By now there is almost universal agreement that a low-quality COVID-19 response will fail. The effectiveness of a single pre-flight test has been thoroughly disproved, in Tahiti, Alaska and other places around the world.
Hawaii has gone from a handful of infected in June, to over 6,400 known active cases, and another 6,000 inferred from the results of the recent surge testing.
We have now set an arbitrary date for travel reopening, neither by meeting measurable metrics, nor recognizing that new, inexpensive rapid tests are soon to become available.
We set this Oct. 15 date without fully consulting the neighbor island mayors, all of whom have test shortages if incoming travelers are to be tested.. These mayors are now backed into a corner.
All islands are being treated with a single blanket approach, even though they face very different realities. Of the 12,400-plus identified and inferred active cases, Oahu probably has 11,850 of them; Hawaii island, 350; Maui, 200; and Kauai, possibly just four.
The mayors are for reopening; we all are. Many livelihoods depend on it. But to reopen in an unprepared manner will, after a few months, bring another shutdown and even greater economic harm. Hawaii will be known as an unsafe place to visit. More of those at risk will die.
None of the islands will be ready to open on Oct. 15, and a single pre-flight test is not robust enough as a screening protocol.
Tahiti, a destination much like Hawaii, declared itself “COVID free” when it reopened on July 15 to great fanfare with a pre-flight test within 72 hours of departure, no quarantine and a second self-administered test on Day 4. It failed miserably. The spike began three weeks after it reopened, with more than 1,300 new cases in the last month. A local union threatened to strike if the 14-day quarantine wasn’t reinstated. Tahiti’s population is under 280,000 and much easier to manage.
If Hawaii plans to dispense with the safest precaution, the 14-day quarantine, the science (tinyurl.com/4kipuka) is clear that for any chance at success, travelers should test before they arrive, and then at least once again on Day 7, with a strict quarantine in between.
We need to reopen wisely, on a timetable vetted by doctors, not politicians, with protocols based on science, and with the necessary testing resources in hand — not hoping that they will arrive by Oct. 15. Even when we are well-prepared, it won’t be perfect. But to reopen when we know we aren’t prepared is to repeat mistakes others have made. Why?
Chad Taniguchi, of Kailua, is a Safe Streets advocate; Lee Evslin, M.D., of Kapaa, is a physician and past CEO of Wilcox Hospital and Kauai Medical Group.