COVID-19 screening capacity grows along with safety merits for 2nd test post-arrival

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HONOLULU (KHON2) — Travel opens up this week with a pre-arrival test option to get out of quarantine. But there are more safety precautions that tourists, locals and Hawaii businesses can take to prevent spread beyond what just one test can catch.

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The Department of Health supports second tests or interval screening post-arrival. But local test capacity, cost and what to do with tourists and returning locals in the meantime between tests remain logistical issues.

Local COVID testing is set to expand, with both state and local labs aiming to boost capacity and turnaround time, a Honolulu County lab coming online soon, and the Abbot BinaxNOW kits, a rapid platform from the feds that gives Hawaii 27,000 tests a week from now through year end.

“That’s not enough to do all the things we would like to be able to do,” explained Dr. Edward Desmond, administrator of the State Department of Health Laboratories Division, “which is to be able to help with schools, but theoretically to help with travel, workplace testing and so forth.”

In unveiling details of the pre-arrival test program last week, DOH Director Libby Char said one-test programs run the gamut, catching as few as 20 percent of COVID cases or as many as 80 percent, whereas a second test would close that gap if and when test capacity allows.

“The department’s position is a second test will improve our ability to detect infected airline passengers,” Desmond said. “The problem is with the logistics. The devil’s in the details.”

Details including deciding when is best to swab for a virus that can take 2 to 10 days to incubate and show up on a test, and what to allow folks to do meanwhile.

“If you tell somebody you’re going to do a second test and you’re keep them in quarantine until a second test, that could be a big deterrent,” Desmond said.

Health experts say says mask wearing, washing hands and keeping distance should be sufficient protection in most cases, especially as visitors enjoy outdoor areas and activities, or stick to their own small groups as they rest, play and dine.

Desmond says conscientious travelers should consider volunteering for the planned second-test surveillance screening, which Lt. Gov. Josh Green said the state plans to offer about four days after arrival. The Big Island is going to do mandatory second tests on landing for those who want to avoid two-week quarantine, though the Desmond cautions that may be too close in timing to the first pre-arrival test.

“Testing on arrival, it will pick up additional positives on some people who tested negative in the test that was done 1 to 3 days before travel. It will pick up some of those,” Desmond said. “But it won’t be completely effective, and if there were some interval testing some days later, then that would pick up more people. If they were infected at the airport or on the airplane, we’d want to test them a week or so later.”

Of course it’s not just tourists flying in. What should conscientious locals, employers and businesses do regarding those who carry one pre-arrival negative test? Experts say second or interval tests several days after arrival and before coming back to work or attending a congregate setting would be a good precaution.

“For people returning home I think it does matter whether they’re coming back to an environment where there are susceptible people,” Desmond said, “So if they’ve got a multigenerational family and the grandparents are there in the house, or they work in a nursing home or working at a jail, with those vulnerable populations it would be good to screen them.”

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