and beach closures and other limitations that were relaxed in a rush to reopen many states to business as usual.
As of Wednesday, Hawaii has recorded 926 COVID-19 cases, with 38 on Kauai, according to the Hawaii Department of Health. None of the state’s 18 deaths was on Kauai.
The national uptrend in new cases and deaths has been particularly pronounced in California, the single largest source of tourists who visit Hawaii.
On Tuesday, Evslin circulated data on social media that he said came from an Alaska district health officer. The data showed that Alaska went from 40 active cases in May to 400 at the end of June. The figures appeared consistent with data posted to the COVID-19 website of the Alaska Department of Health and Social Services.
The official state figures show a marked increase in COVID-19 cases in Alaska starting on June 5, when the state changed its tourist-entry policy to allow visitors to substitute proof of a single negative test in lieu of a 14-day quarantine. In his announcement last week, Ige said Hawaii officials had been coordinating planning with their Alaska counterparts.
Evslin said the Kauai COVID committee praised the extensive work Green and Ige have done to try to plan for safe reopening of Hawaii to tourists. Evslin conceded that adopting a two-test protocol statewide could collide with practical limitations on the number of tests the state can conduct.
“The chances of success are pretty low,” Evslin said of the prospect Ige would accept the committee’s new recommendation, “but the chance of failure, as we’ve seen particularly in Alaska, is pretty dismal.”
Green said that, as a practical matter, testing all tourists after they arrive would add 10,000 to 15,000 tests daily to the state’s existing capacity of 5,300, all but assuring that testing arriving visitors could threaten the availability of tests to local residents. Green said the plan he developed with Ige is likely to permit 10 to 15 positive arriving cases per day to escape detection.
The Kauai COVID committee’s report, titled “A Plan for Safely Reopening Hawaii: Kauai as a Model,” left unanswered question of how testing and quarantine costs of would be paid and how much incoming visitors would pay.
In addition, Green said, “the added quarantine would mean no one would travel to Hawaii—period. If the proponents are OK with 22 percent unemployment, mass poverty and closure of our hospitals and schools, then I suppose it would be an option.”
Despite that, Evslin stood his ground. “It could be an interesting scenario,” he said, “if we try to make Kauai nearly COVID-free and worked with wealthy landowners and others (to designate) a special hotel to handle people during the week-long quarantine.
“What we (would be) advertising is we are doing the best in the country to create a COVID-free vacation spot. That will make this unique.” Even on Kauai, however, case numbers have been increasing in the last two or three weeks, though at a slower rate than Oahu, in particular. The Kauai spike, according to county officials, is largely due to a cluster of three families in the Kalaheo area that grew out of a social event.
JoAnn Yukimura, the former mayor and County Council member, said she has not given up on trying to get Ige to modify his decision. Yukimiura was another of the organizers of the Kauai COVID committee. “Nothing is a done deal until it’s done,” she said. “The governor said that things could change and I think we’re seeing it change dramatically on the mainland.
“I know the governor has the welfare of the people at front and center, so if he sees what’s happening, I am hopeful that he and his team will re-look at their plan to be sure it will be safe.”
Yukimura said that, after the meeting with Green, the group conceded that there are “practical problems” that mean implementing a Kauai-specific system would be difficult.

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