COVID-positive pre-arrival results are a blind spot for Hawaii travel program

Always Investigating

HONOLULU (KHON2) — Just a month into the pre-travel test program, nearly 190,000 negatives tests have helped locals and visitors bypass quarantine. But what about the ones who test positive? Always Investigating found it’s a big blind spot for the state and counties.

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The state tells Always Investigating they can’t make their trusted testing partners tell them which out-of-state travelers came up positive on a pre-arrival test. Only a few dozen people have self-reported positives since the Safe Travels program began last month.

In just the four weeks since the Safe Travels pre-arrival test option began, tiny Kauai has already seen nine locals and visitors come up positive for COVID-19 on the test the traveler hoped would get them out of quarantine. Instead, they went into isolation.

“The cases that we know about are ones either that we learned about sort of accidentally by happenstance,” explained Dr. Janet Berreman, the state Department of Health’s Kauai District officer. “The person who got the positive test told somebody who told somebody who told somebody who was a doctor and told another doctor who said, ‘Let’s call the health department.’ But some of them are people who are doing the right thing, ‘Oh, my goodness, I have a positive test. I wasn’t expecting this. I’m sure the health department wants to know.’”

Kauai’s nine comes out to about one positive every few days of the program so far, just for the Garden Island. KHON2 wanted to know, what are the numbers statewide for pre-travel test results coming back positive after landing? State and county departments pointed us in several different directions, before the Department of Health revealed it’s more than 40.

“But these are only the people who have uploaded their positive results,” a state spokesperson told KHON2.

“I do think that kind of gut-level feeling about this is that we’re seeing the tip of the iceberg and we just don’t know how big that iceberg is,” Berreman said. “There’s no incentive for a traveler to upload a positive test, because that’s likely to interrupt your vacation plans or your returning-home plans.”

Always Investigating asked: Aren’t the trusted testing partners required to tell the state, even if the traveler doesn’t disclose the bad news willingly?

The Attorney General’s (AG) office responded:

“The agreement does require test results to our DOH for Hawaii residents. For non-residents, there are potentially regulatory issues and it’s something we are thinking through. Additionally, we are requiring total numbers per month of tests and positive results.”

Office of the Hawaii Attorney General

The AG’s office did not yet disclose the October tally.

KHON2 asked the department in charge of the technical side of Safe Travels, what happens when someone uploads a positive test on the honor system?

“When the test result is positive or inconclusive, it is forwarded to the Department of Health for further evaluation, follow-up and reporting,” said State of Hawaii Chief Information Officer Douglas Murdock. “The system is not used to track the actual number of positives.”

It’s a big blind spot, especially because when a traveling positive is known, only those Hawaii residents will be included in the state’s daily COVID-19 report. Positive visitors who are pre-travel tested out-of-state are not added in.

“That positive test result is going to go to whatever health jurisdiction I live in,” Berreman explained. “If you think about how huge California is, for example, and how many cases there are, there’s no good way for California to know out of their thousands of cases every day, ‘Oh, this person is on vacation in Hawaii now’ and let us know. So that’s the gap in the system.”

In addition to the nine Kauai pre-travel positive arrivals, the Garden Isle saw another dozen locals and visitors with negative pre-tests later turning up positive on a follow-up second test.

“I hope that the value of the information from Kauai is to kind of shine a light on where there are gaps and deficiencies in the Safe Travels program so that those can be improved and tightened,” Berreman said. “Because our baseline was no disease, I think what it does is really shine a clear light on the risks that are posed by travel.”

It’s a risk that grows along with the rapid rise in COVID cases across the mainland.

“There’s a tsunami headed toward us, and we have an opportunity actually to hold it at bay because we have borders,” Berreman said. “And we’ve done such a good job since March at really keeping our numbers down. The only state in the whole country that’s better than us is Vermont. We’re doing phenomenally well. And I know everybody’s tired. But this isn’t the time to give up. This is the time to have extra resolve because things are so much more out of control on the mainland than there have been at any time.”

Kauai Mayor Derek Kawakami has asked the governor to sign new orders allowing Kauai to require a second post-arrival test before breaking quarantine, and having the first negative pre-travel test results in hand and uploaded to the Safe Travels database before departing for Kauai.

It’s a direction the officials are already moving in for international arrivals and may shift to for mainland arrivals.

“The policy is going to be that for the Canadian travelers and the Japanese travelers, they’re going to have to have their results uploaded beforehand,” Lt. Gov. Josh Green said. “So this is becoming the policy quickly behind the scenes. We’re saying this a lot that we should do it. The benefit of that is you don’t have to worry that someone tries to sneak through.”

Testing partners say they’re already being urged to move in this direction. Last week, CityHealth said it was changing its Oakland airport testing protocol because, “Due to a recent increase in confirmed COVID cases, the state of Hawaii strongly recommends all travelers wishing to enter the state to have proof of a negative COVID test result before boarding a plane bound for Hawaii.”

This verbiage is not yet on the state’s own Safe Travels website, which currently only says your airport wait will be shorter post-arrival if you get all your ducks in a row and get your QR clearance code ahead of landing.

Always Investigating asked the governor’s office, did they officially update their guidance to the testing partner companies, as CityHealth called it a “change to Hawaii Safe Travel restrictions” in its press release. The governor’s spokesperson replied: “The statement by City Health simply reflects what the State of Hawaii has been encouraging travelers to do all along during this pandemic – have proof of a negative test showing they are COVID-free before boarding a plane.”

Nearly 187,000 negative pre-travel tests have been posted to the state’s Safe Travels database since the program started. The program dashboard says that’s out of 283,000 total travelers; about one-third of the travelers are local residents.

Separately, a surveillance study has spot-checked more than 17,000 travelers post-arrival since Oct 19. As of today, there have been 24 confirmed positives, or 1.4 per 1,000.

“The first month of our study’s preliminary results are bearing out our thesis that Hawaii’s Safe Travels program is keeping COVID-positive travel rates exceptionally low,” said Dr. DeWolfe Miller, an epidemiologist from the University of Hawaii John A. Burns School of Medicine, who is part of the study team along with the Hawaii Emergency Management Agency and the lieutenant governor.

“As COVID-19 rates surge on the U.S. mainland, this additional layer of protection for Hawaii is more critical than ever,” Green said, “and we will continue to improve this safety system to meet whatever needs arise, including more testing after arrival if that is what is required to keep our people safe.”

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