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Coronavirus infections spike will not stall reopening Hawaii, officials say

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                                Terminal 1 at the Daniel K. International Airport was relatively busy with travelers on Monday, compared to previous weeks and with the COVID-19 restrictions.


    Terminal 1 at the Daniel K. International Airport was relatively busy with travelers on Monday, compared to previous weeks and with the COVID-19 restrictions.

Hawaii’s daily COVID-19 case count rose to 18 cases Thursday, but officials say the spike was expected and hasn’t reached a threshold that would delay reopening for the state’s local economy or interfere with planning to restart Hawaii tourism.

The state Department of Health said the new cases on Thursday brought the statewide tally to 762 cases since the start of the outbreak in February. Thursday’s cases include 15 Oahu residents and three others diagnosed on Oahu with their residences not yet identified and still under investigation, health officials said in an email.

Government lockdowns, which included the collapse of out-of-state tourism, helped Hawaii achieve low COVID-19 infections and deaths. However, they’ve come at great cost to the local economy, which has seen unemployment claims rise above 230,000 since March 1.

The downward spiral for business was exacerbated when Gov. David Ige ordered a mandatory 14-day self-quarantine for arriving passengers that began March 26. Since then tourism has all but zeroed out. In June 2019, passenger counts averaged about 35,000 a day. The Hawaii Tourism Authority reported Thursday that 1,516 passengers came to Hawaii on Wednesday, and only 418 of them were visitors.

The quarantine for interisland passengers was lifted Tuesday, but that’s expected to bring only a slight boost to business. Hawaii tourism will continue tanking until Ige announces a plan that allows out-of-state visitors to bypass the quarantine, which is slated to go through at least July 31.

Lt. Gov. Josh Green, who was asked by Ige to lead a hui to come up with a plan to reopen tourism, said “tons of progress” has been made on a testing protocol that continues to advance.

“We’ll get updates soon,” Green said. “The recent surge, which I think reflects the large protests, is not influencing my thinking. We are still doing long-term strategic planning the same way.”

>> Click here to watch Part 1 of Gov. David Ige’s COVID-19 question-and-answer livestream with Hawaii’s four county mayors.

>> Click here to watch Part 2.

Dr. Sarah Park, state epidemiologist, said in a statement Thursday, “This spike in cases and other recent daily spikes have been expected as people begin to move around more freely and more businesses are reopening.”

The state’s count of new COVID-19 cases so far in June already has doubled the total of new cases recorded in May.

Speaker of the House Scott Saiki said the session will reconvene Monday despite notification Wednesday that a member of the House Majority Staff Office received a positive COVID-19 test result. The staff member and all HMSO staff were immediately excused to work from home. Park and the state Department of Health have begun contact-tracing employees.

“The House is committed to ensuring the safety and health of all legislators and employees at the Capitol. We will continue enforcing safe practices including social distancing, daily temperature screenings by National Guard members, and modified work procedures,” Saiki said in a statement.

Dr. Sarah Kemble, deputy state epidemiologist, said Hawaii could continue to see new cases over the next two weeks related to a small outbreak that was reported Wednesday at the Hale Nani Rehabilitation and Nursing Center, the state’s largest nursing home.

“When there has been exposure in a health care setting like this, resulting increase in infections are pos­sible and unfortunate but not unexpected,” Kemble said.

By Thursday the Hale Nani case count already had increased to 12, said Dr. Scott Miscovich, owner of Premier Medical Group Hawaii, which is conducting the tests for about 250 residents and roughly 550 staff.

Miscovich said Thursday that seven patients and three staff members have tested positive for COVID-19, adding to a count that already included the staff member who potentially brought the disease to the nursing home and the original patient.

Miscovich said three staff members work in the same unit. A staff member who works outside the unit was asymptomatic but had a family member who had tested positive for COVID-19, he said.

All of the cases so far have been asymptomatic; however, Miscovich said two patients were moved to the hospital as a precautionary measure since their oxygen levels were off slightly.

Miscovich said all Hale Nani residents have now been tested, along with over 90% of the staff. He and his team will continue to follow up until the facility has had two consecutive weeks without any positive tests.

His takeaway from Hale Nani is that the state needs to do more preventive testing. In the Hale Nani case, the staff member was asymptomatic, so Miscovich said it would have been hard for them to know that they had an infection. He said the staff member might have discovered the infection earlier if they had been asked to take a preventive test when their family member was diagnosed.

Miscovich said he’s “very concerned” about the number of new COVID-19 cases that the state has reported, especially over the past 10 days.

“First it was graduations, then it was Memorial Day and then it was the protest,” he said. “Now as our cases go up, it will be because interisland travel has opened up. Then in August if mainland travel reopens, it will go up.”

Miscovich said the trend of rising cases is worrisome. The public needs to be reminded to wear masks, practice social distancing and continue to take COVID-19 seriously, he said.

“I do believe it was human nature that people kind of let their guard down when we went through two to three weeks of barely a case that was present, but everyone has to go back to taking responsibility and trying to protect people, especially our kupuna,” Miscovich said.

He said he also wants Hawaii’s entire health care community to embrace preventive testing.

“Right now (the state Department of Health) uses the policy that they will do contact tracing and will contact people and ask them if they have a runny nose, cough or symptoms. If they don’t, they won’t test them,” he said.

Instead, Miscovich wants people who have been “anywhere near” someone who is positive for COVID-19 tested for the illness within 12 to 24 hours regardless of whether they have symptoms.

“That may mean we are testing 30 to 50 people for every one positive, but it’s broad prevention,” he said.

As the state moves to reopen tourism, Miscovich said preventive testing should be one of the protocols. So far, contact tracing, thermal screening and testing have dominated the discussion.

Green has said his tourism reopening proposal would not allow passengers to break quarantine unless they have taken a COVID-19 test within 72 hours of arriving in Hawaii and are able to produce a negative result.

Miscovich also wants the state to implement a requirement that passengers who intend to stay in Hawaii a week or more must take a second COVID-19 test on the seventh day of their stay.

“The reopening of (broader tourism) is the biggest concern that every person in Hawaii has to be really concerned about,” Miscovich said. “If we reopen tourism in August … and have not done this right … by November or December we could be facing closure again and hospitals coming to capacity.”

Hawaii’s earliest COVID-19 cases were often travel-related, meaning that they were brought here either by visitors or by residents who had traveled.

Park said only a handful of recent cases have been detected in travelers, known as travel-associated infection. She said the “vast majority” of Hawaii’s cases now “are being spread by what we call community-­associated infection.”

Health officials reported Thursday that 640 patients have been “released from isolation” since the start of the outbreak in February. As many as 105 infections in Hawaii are still active.

About 83% of the Hawaii people who have been infected are now classified as released from isolation.

Kauai reported one new case Thursday evening — the first new case for the island since early April.

The state’s coronavirus death toll remains unchanged at 17. Eleven of the deaths have been on Oahu, and six on Maui.

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