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Editorial: State must boost contact tracing

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For the early months of the coronavirus pandemic, Hawaii saw itself, justifiably and fortuitously, as standing apart from the rest of the states. That is certainly less than true today. The islands have lapsed into the same kind of surge as is flaring up across the nation.

And even though the outbreak hasn’t produced numbers of new cases on the same order of magnitude seen in the worst hotspots, when Hawaii’s level is considered alongside its limitations in intensive-care capacity at hospitals, it’s every bit as scary.

What’s also concerning — “extremely troubling,” as Mayor Kirk Caldwell put it on Monday — are anecdotal reports from the state’s contingent of contact tracers that they are overwhelmed by the task.

Contact tracing is a tool that, while not an ironclad defense against disease, should help to reduce the spread of this potentially deadly disease and should be right-sized to deal with a problem that’s clearly mounting. And Hawaii is still within reach of accomplishing that.

Contact tracers respond when they are relayed test results that show positive for COVID-19, the disease caused by this virus, and they reach out to those identified as being in contact with the infected person, advising them to self-isolate to avoid passing it further.

At the outset of the pandemic in Hawaii, with shutdowns in force, the state Department of Health maintained it was able to conduct sufficient contact tracing to manage and suppress outbreaks, and for several months that seemed to be true. The case counts dropped to the single digits for weeks, before the “kamaaina economy” was reopened with care.

However, as summer arrived, clusters became more frequent and, as people began gathering in uncontrolled settings, the degree of community spread advanced. The re-closure of parks and bars was the result on Oahu, where the problem is far worse than on the neighbor islands.

DOH officials have said, rightly, that it’s most critical to get infection counts down overall, so that contact tracing becomes more effective. Personal responsibility via masking, physical distancing and limiting interactions are paramount.

But that doesn’t negate the need to enlarge the tracing workforce considerably, especially considering the state’s intent to bring in tourists who test negative before they fly; the date for that relaunch is set for Sept. 1, but looks increasingly dubious.

In concert with the University of Hawaii, the Health Department has trained 450 potential tracers, most of them with a medical background, which plainly would be helpful. But adding staffers who can overcome language barriers in some affected communities also should be considered.

Only 105 tracers are active now, Dr. Sarah Park, state epidemiologist, said last week, adding that the state is in the process of adding more. That process needs to accelerate immediately. The current count of staff includes 62 on Oahu; Maui and Hawaii island each have 18, and there are seven on Kauai.

Today’s reinstatement of the 14-day quarantine for interisland travel should help insulate the neighbor islands from some of the big-city surge. The worry is clearly about Oahu, and just 62 contact tracers seems low given recent case surge that’s reached as high as 231 in one day.

Ramping up considerably could relieve some of the strain on active staff and give new additions some critical on-the-ground experience. This is a corps that also merits management focused on efficiency and rapid onboarding of new staff.

In a prepared statement, Gov. David Ige acknowledged the need for the state “to improve and expand our response,” adding that he is “in ongoing discussions with DOH leadership on ways to improve our testing and contact tracing systems and capacity.”

That’s a commitment, but there needs to be prompt action to deliver on the promise. Hawaii must not let any opportunity pass for getting this outbreak under control.

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