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Column: 60,000 coronavirus tests in Hawaii. Then what?

CINDY ELLEN RUSSELL / CRUSSELL@STARADVERTISER.COM
                                Free federal surge testing for COVID-19 was held at Queen Kapiolani Regional Park on Monday. Pictured is a bucket holding packages of the self-administered tests.

CINDY ELLEN RUSSELL / CRUSSELL@STARADVERTISER.COM

Free federal surge testing for COVID-19 was held at Queen Kapiolani Regional Park on Monday. Pictured is a bucket holding packages of the self-administered tests.

Since 10% of coronavirus tests are turning out positive, we can predict that this extensive testing will identify several thousand individuals infected with SARS-CoV-2. Then what?

If we send them home and ask them to self-isolate, which is what we have been doing in Hawaii, they will infect the rest of the family, which is what happens regularly. These family members are not under quarantine, are not being tested, and therefore they will meet and infect other people.

Moreover, Hawaii has closed parks, trails, beaches and the whole outdoors, where infections occur exceptionally and only in situations in which there is a crowd. Since the outdoors is closed, family members stay at home: this creates the perfect environment for the virus to spread.

This ill-advised approach has caused the current epidemic of infections in Hawaii, and in particular, among Pacific islanders, as they often live in crowded environments. Under these circumstances, testing is a waste of time and money, just an epidemiological exercise to see how bad it really is.

Instead, we should send those who are found positive to hotels set up to isolate them for two weeks, and also test the family members of those who test positive to identify additional members of the household already infected. Only by isolating infected people, not sending them home to infect more people, and by testing their close contacts, can we rein in the epidemic.

This approach would also help restart our hospitality business in Hawaii as hotels could reopen to serve a different crowd.

In parallel, the outdoors must be kept open — because it is safe, one does not need a mask, the viruses do not fly; all one has to do is avoid close contacts with others. Conversely, one needs a mask in enclosed environments, shops and businesses that should also, as much as possible, keep their doors and windows open, a simple effective measure to prevent viral spread. Instead, presently when we enter a shop or business, the door closes behind us.

How do I know this is the right approach? I am an expert, I write on the topic in the top medical journals, I teach this issue nationally and internationally. But in fact what I wrote does not require an M.D. or a Ph.D.; it is simple common sense.

Look at Calabria for example, the poorest region in Italy with an environment and climate very similar to Hawaii where thousands of tourists visit during the spring/summer months. Incidence of infections in Calabria, where over 150,000 out of a population of 1.85 million have been tested, is well below 1% and there have been no COVID-19-related deaths in over three months.

Yet tourists are welcome and hotels are open. Compare to Hawaii, where about 10% of tests turns out positive and several people die each day, and we banned tourism. How did Calabria do it? They did and do, as I wrote above. Simple, inexpensive, common-sense measures.

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For more, view a podcast with Dr. Michele Carbone at youtube.com/watch?v=Z77XBnwsBHo&feature=youtu.be.


Michele Carbone, M.D., Ph.D., is the William & Ellen Melohn Chair in Cancer Biology and director of thoracic oncology at the University of Hawaii Cancer Center.


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