Gov. David Ige announced Thursday that trans-Pacific travelers to Hawaii who can’t present evidence of a negative COVID-19 test upon arrival in the islands won’t be able to bypass the 14-day quarantine once their test results are received.

During a media briefing Thursday, Ige said the policy change will start Tuesday and does not apply to interisland travel. He also clarified that trans-Pacific travelers don’t have to have uploaded the test results to the Safe Travels Hawaii website and could still exempt out of quarantine if they arrive with a valid negative COVID-19 test in hand.

“We are adding this safety precaution now in response to the dramatically increasing number of COVID-19 cases in the continental U.S. and around the world,” Ige said. “Currently, 94% of travelers participating in the pre-travel testing program for Hawaii arrive here with their test in hand. But at least 44 travelers who took the pre-travel test before departure got a positive result upon arrival or a day or two later. It isn’t a large number, but it’s enough to change the policy.”

Hawaii is tightening its travel entry requirements at a time when demand already is expected to plummet due to a warning from the nation’s top public health agency not to travel for Thanksgiving.

The Centers for Disease Control and Prevention issued the recommendations just one week before the holiday at a time when diagnosed infections, hospitalizations and deaths are skyrocketing across the country. In many areas, health care systems are being squeezed by a combination of sick patients filling up beds and medical workers falling ill themselves.

The CDC’s Dr. Erin Sauber- Schatz cited more than 1 million new cases in the U.S. over the past week as the reason for the new guidance.

“The safest way to celebrate Thanksgiving this year is at home with the people in your household,” she said.

If families do decide to include returning college students, military members or others for turkey and stuffing, the CDC is recommending that hosts take added precautions: Gatherings should be outdoors if possible, with people keeping 6 feet apart and wearing masks and just one person serving the food.

The United States has seen more than 11 million diagnosed infections and over 250,000 deaths from the novel coronavirus. CDC scientists believe that somewhere around 40% of people who are infected do not have obvious symptoms but can still spread the virus.

As COVID-19 cases have spiked across the mainland, domestic travel demand for Hawaii is dampening.

Ige also announced Hawaii is further diversifying the mix of travelers allowed to participate in the state’s pre-arrival testing program. Visitors from Canada, Hawaii’s second-largest international market, will be added to the testing program, with South Korea and Taiwan coming soon.

Since Oct. 15, domestic trans-Pacific “travelers who, upon entry into the state, provide written confirmation from a state-approved COVID-19 testing facility of a negative test result from a test administered to the traveler within 72 hours from the final leg of departure” have been exempt from the mandatory quarantine.

Travelers who came in with a pending test result have been allowed to get out of the quarantine once it could be verified through the state’s Safe Travels Hawaii system.

Lt. Gov. Josh Green said during Thursday’s briefing that roughly 6% of people coming into Hawaii as part of the Safe Travels Hawaii program have either not gotten their test results in time or have had challenges getting it uploaded.

However, the state quickly found itself with a backlog of pending tests. Travelers grew frustrated as they waited sometimes four days or more for a manual review. During one low point there were more than 3,700 travelers waiting to get out of quarantine. Green said the numbers are much better now but still a concern.

“It’s a much stricter policy that is being taken,” Hawaii Tourism Authority President and CEO John De Fries told his board Thursday. “This has been brought about by the number of people who have arrived with no test uploaded, test results pending. That segment of traveler has caused a tremendous amount of workload and a bottleneck in the system.”

While state officials link most of Hawaii’s COVID-19 cases to local spread, Ige said that “we do anticipate that there would be a few COVID cases that would be introduced because of travel.”

So far, Green said, surveillance testing shows the positivity rate is less than 1 out of every 700 travelers arriving in Hawaii, “which means we are able to control that spread.”

Ige said the state is working to keep traveler-related cases of COVID-19 down through pre-arrival testing and partnering with hotels and other members of the visitor industry to mitigate spread. The state is also the only one in the nation to offer thermal screening at the airport, he said.

The state’s approach to recovering travel has been safety first.

It wasn’t until Nov. 6 that the first international visitors were allowed to take part in the testing program under an agreement that allowed travelers from Japan to visit Hawaii under the same rules as domestic passengers.

Only a few thousand visitors from Japan are expected during the remainder of this year.

Canada’s early recovery has the same challenge as Japan: a requirement that nationals returning from trips abroad quarantine for 14 days upon their return home.

However, some eligible international travellers returning to Alberta at select airport and border crossings may participate in the Alberta COVID-19 Border Testing Pilot Program, which allows for a reduced quarantine. Right now the program is available only at the Coutts land border crossing or Calgary International Airport. Passengers arriving from another Canadian airport are not eligible.

De Fries said it’s too early to estimate how much Canadian travel demand will materialize for Hawaii.

Still, the trickle of international visitors, no matter how small, is an important step to recovering Hawaii’s economy because not all of the state’s visitor industry infrastructure is built around catering to domestic visitors.

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The Associated Press contributed to this story.