Hawaii’s Safe Travels program will likely stay in place through 2021

Gov. David Ige has taken flak for insisting that Safe Travels, the nation’s strictest traveler entry program, which is costing the state about $3 million a month, needs to run until at least 70% of Hawaii’s entire population is vaccinated against COVID-19.

Given the vaccines have not been approved for children under age 12, the benchmark is really 82% of those eligible for immunization. That already seemed a lofty goal, but two Hawaii epidemiologists say that target is now not likely high enough to prevent spread of the highly transmissible delta variant.

“No, I don’t believe that’s a safe benchmark anymore,” said Dr. Tim Brown, an infectious disease modeler and senior fellow at the East-West Center. “It actually would have been a safe benchmark probably for the virus last year. It was low enough, effectively, at that point.

“The problem is the more infectious the virus is, the higher the level of protection needed to reach so-called herd immunity.”

In Hawaii, all residents and visitors arriving from out of state need to enroll in the Safe Travels screening program. Domestic travelers who are fully vaccinated may bypass a 10-day quarantine. Unvaccinated domestic travelers age 5 and older must enter with a negative result from a state-­approved COVID-19 test.

International travelers who aren’t from nations that have been added to Safe Travels are not eligible to bypass the quarantine.

Many Hawaii businesses, especially those with visitor industry ties, have pushed to end the program soon.

But Brown and Dr. DeWolfe Miller, an epidemiologist, University of Hawaii emeritus professor and fellow in the American College of Epidemiology, say the state needs to keep Safe Travels in place longer. In fact, if they had their way, no one would get on a plane to Hawaii that had not been vaccinated.

“We need to take every effort to crush this right here or we are just playing Russian roulette,” Miller said. “Right now, I don’t think that I’ve ever been so concerned. The safest, most conservative policy would be 100% vaccinated — that’s not epidemiological, it’s common sense. All the rest (public safety policies) are just workarounds.”

The epidemiologists say the COVID-19 landscape has changed again, as the highly transmissible delta variant contributes to rising cases in Hawaii and the rest of the U.S. Case counts have been surging here after the Fourth of July holiday, and Saturday marked the 10th day in a row that new case counts reached triple digits — 258 to be exact.

“The seven-day average of new cases went vertical this week,” Brown said. “Most of the rest of the U.S. is going vertical too.”

Meanwhile, there has been a sharp drop-off in vaccinations in recent months. The percentage of Hawaii’s total population that is fully vaccinated has yet to hit 60%. The most recent Department of Health data sets the figure at 59.6%.

Lt. Gov. Josh Green shares the epidemiologists’ level of concern.

“It’s highly likely that Safe Travels will be left in place throughout the rest of the year because it has effectively kept our travel-related cases down,” said Green, who is an emergency room physician. “I would like to see us beef up our approach to some of the residents returning, who are choosing to quarantine rather to get vaccinated or to take a test.”

Green said about 22% of new COVID-19 cases in Hawaii this month have been travel-related.

Hawaii, like other states, cannot force travelers to get vaccinated against COVID-19 before getting on a plane. However, he is encouraging returning residents who are choosing not to seek a Safe Travels exemption to self-­isolate away from friends and family for the first three days of their quarantine and take a post-arrival test.

If the state decides to make post-arrival testing mandatory for travelers who choose to go into quarantine, Green said the state could offer the tests free and seek reimbursement through the Federal Emergency Management Agency.

“Everyone should be vaccinated if traveling or at least get the pre-test,” Green said. “If you are not vaccinated, you shouldn’t travel right now because the risk of catching delta is so high. People with the delta variant have as much as 1,000 times the viral load.”

EVEN so, all other U.S. states have managed to lift mandatory travel restrictions. That’s a sore spot for those who fear continued state and county interference will eventually cause Hawaii to become less competitive with other tourism spots.

Keith Vieira, principal of KV & Associates, Hospitality Consulting, said some mainland visitors are frustrated because Hawaii’s travel policies are so different from the ones they see at home.

Hawaii might find visitors are less tolerant of its policies once a greater variety of destinations reopen, Vieira said.

For instance, Los Angeles recently reinstated indoor mask wearing in public places. But Visit California is now advertising that “with one of the nation’s highest vaccination rates and lowest case rates, California is open to welcome visitors.”

Miller argues that Hawaii should be more restrictive about travel than other destinations because of its location and unique circumstances.

“We are 5,000 miles out in the middle of water. You have a very small number of people coming by water, but most are arriving by air,” he said. “If you live in Wyoming, there’s not a thing you can do about your borders — there’s just too much space.”

Not that controlling Hawaii’s borders has been easy either. From the start, opening Hawaii tourism has been a complicated and expensive balancing act that hasn’t always gone as smoothly as the state, the visitor industry or residents would have liked.

Hawaii tourism was on virtual lockdown from March 26, 2020, when the state instituted a travel quarantine.

Hawaii’s tourism counts began improving after the Oct. 15 introduction of Safe Travels, a travel-entry program that allowed visitors to bypass the quarantine with an approved test. Arrival counts are currently at or closing in on pre-pandemic levels.

STILL, keeping the quarantine in place through Safe Travels isn’t exactly cheap, and it has certainly been complicated.

The Hawaii Department of Defense told the Honolulu Star-Advertiser the state spent $10 million on the program in the first six months of 2021, and that costs are averaging $3.1 million a month, not including National Guard support, which is being paid for with federal money.

Keli‘i Akina, president and CEO of the Grassroot Institute of Hawaii, is among those who view Safe Travels as an expensive overreach that raises privacy concerns.

“We appreciate and respect the need of our state officials to protect public health, but we are concerned about the state’s Safe Travels program and its potential to compromise private health information.”

Additionally, Akina said, the “state’s continued travel restrictions have Hawaii residents wondering how long it will be before our personal liberties are fully restored.

“The fact that we have spent more than a year in an economically devastating lockdown, and that travel is still restricted via an expensive and minimally effective program, underscores the need to restore the balance of powers in our state’s emergency management law.”

Angela Keen, who heads the citizens’ group Hawaii Quarantine Kapu Breakers, said Safe Travels is worth the inconveniences and the cost, although she recommends that the program be tightened to make it harder for someone to use false documents, break quarantine or avoid contact tracing.

“You can buy stacks of fake vaccination cards off the internet,” she said.

Green has said the risk of someone entering Hawaii with a false document is low. However, Keen said she would like to see less reliance on manual screening.

State Chief Information Officer Doug Murdock said Safe Travels uses artificial intelligence to verify COVID-19 test results.

“If, for some reason, the test result doesn’t read it as COVID-19 negative, even if it meets all the requirements, or if the traveler chose not to upload their test results prior to departure, it will require manual review by airport screeners,” he said.

Murdock said Safe Travels uses the state Department of Health’s database to verify Hawaii-issued vaccination cards.

The state recently began partnering with CLEAR and CommonPass to expand the network of testing partners and validate travelers’ Safe Travels exemptions through medical provider data.

Digital screening services like CLEAR and CommonPass reduce the risk of someone coming into Hawaii with a falsified test or vaccine card. However, Murdock said the state isn’t making the services’ use mandatory because “they only cover a limited number of states and vendors.”

He added that vaccination documents for travelers immunized outside Hawaii that haven’t used CLEAR or CommonPass also must be manually reviewed by airport screeners upon arrival.