HONOLULU (KHON2) — Hawaii doctors have alerted the Department of Health at least 8 times about patients they thought could have coronavirus, but none of them were tested. Always Investigating explains why.

The state tells KHON2 the eight patients flagged by doctors did not meet the definition requiring testing. Hawaii is among just a handful of U.S. states and territories that have not submitted samples to the CDC.

The state Department of Health’s daily update still shows no confirmed cases of COVID-19 in Hawaii. There are 61 people self-monitoring (55 on Oahu, 4 Hawaii Island,1 Maui, 1 is Kauai) but none are in quarantine. The DOH says there are no “persons under investigation.”

Always Investigating found out Hawaii doctors submitted eight “Patient Under Investigation” report forms to the Department of Health.

But the DOH spokesperson tells KHON2: “After DOH evaluation and follow-up, none of these requests met the CDC case definition for a Person Under Investigation and for testing.”

Always Investigating asked: What might lead a doctor to go ahead and submit that form?

“Coronavirus is a respiratory illness, and it has a lot of symptoms that are identical to influenza and also the common cold. Except that with influenza you have a fever and with coronavirus, frequently you have a fever,” explained Dr. Kalani Brady of the University of Hawaii John A. Burns School of Medicine. “So a doctor will see a patient with those symptoms and then might be concerned that this would be coronavirus.”

Currently nationwide all testing must be done by the CDC at its mainland facility. As of today the state of Hawaii still has not submitted any samples, while 43 other states and territories have sent in a total 479 for testing. The CDC says 14 tested positive, 412 tested negative, and 53 are still pending results.

The state of Hawaii DOH currently instructs doctors to collect and give the state 2 specimens along with any PUI form if both exposure and illness are present.

We asked the state how it handled the samples provided with the 8 PUI forms. The DOH spokesperson told us: “The forms were sent to our state lab with specimens and the specimens were not tested because the samples did not meet the criteria. The samples were discarded.”

Dr. Brady tells KHON2 a change is being made, as of this week, to both the form and the PUI procedure.

“(Hawaii State Epidemiologist) Dr. (Sarah) Park and her team at the Department of Health have developed a new clearer direction for how to identify a person under investigation which we call a PUI,” Brady said, “to avoid false positives and alarming follow-up by the Department of Health of cases that may have nothing to do with coronavirus.”

KHON2 asked, will this new form also require specimens?

“It may,” Brady said, “but they will probably be collected by the Department of Health” rather than by the physician as currently instructed.

Brady says it will still likely be weeks before any in-state testing becomes possible.

We’re checking on whether any of those 8 are among the 61 people self-monitoring.