Hawai‘i Officials Push Enhanced Enforcement Over Interisland Quarantine, Lockdown

The state of Hawai‘i is weighing its options after reporting more than 500 cases of COVID-19 over the last week, and they include the potential reinstatement of the 14-day interisland travel quarantine.

Gov. David Ige echoed Hawai‘i County Mayor Harry Kim’s comments Monday after the two participated in a statewide meeting that coincided with the Hawai‘i’s largest single-day coronavirus total (207) since the pandemic began.

“We do meet three times a week, and we are talking about the interisland travel quarantine,” Ige said. “The mayors have expressed concern.”

Maui Mayor Michael Victorino has been particularly vocal on the topic, as Mayor Kim said he was again on Monday. The primary concern is travel to and from the state’s largest population center on O‘ahu, where Department of Health Director Bruce Anderson on Monday said COVID-19 has become “endemic,” with community spread to a point that tracing the sources of new cases is now exceedingly difficult.

Ige made it clear he’s not ready to cede free-flowing interisland travel just yet, which rebooted on June 16 after a widespread lockdown brought the spread of coronavirus to a near halt across the islands throughout the preceding weeks.

“I would note the number of cases (is) still very low in the neighbor counties … still significantly less than the number of cases we are seeing here on the island of O‘ahu,” said Ige, adding that available data still supports the notion that interisland travel remains largely safe.

A total of 13,000 interisland trips were taken over the last week, according to numbers provided by the governor Monday afternoon. Relevant government departments and agencies are now evaluating that data to see what kind of impact interisland travel has had on virus counts. Many of the travel-related cases, Ige said, remain identified with residents who have traveled to the mainland or elsewhere and brought the disease back to the Hawaiian Islands with them.

Smaller data sets can be a problem, however, due to the nature of COVID-19 and its tendency to rest dormant inside of infected individuals for several days. The last week saw health officials confirm more than 500 cases of coronavirus across all islands. The impact of infected travelers moving between O‘ahu and neighbor islands during that timeframe won’t become fully apparent for up to another two weeks.

A second position Ige put forth Monday is one the mayors largely agree with — that strategic enforcement of any kind is a better option than widespread shutdowns of entire industries and should be executed on an island-to-island basis. The strategy represents an evolution from the statewide lockdown Ige implemented in late March, which shut down nearly all state businesses and restricted people to life almost exclusively inside their homes for weeks.

“The discussion we’ve had with the mayors is how can we do a better job of enforcement rather than shutting down all the businesses in an industry,” Ige explained, ” (and) differentiate between those who ignore the limitations of people in (their) establishments and other recommendations for social distancing.”

Honolulu Mayor Kirk Caldwell on Friday closed all bars on O‘ahu for three weeks, then limited all indoor and outdoor gatherings to 10 people or fewer on Monday. While that decision may end up proving a necessity for Honolulu County, Mayor Kim said those measures are far from necessary on the Big Island.

In an interview with Big Island Now Monday, Kim said the island has no plans to close any bars, restrict access to any beaches, or limit indoor gatherings (50) or outdoor gatherings (100) until case counts prompt such action.

Like the governor, Kim spoke of keeping most doors open by shutting a few that don’t follow the rules. The county strategy, he said, will then be working with the hundreds of establishments on the Big Island that serve food and alcohol to better protect themselves against the virus.

“That’s our job,” Kim said.

Testing Rates

Enforcement could prove trickier with a bounce in cases on the Big Island, which should be expected to at least some degree if interisland travel remains free-flowing and testing rates continue as they have across the state.

Health Director Anderson said Monday that Hawai’i has historically recorded positive COVID-19 results in 1–2% of those tested. In recent days, that number has climbed to as high as 6%. Anything over 5%, Anderson said, is problematic and a troublesome omen for future virus metrics.

The testing turnaround times are crucial for contact-tracing to stop the development of endemic community spread on neighbor islands, as well as to curb the endemic nature the virus has now cultivated in Honolulu County.

There remains a 24-hour turnaround time for tests on O‘ahu, which doubles on neighbor islands. A “glitch” with the Electronic Medical Records (EMR) system created an obstacle to mainland reporting and returns for Clinical Laboratories Hawai‘i over the weekend, which deflated positive tests on Saturday (87) and Sunday (45) while inflating them on Monday (207), Anderson said. That problem is not expected to be longstanding.

DOH said the state’s hospital capacity, namely intensive care unit (ICU) beds and available ventilators, remain adequate for the current surge. However, their adequacy could be tested, along with the ability to effectively contact trace, if numbers continue to rise. Lt. Governor Josh Green has predicted several thousand cases monthly if Hawai‘i doesn’t begin curbing coronavirus spread immediately.

Contact tracers working in Hawai‘i as of Monday totaled 105. Another 20 people were hired this week, and Anderson said he expects 20 more will be hired next week. Another 100 are ready to be activated, with 300 more trained.

“We’ve got a pretty deep bench,” Anderson said. But the Health Director added that contact tracing totals aren’t a “panacea for the problem.” The only deterrents that can curb the spread of the virus are social distancing, wearing face masks at all times when interacting with others, washing hands frequently, and staying away from large gatherings whenever possible.

Both Anderson and the governor said there is no specific number of cases in a day or a week that would automatically trigger reinstatement of a lockdown. However, if numbers of positive COVID-19 tests continue to climb and hospital capacity continues to wane, the chances of rebooting Hawai‘i’s tourism industry starting Sept. 1 will grow bleaker and bleaker.

It’s on that date Ige has said he’d like to institute a pre-arrival testing program, which could exempt out-of-state travelers from quarantine if they can show proof of a negative COVID-19 test within 72 hours of boarding their airplanes.

“We continue to monitor conditions in the state and the country,” Ige said. “We will be making a further determination as we get closer to the Sept. 1 date.”

The necessity of advanced notice may force the governor to a decision earlier than he’d like, as hotels have told the administration they need 3–4 weeks notice on any changes to the current plans, while airlines said they’d need at least two weeks notice.

Mayor Kim said Monday he, and several others, continue to strongly oppose the rollout date of the governor’s pre-arrival testing plan, as well as the way the University of Hawai‘i is planning to bring back college students by the thousands to O‘ahu without appropriate pre-testing protocols in place. The state simply does not have the infrastructure in place yet to manage either endeavor, the Big Island mayor said.

“I was very strong in reinforcing my position in regards to opening up our doors to tourism without the controls in place, as well as the University system,” Kim said of his comments during Monday’s meeting.