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Hawaii’s weak contact tracing effort is hindering the control of coronavirus’ spread

  • CINDY ELLEN RUSSELL / CRUSSELL@STARADVERTISER.COM
                                A medical professional swabbed a man in his truck during drive-thru COVID-19 testing held at Kakaako Waterfront Park on Sunday.

    CINDY ELLEN RUSSELL / CRUSSELL@STARADVERTISER.COM

    A medical professional swabbed a man in his truck during drive-thru COVID-19 testing held at Kakaako Waterfront Park on Sunday.

  • STAR-ADVERTISER
                                <strong>“We have over 1,600 active cases right now and we have to stop it. We can either contact trace or lock down.”</strong>
                                <strong>Josh Green</strong>
                                <em>Lt. Governor</em>

    STAR-ADVERTISER

    “We have over 1,600 active cases right now and we have to stop it. We can either contact trace or lock down.”

    Josh Green

    Lt. Governor

Jendrick Paul, president of the Marshallese Community Organization of Hawaii, said Sunday that he’s worried state Department of Health contact tracers can’t keep up with the surge of coronavirus cases in Hawaii’s tightknit Pacific Islander community.

Pacific Islanders make up just 4% of Hawaii’s population, but on Friday they had 30% of the islands’ latest COVID-19 cases, far more than any other ethnic group.

The community generally is made up of people descended from Tonga, Samoa, Fiji, Tahiti, Papua New Guinea and the Marshall Islands, among other Pacific islands. It’s been particularly susceptible to COVID-19 in Hawaii, where higher percentages work as front line workers or live in multi-generational family homes.

Paul said he’s aware of four individuals from separate Pacific Islander families who tested positive for COVID-19 on Aug. 3 but six days later still hadn’t been contacted by DOH contact tracers.

“In one of the four cases, one of the positive people is sleeping in the living room because he doesn’t have a room to stay. That poses a greater risk to this household. It’s hard for everyone in the family not to catch it,” Paul said.

He said another COVID-19 patient, who is part of a family of 17 people who live in a two-­bedroom, one-bath home, is still waiting to be contacted two days after learning of the infection.

“One of the family members is a dialysis patient,” Paul said. “The quicker the response from the DOH contact tracers, the quicker they can find out stuff from families and be able to react to it better and provide resources.”

Stories like these are a pivotal part of an ongoing debate in Hawaii on whether the state has enough contact tracers — the people hired to locate everyone who comes in close contact with a person who has tested positive for COVID-19.

“We have over 1,600 active cases right now and we have to stop it. We can either contact trace or lock down,” Lt. Gov. Josh Green said Friday. As of Sunday, the number of active cases topped 1,900.

Green wants to see 400 or 500 contact tracers in the state’s arsenal. He estimates the state needs hundreds more contact tracers.

Green and Dr. Scott Miscovich, who leads broad testing efforts across the islands, say the DOH must expand hiring not only to relieve the workload for current staff, but to avert a public health crisis.

High caseloads and test lags mean DOH’s tracers can’t get to cases fast enough. Ideally, Miscovich said tracers would contact a COVID-19 patient within 24 to 48 hours, but even the DOH admits in some cases it’s taking 72 to 96 hours. Critics say the time frame is sometimes even longer, especially when there are added complications like extra-large families that need translators.

“There’s also been an explosion of cases in Kalihi with the Pacific Islander community,” Green said. “Pacific Islanders are getting crushed, and not traced.”

State Epidemiologist Sarah Park told the Senate committee Thursday that the DOH has 105 active tracers, and is in the process on adding more. She said there are 62 contact tracers on Oahu, 18 each on Maui and Hawaii island and seven on Kauai.

However, Park failed to provide a clear answer about how many tracers were employed full time by the DOH. She also couldn’t provide a count of volunteers or Hawaii National Guard employees. Nor did she answer queries about why the DOH hadn’t accepted offers for additional volunteers from places like Hawaii Pacific University, Chaminade and Tripler Army Medical Center.

Park said the DOH could only bring on additional contact tracers as part of a phased-in approach that accounted for work space limitations and the need for the team to work well together.

On Friday, Green called for Park to be removed from the job of managing the contact tracing effort in the state.

Lawmakers said the DOH could use the Hawai‘i Convention Center as a temporary work site for contact tracers.

Park touted the role of contact tracers when advocating for $2.5 million in CARES Act funds to form a training partnership with the University of Hawaii. But she frustrated the Senate committee Thursday when some of her testimony seemed to downplay the role of contact tracers in the battle on COVID-19.

“Some states have abandoned contact tracing a long time ago. We could have done so as well, but we have chosen not to,” Park said.

Green said Park’s response showed a concerning lack of commitment to contact tracing, as only states that have been overrun with COVID-19 cases have abandoned contact tracing.

“We were pleading with them to ramp up contact tracers when we were at 10 and 20 cases a day,” Green said. “They should have been assembling an army. If it gets to the point that we have too many cases to trace, we will be condemned to locking down or watching the virus roll over us.”

Sen. Sharon Moriwaki (D, Waikiki-Kakaako-McCully-­Moiliili) said Park’s responses prompted a surprise visit by the Senate committee to the DOH on Friday, where members documented understaffing and poor working conditions.

“We only saw about 10 workers and two supervisors here,” Moriwaki said. “It was like a sweatshop. People were working 7 a.m. to 6 p.m. every day, including weekends. One person had a caseload of 190 cases, another 100.”

“I hate to paint a picture that bad, but it was that bad,” Moriwaki said.

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