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Column: Pre-travel testing won’t protect Hawaii from surge of cases

As new COVID-19 cases surge to unprecedented levels on the mainland, Hawaii remains safe for now. The economic fallout from the pandemic has been profoundly painful, but the health of our people must take precedence.

It has been a rough ride so far. During the second quarter of 2020, we saw U.S. unemployment as high as 15%, the stock market drop as low as 30% from its peak and oil prices decline by 70%. Sheltering in place and job layoffs, together with disruptions to retail supply chains and manufacturing, caused a reduction in second-quarter gross domestic product of between one-third and one-half.

Denial on the part of the U.S. executive branch caused a critical delay in addressing the pandemic, resulting in the nation now having 25% of recorded cases worldwide with only 3% of the world’s population. Many states adopted reasonable, multiphase protocols for reopening. Now, however, one month after most of the country has moved toward business as usual, the number of new cases nationally has spiked to levels more than twice those seen in mid-April, when New York City was brought to its knees.

Economic desperation drove much of the country to open prematurely a month ago. Opening buoyed the capital markets, but decisions to resume sheltering in place have been far too slow owing to resistance from political and business leadership. Texas, Florida, Arizona and parts of California are now facing the grim reality of their medical systems being overwhelmed. Only in recent days have they decided to close their bars and beaches and begin to shut down once more.

Hawaii finds itself in a uniquely difficult position. Today we have recorded fewer than 1,000 cases in total, less than any other state, despite having been accused early on of shutting down too soon. Without our visitors, however, jobs, businesses and government coffers are under immense pressure.

Gov. David Ige just announced that Hawaii will reopen Aug. 1 to visitors who test negative for the virus within 72 hours prior to arrival. This is a mistake. A single pre-travel viral test is a poor strategy to protect the people of Hawaii from COVID-19 because too many visitors will still develop the disease within days after coming to the islands. This is because the virus might still be incubating and yet undetectable when visitors fly in.

Alaska set up a protocol similar to Hawaii with pre-travel testing but added the requirement that they must retest five days later. One might argue the enhanced protocol may be more manageable in Alaska, which after all has only a fraction of Hawaii’s visitor numbers. However, two weeks after implementing this policy, Alaska officials have conceded that two-thirds of their visitor arrivals are unable to provide documentation that they completed the viral test prior to flying in. This places the burden of testing at the airport upon arrival, requiring a 14-day quarantine or refusing entry.

The national surge in COVID-19 cases makes a simple, pre-travel viral test even more futile because that means so many more cases will slip through the cracks. Recall that the western part of the country is Hawaii’s largest market. This week California had more new cases than any state after Florida. The surge could easily double again to 100,000 cases per day, according to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health.

Hawaii’s public and private leadership must thread an increasingly perilous needle. People must have jobs to care for their families, businesses must remain open and the government coffers cannot run dry. Yet, if visitors return too soon and without a more comprehensive screening program, there is every possibility of a COVID-19 surge in Hawaii, one that could overwhelm our medical system.

The second half of this year is likely to be even more arduous than the past quarter. We must actively guard against COVID-19’s national surge spreading to Hawaii while understanding that this comes with economic costs. Continuing to take all necessary precautions at home, in the workplace and in the community at large is essential. It begins with taking care of ourselves and remaining diligent with our own health care.


Ira Zunin is a practicing physician and medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center. His column appears the first Saturday of every month. Please submit your questions to info@manakaiomalama.com.


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