Where stakeholders stand on pre-flight COVID testing

Coronavirus

HONOLULU (KHON2) — Requiring COVID testing prior to boarding flights to Hawaii could help reopen safe travel for visitors and locals. But key hurdles are blocking the pre-test efforts. Always Investigating finds out what has to happen to get a green light.

The feds tell KHON2 that tests can be required, but by the airlines not the government. Hawaii’s hometown carrier is at a “maybe” for now along with other key stakeholders, and some state authorities are not ready to drop the 14-day quarantine even with a clean test.

Nonetheless, the chorus is growing among leaders calling for COVID clearance before flying to Hawaii.

“That somebody was negative within the past 72 hours, from a physician’s standpoint, gives me a lot of reassurance,” said Dr. Josh Green, Hawaii’s lieutenant governor. “I’ve spoken with the head of the Centers for Disease Control directly who was more than willing to see this kind of plan take place.”

“The quarantine itself is not going to regain tourism,” said U.S. Rep. Ed Case. “We want to test on the front end and phase out the quarantine on the back end, otherwise people are not going to come here.”

“If we’re going to be able to stop this, we’ve got to stop it at its source, and that’s the people who are coming here or visitors who are coming back,” said state Rep. Gene Ward, (R) Hawaii Kai.

Ward says a White House representative told him the same this week: “It was a phone call that I got Wednesday morning. They called and they said we’ve been going back and forth, and after going fully through the vetting of the FAA and USDOT, they have concluded there’s nothing that can deny it that you guys have the right to do it. So I said is that a green light? He said yes.”

With so many saying “yes,” where are the hurdles?

Always Investigating found two key state departments are still a “no” for letting any test qualify for release from quarantine: the Hawaii Department of Health and the Hawaii Department of the Attorney General.

The governor and several others are a maybe, including the state Department of Transportation, the Hawaii Emergency Management Agency, and Hawaiian Airlines.

The lieutenant governor, other local and national lawmakers, even White House officials and head of the Centers for Disease Control have signaled support. Always investigating found out the plans would not run afoul of any rules of the Federal Aviation Administration nor of the U.S. Department of Transportation.

But there’s a wrinkle: While the U.S. DOT tells me “airlines can refuse transport to passengers” they say “states do not have the authority to require airlines to do so.”

We asked Hawaii’s congressional leaders at KHON2’s virtual town hall this week: What about changing that rule? How quickly could that be changed where testing could be a barrier for entry?

“How quickly is an interesting question,” said U.S. Rep. Tulsi Gabbard. “I don’t think there’s a clear answer to that. Unfortunately, even in this public health crisis, some of these requirements that are in the best public health interest have been relegated to partisan issues.”

And as for those two big local “no” red lights? The state health director, Dr. Bruce Anderson, told KHON2: “There is currently no laboratory test that can determine if someone is infectious.”

The state attorney general’s spokesperson says a negative test wouldn’t shorten quarantine anyway.

The governor told KHON2 he’s keeping an open mind and could pilot a project with international guests first.

“Being able to test before they get on the flight is a critical component,” Ige said at KHON2’s town hall. “We do have a little more authority for foreign and international travelers, working with the state department, and so certainly we’re looking at potential pilots with Japan or Korea.  New Zealand comes up a lot or Australia.”

Short of a change in U.S. law, it’s still up to American air carriers as to whether they will each require testing.

Hawaiian Airlines tells Always Investigating: “Until tests become readily available to all who wish to travel, we believe a system of layered protections that begins with temperature screening at TSA departure checkpoints, continues with health and sanitization protocols at check-in and on board the aircraft, and is followed by rigorous contact tracing post-arrival will be the most effective means of providing the confidence needed to re-open Hawaii.”

“Temperature testing is like after the horse leaves the barn, the contact tracing of which  we have $36 million for is after the horse left the barn,” Ward said. “We are chasing the tail of an animal that will never be caught.”

We followed up with Hawaiian Airlines, asking what constitutes “readily available,” and do they envision a phase at which testing becomes a requirement in the future?

“Readily available = accurate and affordable tests that are readily available for travelers as demand returns from all points of departure,” Hawaiian Airlines responded in a statement.

As for whether foresees initiating a testing requirement, versus just abiding by any mandatory procedures if it became a requirement of law, Hawaiian Airline responded: “As with all screening protocols, it would make most sense as part of a national system.”

While working toward legislation to require preflight testing, supporters hope to try pilot projects on a voluntary basis.

“The technical legal nuances, right now we can’t make you, but maybe we give you the option, you want to go 14 days in quarantine fine,” Ward said. “If you don’t want quarantine, go to Longs or CVS or Walgreens and get the test.”

Always Investigating questioned Ward about the efficacy of a voluntary program, stating: Even with a planeload of people who want to do the pretest option, if one boards who didn’t and they’re on that plane for 6 or 7 hours together, they could literally be the poison pill. How do they propose to prevent that?

“It’s not 100 percent risk free,” Ward said. “But that one passenger, it would be illogical to want to stay in quarantine 14 days versus spending $31 to get a COVID 19 test.”

Both the “no’s” – the AG’s office and the Health director — left the door open just a crack, telling KHON2 their positions are based on the current state of testing science. The health director said he may update recommendations if a suitable test becomes available.

“I’m going to make it a personal mission whether it becomes full-tilt policy or just a ‘get of out jail free’ pass to come in quickly, or just an add on, I’m going to socialize this idea across the planet because it will no matter what provide for more protection,” Green said.

FULL STATEMENTS FROM STAKEHOLDER AGENCIES

Federal Aviation Administration

The FAA doesn’t have anything to do with health screening of visitors. This is not an FAA issue. DOT might have regulations addressing this, but the FAA does not.”

– FAA spokesperson

U.S. Department of Transportation

“The U.S. Department of Transportation regulates whether airlines may limit access to transportation because a passenger has a communicable disease, such as COVID-19.  Airlines are permitted to limit access to transportation to any person suspected of having a communicable disease if the person’s condition poses a direct threat to the health or safety of others.  Airlines are required to make the determination as to whether a person’s condition poses a direct threat based on reasonable judgment that relies on current medical knowledge, including directives issued by public health authorities, such as the Centers for Disease Control and Prevention.  For example, airlines can refuse transport to passengers if they have tested positive for COVID-19 or exhibit symptoms of COVID-19 unless the passengers present a medical certificate stating, under the present conditions, they do not have COVID-19.  While airlines may deny boarding to passengers that pose a direct threat to the health or safety of others, States do not have the authority to require airlines to do so.”

– USDOT spokesperson

Hawaii Department of Health

“The Department of Health is actively working with partners, DOT, AG and others on the requirements to minimize risks associated with lifting the mandatory 14-day quarantine period for interisland travel. Conditions on lifting interisland quarantine will include maintaining a low incidence of disease throughout the state and the capacity to investigate and respond to any new cases in a timely manner, which currently exists. In addition to physical distancing and other requirements to prevent the spread of disease aboard the aircraft, a passenger declaration form and thermal temperature screening before departure is being considered. In addition, travel history will be reviewed to ensure the passenger is not subject to the 14-day quarantine prior to departure. The mandatory 14-day quarantine will l remain in effect for domestic and international travelers. There is currently no laboratory test that can determine if someone is infectious. Testing is a useful diagnostic tool used in the investigation of cases and for contract tracing, but testing all passengers as a condition for allowing travel on an aircraft is not supported by the current scientific knowledge that exists on available testing methods. Nevertheless, the Department of Health is monitoring scientific developments and we may update our recommendations if a suitable test becomes available.”

– Dr. Bruce Anderson, director, Hawaii Department of Health

Hawaii Department of the Attorney General

“The 14-day traveler quarantine is based on current science that says the incubation period for COVID-19 is 14 days. Therefore, the 14-day traveler quarantine is intended to protect the state from someone, whether resident or not, who flies into the state. CDC currently advises that a negative test does not mean you won’t get sick or that you won’t spread the diseases. Therefore, at least for right now with the current state of the testing science, providing the state with proof of a negative test will not shorten the period of quarantine.”

“Per the CDC: If you test negative for COVID-19, you probably were not infected at the time your sample was collected. However, that does not mean you will not get sick. It is possible that you were very early in your infection when your sample was collected and that you could test positive later. Or you could be exposed later and then develop illness. In other words, a negative test result does not mean you won’t get sick later. This means you could still spread the virus.”

– Krishna F. Jayaram, special assistant to the Attorney General

Hawaiian Airlines

“Until tests become readily available to all who wish to travel, we believe a system of layered protections that begins with temperature screening at TSA departure checkpoints, continues with health and sanitization protocols at check-in and on board the aircraft, and is followed by rigorous contact tracing post-arrival will be the most effective means of providing the confidence needed to re-open Hawaii. Readily available = accurate and affordable tests that are readily available for travelers as demand returns from all points of departure. As with all screening protocols, it would make most sense as part of a national system.”

– Hawaiian Airlines spokesperson

Rep. Ed Case, excerpt of KHON2 May 21 town hall

“What is it going to take for a tourist to want to travel to Hawaii? They’re going to have to feel like they’re safe getting on an airplane. They’re going to have to feel like when they get off and start wandering around Hawaii, which we hope they will do again, that they are safe. And we want to know that those tourists are getting off the plane safe, too, that they’re not going to mess up our hard-earned gains.”

“The quarantine is an imperfect solution, we all agree on that. That’s forced by the fact that at present the federal government is saying we cannot test before people get on a plane and furthermore deny them boarding if it’s indicated that they have COVID-19. We have to have some form of pre-board testing whether it’s specific to Hawaii — to give the governor authority to do that — or whether it’s a national standard where all travelers going through airports have some basic test by the Transportation Security Administration or by Customs & Border Protection or by the airlines themselves. That’s what it’s really going to take. The quarantine itself is not going to regain tourism, we want to test on the front end and phase out the quarantine on the back end. Otherwise people are not going to come here.”

Governor David Ige, excerpt of KHON2 May 21 town hall

Gina Mangieri: “Gov. Ige, what more do you need to know or see or be proven about the testing to even start to give these kinds of pre-entry tests a pilot project or a try? This quarantine can’t go on forever, so what more needs to be known to pull the trigger on some degree of a testing pilot program for tourism?”

Gov. David Ige: “A couple things, Gina, and just to try to lay the groundwork, I agree with Ed (Case), we continue to push outside of what we totally control, and being able to test before they get on the flight is a critical component of that. We do have a little more authority for foreign and international travellers, working with the State Department. Certainly we’re looking at potential pilots with Japan or Korea, New Zealand comes up a lot, or Australia, where the virus counts are relatively under control and they have pretty good testing capability and regimes in those countries.”

“It’s working with the entire hospitality industry, the airlines in the international sense, Japan Airlines, Korean Air, ANA and really having a conversation about what they can do prior to their customers boarding a plane. Within the state of Hawaii what we are looking at is, can we create an integrated system involving hotels and visitor attractions, tour companies, everyone involved in the hospitality industry to create a layered screening process so everyone is looking for disease in a way that is appropriate, so we can identify those that are ill and really have a game plan for isolating and keeping them away from other visitors as well as keeping them away from our residents.”

“Until we can do all of those things, until visitors feels safe that they won’t get infected, or if they are and get sick here that we can provide them quality health care, we will have a very difficult time reopening the visitor industry.”

Rep. Tulsi Gabbard, excerpt of KHON2 May 21 town hall

Gina Mangieri: “If just about every state wants to do this and we’re on the tip of the spear so to speak with having the quarantines, what about changing that rule, how quickly could that be changed where that could be a barrier for entry?”

Rep. Tulsi Gabbard: “How quickly is an interesting question. I don’t think there’s a clear answer to that unfortunately. Even in this public health crisis some of these requirements that are in the best public health interest have been relegated to partisan issues.”

(Regarding “travel bubble” countries Gov. David Ige referred to): “When we look at some of these other countries that are in a very good place, they have good practices, they are meeting the benchmarks necessary to say there’s a much lower risk of travelers coming to and from these other countries to Hawaii and therefore more easily being able to instill that confidence that we in Hawaii re not going to be welcoming people who may be carriers  for the coronavirus.”

“I think that we’ve got to pursue all avenues at the federal level as well as at the state level to try to form these agreements that make this possible, but once again in a really responsible way and not prematurely jumping the gun, because otherwise we get to the point where there’s no turning back. We’ll have to do far more and experience far more suffering and damage than if we just act responsibly and do the right thing now.”

Hawaii Emergency Management Agency

“HI-EMA is leading a future operations planning effort to address how the state opens out of state travel.  The team is considering several layers of actions to mitigate risk. However, the planning is still ongoing so commenting on testing at this point would be premature.”

– Adj. Gen. Ken Hara, Hawaii Emergency Management Agency

Hawaii Department of Transportation

“HDOT welcomes all ideas and will work toward any plan as directed. In this case, interagency collaboration is necessary to determine if negative tests are reliable and thus able to exempt the 14-day quarantine order. Implementation of any plans are policy decisions from the Governor and incident commander.”

– Tim Sakahara, DOT spokesperson

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