DOH Testing in Hawaii For COVID-19 Remains Deliberately Narrow

Coronavirus In Hawaii

DOH Testing in Hawaii For COVID-19 Remains Deliberately Narrow

By Eleni Gill / March 20, 2020

Gov. Josh Green slammed the pace of the state Department of Health’s screening program as a “total fail.”

By Thursday, more than a thousand Hawaii residents had been screened for the new coronavirus, with less than 3% confirmed as a COVID-19 case.

In just a few weeks, commercial laboratories have far outpaced the state in their rate of testing, but Hawaii Department of Health officials say their screening methodology is deliberately narrow to conserve resources.

To date, the state has conducted 40 tests based on direct physician referrals for patients who are severely ill. Six of those 40 tests returned positive for COVID-19.

In addition, the State Laboratories Division has tested another 124 people randomly, none of whom were found to have the coronavirus. They were sampled from a random pool of patients who had suspect symptoms confirmed to not be caused by the flu.

The health department has said it would be capable of testing 250 specimens a week, and 500 within a week if needed for an emergency.

But Lt. Gov. Josh Green says he’s disappointed by the state’s slow testing pace.

“It’s a total fail,” he said. “We have to protect our people. We have to test those who are sick and every municipality across the country knows now we have to test and find where the disease is and test any contact cases and that’s the way to slow the spread of this disease.”

The Hawaii State Laboratories Division has conducted 124 random tests and 40 physician-referred COVID-19 tests as of Thursday.

Cory Lum/Civil Beat

Private laboratories, in partnership with sister laboratories on the mainland, have conducted more than 1,000 tests, resulting in 20 positives, according to DOH. Officials with the State of Hawaii COVID-19 Joint Information Center said Thursday the JIC did not “have the exact figures” for private laboratory testing and directed Civil Beat to ask laboratories directly. But a Clinical Labs of Hawaii spokesperson said the company is “providing all the data for DOH to release.”

Green confirmed that Clinical Labs, just one of two private laboratories currently conducting tests in the state, had conducted more than 2,000 tests, but some may have not yet been verified by state laboratories.

Private sector laboratories will need resources to keep up the pace. According to the Legislature’s Senate Special Committee on COVID-19, commercial laboratories report they’re “running low on supplies” to screen for COVID-19.

26 Cases So Far

Green considers Hawaii lucky that only 26 cases have been confirmed to date.

Lt. Gov. Josh Green, the state’s medical liason for COVID-19 response efforts, says the medical community is frustrated by the slow pace of testing by the state.

Cory Lum/Civil Beat

“The DOH is working very hard and I have complete respect for the tough decisions they are making, but I’m talking to clinicians across the state and they’re calling me beyond disbelief that some of their patients are getting disapproved (for testing),” he added.

“I’m not interested in arguing with DOH. The World Health Organization, Singapore, Taiwan — everyone who has done wide screening has been able to have a chance to diminish the spread and flatten the curve. Everyone who didn’t do that is now suffering extreme mortality rates.”

All cases have been related to travel, either directly or indirectly, Hawaii State Epidemiologist Dr. Sarah Park said Thursday.

“Indirect travel” signifies someone picked it up from someone else who had traveled, she said, noting two people fit in that category to date.

“It doesn’t mean there’s absolutely no community spread in Hawaii,” Park said. “It just means we’re not seeing widespread community transmission. There still exists a possibility that there’s localized transmission we have not yet picked up.”

A medical team collected COVID-19 specimens at the State Capitol Thursday after state Sen. Clarence Nishihara was diagnosed with the virus.

Courtesy

Most of the 26 cases have been on Oahu. The figure will rise in the coming days, health officials say.

Some high-profile figures have made their COVID-19 diagnosis public, including Sen. Clarence Nishihara and actor Daniel Dae Kim. One Family ‘Involved’ In Latest 10 Cases

When pressed for more details about the confirmed COVID-19 patients, such as age range or where the patients had traveled, DOH would not divulge many details because investigations were “ongoing.”

“At this point we don’t have a lot of information on the cases, and with 10 all at once there’s a lot of work to be done,” Park said.

All 10 cases confirmed Thursday were Hawaii residents — not visitors — who had infections related to travel or someone who traveled, Park said. Among those 10, at least one infection “may be indirectly travel associated,” Park said.

A second case confirmed Thursday was “similar to the previous case where there was no travel associated but the person was working in the visitor industry,” Park said, perhaps alluding to a recent case confirmed in a Kualoa Ranch employee, although she did not specify.

A third case confirmed Thursday was “similar,” Park said, in that the person did not work in the visitor industry, but was “very much exposed to a lot of visitors potentially, so we are investigating further on that case,” she said.

When asked how many patients are related, Park said there was “one family involved,” but did not say how many people were included within the family.

Any visitors who theoretically come to the islands and are diagnosed elsewhere after leaving Hawaii would not be included in the state COVID-19 totals.

Hawaii residents are more likely to contribute to increasing the rate of transmission than visitors are, Park said.

“Think about who actually associates in the community,” she said. “Think about yourselves when you have potluck with friends and families. We need to be mindful that every single new case has potential to start community transmission in our state.”

Legislature Pushes For A Tougher Approach

Elected leaders moved to implement measures Thursday to limit the number of visitor arrivals to the Aloha State.

The Senate Special Committee on COVID-19 announced a recommendation in a press release late Thursday evening that the state mandate home quarantine for all passenger arrivals.

“The recommendation is anyone who lands here to go under home quarantine,” said Green, who sits on the committee as the state’s COVID-19 medical liaison. “We do have that capacity legally and this will act as a extreme deterrent for any non-essential travelers to come to Hawaii until the coronavirus passes.”

Maj. Gen. Kenneth Hara, director of the Hawaii Emergency Management Agency, will recommend Hawaii extend a home quarantine directive to all airline passengers who arrive in the islands.

Cory Lum/Civil Beat

Maj. Gen. Kenneth Hara, the state’s adjutant general and director of the Hawaii Emergency Management Agency who is leading the COVID-19 response, is endorsing the recommendation to Ige, according to the press release.

Gov. David Ige’s spokeswoman Cindy McMillan told Civil Beat there weren’t official plans to do that as of Thursday, but the public can expect more stringent measures to be introduced in the coming days.

Enter Philanthropy

On Wednesday, the Hawaii Community Foundation in partnership with The Omidyar Ohana Fund and Stupski Foundation launched a $2.5 million fund designated to support nonprofits involved in public health efforts.

By Thursday, several anonymous donors boosted the pool to $3 million, Hawaii Community Foundation President and CEO Micah Kane said.

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SIGN UP The first grantee is the Hawaii Homeless Healthcare Hui, known as H4, which will circulate two mobile screening vans to screen people without permanent housing who are living on the streets. H4 was founded by Green, who still works part-time on the Big Island as an emergency room physician, and Kaneohe physician Dr. Scott Miscovich. Since 2018, H4 has offered medical services to the Institute for Human Services’ men’s shelter in Iwilei and the Chinatown Joint Outreach Center.

In the future, the mobile units may conduct home visits to elderly people living at home in self-quarantine to screen them for COVID-19 and provide meals, Kane said.

“We’re really concerned about rural communities especially on neighbor islands, and we’re working with some nonprofits to try and figure out how those communities can be reached,” Kane said.

Editor’s Note: The Omidyar Ohana Fund, established by Pierre and Pam Omidyar, is managed by the Hawaii Community Foundation. Pierre Omidyar is the CEO and publisher of Civil Beat.