A surveillance testing program meant to be a key safety net in the reopening of tourism has found 18 COVID-19 positives out of 15,158 tests of travelers to Hawaii since Oct. 19.

The voluntary program is meant to accurately assess how much coronavirus may be coming into the state despite pre-travel testing that allows travelers to bypass the mandatory 14-day quarantine if they get a negative COVID-19 result 72 hours before their departure to Hawaii.

Early results of the post-travel surveillance show a positivity rate of 0.1%.

Dr. DeWolfe Miller, an epidemiologist from the University of Hawaii John A. Burns School of Medicine, who is leading the study, said that despite the positive results thus far, visitors and residents must remain vigilant in order to keep the community safe.

“We only had 18 true positives — 1 per 1,000. We have a lot more local infection,” he said. “(But) this isn’t going to mean that these people who are coming in who have tested negative get a card out of jail. They still got to wear their masks and behave. We still have to have the prevention or it’s not going to work.”

Some state officials are frustrated by the many maskless faces as tourists pour into the state and cases surge to their highest levels on the mainland.

“People thinking we got a negative test and can run around not wearing masks, that’s a big problem,” Miller said.

Health officials reported one new coronavirus death on Oahu — a man in his 60s with underlying medical conditions — and 78 new infections statewide, bringing the totals since the start of the pandemic to 222 deaths and 16,088 cases. The state has yet to verify the novel coronavirus as a factor in 17 Hawaii island deaths.

Hilo Medical Center warned Tuesday that Hawaii island has seen a large spike in cases in recent weeks, most unrelated to travel, “which means the virus is being transmitted within the community” largely among those between 1 and 40 years old in West Hawaii.

Meanwhile, the Kauai District Health Office reported three new positive cases — all related to travelers who participated in the state’s Safe Travels pre-testing program.

Maui County said a large outbreak on Lanai has been contained. In response to fewer positive cases, the county is issuing a “safer at home” order, less restrictive than the current stay-at-home rule, for Lanai residents and visitors starting Thursday.

Of the state’s total infection count, 1,319 infections are currently considered active, mostly on Oahu. The U.S. coronavirus death toll is now over 239,000.