HONOLULU (AP) – On the rural island of Kauai in Hawaii, where white sandy beaches and dramatic coastal mountains attract visitors from around the world, locals have spent the first seven months of the pandemic protected from the viral storm.
Early and aggressive local measures, coupled with a state-enforced travel quarantine, kept Kauai’s 72,000 residents mostly healthy – the island had only 61 known cases of coronavirus from March to in September. But on October 15, the state launched a pre-trip test program to revive Hawaii’s decimated tourism economy.
Kauai has gone from having no infections to at least 84 new cases in seven weeks. The growth sowed the community’s transmission and led to the first – and only so far – death of COVID-19: Ron Clark, who worked for decades as a tour driver.
Despite Hawaii’s cautious effort to reopen, which has allowed travelers who tested negative for COVID-19 before flying into the state to avoid quarantine rules, Kauai Peak illustrates the difficulty of maintaining public health – even on an isolated island. – when the economic recovery is based on travel. Kauai officials have decided that the cost of a holiday in paradise is too high for now.
Clark received COVID-19 in November and died about 10 days later. At the age of 84, he worked until he contracted the disease and, most recently, transferred pilots and airline crew to and from the airport. Airline crews are exempt from state testing and quarantine regulations.
The day after Clark’s death, Kauai officials said they would drop the state testing program and ask visitors to quarantine them again for two weeks, whether or not they were negative for COVID-19 before they arrived. .
Kauai officials say the single test scheme did not do enough to protect the people living there. With just nine ICU beds and 14 fans, the island’s health care system could be quickly overwhelmed by a major outbreak, said Kauai Mayor Derek Kawakami.
In an attempt to prevent such a scenario, Kawakami proposed a second mandatory test for all passengers upon arrival. His plan would have included a short quarantine while people waited for the second result.
“We believe that having a negative test is a good precondition for boarding a plane,” Kawakami said. But “once you land on Kauai … (travel) it should be able to stay and cool for three days.”
But the proposal was rejected by state officials, and Democratic Gov. David Ige said the plan would have to be funded and administered locally.
After the rise of Kauai, the State Department of Health tracked most of the island’s October and November cases to returning residents and tourists who brought the virus despite the pre-flight testing program.
JoAnn Yukimura, a former Kauai mayor and friend of Ron Clark for more than three decades, said his death shook the community and that she was constantly thinking “about himself alone in the hospital. … How lonely you must have been to die. “
“Ron’s death may seem like such a small matter to outsiders,” Yukimura said. But “it hit us hard because we, on Kauai, didn’t fall in love with death and disease – and we never want to end up like that.”
Before the pandemic, Hawaii welcomed about 30,000 tourists a day who spent nearly $ 18 billion last year.
In March, when the state’s two-week quarantine rule was imposed, tourist arrivals and incomes fell. The number of visitors has since increased with the testing program, but only to about a third of pre-pandemic levels.
On Kauai, 57-year-old Edwin Pascua has been out of work at his hotel since March and worries that he will have contact with infected travelers – but would prefer to work.
“If there are guarantees in place, this would diminish everything,” he said. “I wouldn’t be as scared.”
Pascua and his wife, who work at the same hotel, managed to receive unemployment benefits, but he knows people who “haven’t even received a check yet, a check from unemployment.”
Despite the increase in the new infection and the registration of deaths on the American continent, top officials in Hawaii insist that the pre-trip testing program works.
“The proof is in the pudding,” said Josh Green, Lt. Governor of Hawaii. “Hawaii has the lowest COVID rate in the country because of this program right now.”
Hawaii has relatively low hospitalization and death rates, but health experts say that because of the way COVID-19 builds up in the body over time, the second test for travelers would eliminate more infections.
Dr. Kapono Chong-Hanssen, a Hawaiian native who runs a Kauai community health center, said the single test requirement “goes against medical evidence.”
“We’re starting to see these big holes in the plan and I think it’s a matter of time before we pay the price,” he said.
There have been more than 380 travel-related infections in Hawaii since the launch of the test program, according to the state Department of Health.
It is believed that the actual number of infections among the general population is much higher than reported. Many asymptomatic people, who can still spread the disease, are not tested.
Dr Ashish Jha, dean of the School of Public Health at Brown University, said travel restrictions for most places at this time of the pandemic were “either counterproductive or relatively unnecessary” and could give a false sense of security.
“There is evidence that international travel bans are useful in slowing things down,” Jha said. But “if you don’t seal your country completely and do it early, it’s pretty hard to use it as a strategy.”
Kauai, isolated from the ocean and largely protected from early restrictions, had done just that.
When the initial quarantine rule was in place, Kauai residents went to restaurants, schools were open, and locals spent their money in the community. This could happen again with Kauai’s reintegration of the quarantine rule, amid local hope that the community will remain healthy.
The trips “introduce a steady stream of new infections,” said Dr. Janet Berreman, Kauai’s state health officer.
“This tsunami, if you will, of the disease,” she said, “has marched across the continent from east to west.” We are a little further west, over a body of water. But everyone wants to come here for the holidays. “
___
Associated Press writer David Koenig of Dallas contributed to this report.