Despite the discouraging stream of announcements of new coronavirus cases that have been detected in Hawaii, data compiled by Johns Hopkins University shows that as of Monday this state had the third- lowest per capita infection rate of any state.
While that is good news for Hawaii residents and the state’s health care system, experts warn it is too soon to begin relaxing the statewide stay-at-home order, quarantine orders or other restrictions that have been imposed to try to prevent the spread of the new coronavirus.
Dr. Mark Mugiishi, president and CEO of the Hawaii Medical Service Association, on Monday told the House Select Committee on COVID-19 Economic and Financial Preparedness that despite some positive signs, COVID-19 remains “highly infectious and devastating, and right now there is no vaccine, no cure, no evidence of herd immunity.”
“So, as we gain control of this first outbreak, which is really wonderfully, happily, slowly we’re starting to see the light at the end of the tunnel, but we must be careful not to trigger a second or a third outbreak in our attempts to recover,” Mugiishi said.
Adjutant Gen. Kenneth Hara, incident commander with the Hawaii Emergency Management Agency, said during the same online discussion Monday that “we really did flatten the curve,” and announced there were only five new positive test results Monday for coronavirus cases. It has become routine during the past three weeks for state health officials to report 20 or more new cases per day.
The data provided by Johns Hopkins and published by time.com shows that only Minnesota and West Virginia have per capita infection rates that are lower than Hawaii’s rate of 36 coronavirus cases per 100,000 population. That is far below the national rate of 177 infections per 100,000 population.
It is also noteworthy that Hawaii tests for coronavirus at a considerably higher rate than most states. According to data compiled by Vox, Hawaii continues to rank among the top 10 states for testing per capita, which suggests Hawaii’s infection rate may be more accurate than rates reported by some other states.
Gov. David Ige cited the state’s early push to become certified to conduct coronavirus testing as a factor that has helped cope with the pandemic, adding that “we’ve also been very aggressive in setting up testing sites across the state.”
“Also, our quality health care system has kept hospitalization, intensive care and mortality rates among the lowest in the country,” Ige said in a written statement. “And the collective actions of responsible Hawaii residents who are obeying stay-at-home orders have contributed to Hawaii’s ranking as one of the best-performing states in the country in dealing with this pandemic.”
University of Hawaii- Manoa epidemiology professor Alan Katz also has cited Hawaii’s geography as a considerable advantage, since this state has the means to almost entirely shut off the flow of people into the islands. Other states cannot exercise that degree of control over people’s travel, and therefore have less control over the disease’s spread.
“We took strong action, and I believe the population has been adhering to the recommendations” for social distancing as well as the stay-at-home orders, Katz said. “I’m not seeing the sort of aggregate crowds you are seeing on the news in other places.”
He noted news reports of people gathering to party on the Kaneohe Bay sandbar, or a couple who arrived on Kauai and ignored quarantine warnings and were finally arrested, “but I think that’s more the exception than the rule. I think people have been behaving appropriately.”
Katz said he would expect to see a downward trend in the number of infections about two weeks after the statewide stay-at-home order went into effect March 25, which appears to be happening “and which I hope will continue.”
But he said the state needs to make sure that is a true trend and not meaningless variation in the data. “I think we do have to wait until the end of the month — minimum, the end of the month,” he said.
Tim Brown, a senior fellow at the East-West Center with expertise in infectious disease and behavioral epidemiology, said the stay-home order and social distancing, for the most part, are “having the desired effect.”
There has been relatively slow growth in hospitalizations and deaths, and “because this virus usually manifests in symptoms in less than two weeks, if the virus were widespread in the community, these numbers would be growing more rapidly,” Brown told the House select committee Monday.
But before the state can lift the statewide lockdown, it must have the capacity to more rapidly test suspected cases, quickly trace their contacts and quarantine people as needed, he said. The state also needs “data to inform triggers for reimposing lockdown should the epidemic surge,” Brown said.
Hawaii health officials will need that extra lab capacity and other resources to cope with the new coronavirus for the next one to two years until a vaccine is developed, he said.
“If we were to lift the shutdown measures now and go back to our previous way of life, we could easily find ourselves in a New York type of situation within a month or two,” he said. He cited the example of Singapore, which has traced clusters of infections around workplaces, preschools, gyms, shipyards, private functions and dormitories, he said.
China is now seeing new coronavirus cases that are being imported into the country by travelers, Katz said, which also underscores the need for careful planning as businesses seek to reopen and the tourism industry attempts to restart.
“Because things are looking pretty good here, I’m hoping that we will be able to adopt the best strategic plans for getting back to normal, but it’s really sort of tiptoeing back into it,” Katz said. “You can’t just sort of say, ‘It’s over.’ It’s a slow process of what is the next step, step by step, and watching to make sure that things don’t rebound.”