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Coronavirus testing in Hawaii comes under fire

Ditmar Hoerl returned to Hawaii from Singapore when he came down with flu-like symptoms Feb. 1.

The 67-year-old Kula resident developed a 102.4-degree fever, cough, congestion, shortness of breath and headaches, and immediately sought to get tested for the new coronavirus, which had recently broken out in Singapore.

His requests were denied.

Although Hoerl had tested negative for the flu — both influenza A and B — the state Department of Health declined testing for the virus that has sickened more than 110,000 people worldwide and killed more than 4,000.

“On a gut level I just had a very, very strong feeling it was the coronavirus,” he said. “There’s not a way for me to prove it because I wasn’t tested, but I definitely feel that is what I had. I’m also certain it’s in the state already. It’s just that, you know how the politics work here in Hawaii. They don’t want to have a case, so they’re not too eager to get one because it’s going to affect tourism and everything else.”

Clinical Labs of Hawaii will begin testing for the coronavirus today, while other private labs, including Diagnostic Laboratory Services and Kaiser Permanante, are racing to come online as concerns grow over potential community spread in the islands. The Centers for Disease Control and Prevention in Atlanta was the only agency testing for the virus up until this month when Hawaii received kits to test locally, though the criteria remained stringent: Individuals would need to have severe respiratory illness and travel history to the countries with outbreaks or have been in close contact with a confirmed case.

The state confirmed its first case Friday and a second on Sunday, though doctors have been frustrated at the lack of widespread testing in the community and say the Health Department has denied testing for some patients who physicians suspect might have the disease.

The first case involved an individual who was on the Grand Princess cruise from San Francisco to Mexico from Feb. 11 to 21. The second patient, an elderly man who recently returned from Washington state, where most U.S. coronavirus deaths have occurred, is in critical condition at Kaiser Permanente’s Moanalua Medical Center.

Health officials said Monday that 19 people have been tested for COVID-19 in the islands, four of whom are still awaiting test results. The state is also tracking 62 individuals who are self- monitoring, and scrambling to find any close contacts of 21 people who tested positive for the virus after stopping on the four main Hawaiian Islands aboard the Grand Princess cruise ship last week.

Over the weekend, physicians said there were at least two suspected cases that did not get tested by the DOH, which has the ability to test 250 to 500 people a week.

“It’s such a joke. Korea, China, Singapore — all those places — they’re doing thousands of tests, and they’re getting results overnight on whether you’re positive or not,” Hoerl said. “It’s absolutely laughable. If I would’ve been tested days after I showed my symptoms, I almost guarantee I would’ve been positive. That’s why I felt it was my civic duty to isolate myself, to self-quarantine. I may have been one of most dangerous people in the state or in the country.”

Lt. Gov. Josh Green told the Honolulu Star-Advertiser that the state should be maximizing testing capacity at least until the private labs open, at which point the state should be doing “thousands of tests to assess the full scope of the disease” in the islands.

“It’s critical we expand our testing to max out the 250 tests per week, which must include testing anyone in the ICU when a physician asks for it … and testing additional individuals as we have availability so that we have a clearer idea on how far COVID-19 may have spread in Hawaii,” he said. “I’m still hopeful we have very minimal cases, but our whole country has awakened to the fact that we have to test our citizens.”

At a news conference hosted by the Kokua Council, a senior advocacy group, Green explained that there’s been a “severe rationing of tests” because of concerns that Hawaii wouldn’t have enough kits to test people in intensive care units.

However, testing is essential to keeping front-line medical workers safe, he said.

“We need to preserve our health care community and their capacity to deliver care. So we need to know if people just have the flu … versus COVID-19, which requires a lot more protective gear,” he said. “We have to keep them clean and well so they can provide care to the other 1.3 million of us who are going to need the care.”

Green said he is working to establish quick drive-thru centers to screen people for the virus and to ensure there are enough supplies in state to handle any future outbreaks.

Dan Ross, president of the Hawaii Nurses Association, representing roughly 4,000 mostly registered nurses, said concern over the lack of testing in the community is growing.

”There’s obviously a level of anxiety there within the general public and among the health care professionals. There’s been kind of a lot of missteps along the way in getting the testing going,” he said. The CDC earlier sent Hawaii faulty test kits. “Every time a physician feels that testing is warranted, we think it should be tested. That’s what will really help control the spread. There’s probably a lot more positives out there than we know about because of the limited testing. It’s kind of the tip of the iceberg — we’re going to see (if) this is going to explode or if it’s going to calm down.”

House Health Committee chairman John Mizuno (D, Kalihi Valley) said public health and safety are at risk.

”We don’t want what happened in Seattle, Washington, at the nursing home. We don’t want that situation to happen in Hawaii, especially if it’s preventable,” Mizuno said. “Coronavirus cases went undetected for weeks in Washington state due to a delay in testing. All of them are potential casualties if we don’t do anything. It shouldn’t be a delay in testing when public safety and health are top priority. A life is priceless.”

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