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Hawaii’s rural island of Kauai has seen a spike of COVID-19 cases since launching pre-travel testing to reignite the state’s decimated tourism industry.
Early and aggressive local measures coupled with a strictly enforced statewide travel quarantine kept the island’s 72,000 residents mostly healthy — with only 61 known coronavirus cases from March through September. But on Oct. 15, the state allowed travel to partially resume
Kauai then went from having no active infections at all in the first part of October to at least 84 new cases in the ensuing seven weeks. The surge seeded community transmission and led to the island's first — and so far only — COVID-19 death.
A woman walks into the international airport in Honolulu amid a quarantine rule that effectively shut down the tourism industry in the state. (AP)
Hawaii's cautious reopening allowed travelers who tested negative for COVID-19 before they flew to the state to sidestep quarantine rules.
After the island’s first recorded death, Kauai officials said they would opt-out of the state's testing program and require visitors to again quarantine for two weeks whether or not they tested negative for COVID-19 before arriving.
Officials say the single-test scheme did not do enough to protect the people who live there. With only nine ICU beds and 14 ventilators, the island's health care system could quickly become overwhelmed by a large outbreak, said Kauai Mayor Derek Kawakami.
Seeking to prevent such a scenario, Kawakami proposed a mandatory second test for all passengers after arrival. His plan would have included a short quarantine while people awaited their second result.
But the proposal was turned down by state officials, with Democratic Gov. David Ige saying the plan would have to be locally funded and administered.
After the Kauai surge, the state Department of Health traced most of the island's October and November cases to returning residents and tourists who brought the virus in despite the pre-flight testing program. Before the pandemic, Hawaii welcomed daily about 30,000 tourists who spent nearly $18 billion last year.
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In March, when the state's two-week quarantine rule was imposed, tourist arrivals and revenue plummeted. Visitor numbers increased with the testing program, but only to about a third of pre-pandemic levels.
Other top Hawaii officials, meanwhile, insisted that the pre-travel testing program works – despite the new infection surge and record deaths on the U.S. mainland.
"The proof is in the pudding," Hawaii Lt. Gov. Josh Green said. "Hawaii has the lowest rate of COVID in the country because of this program right now."
Health experts said because of the way COVID-19 accumulates in the body over time, second tests for travelers would weed out more infections.
Dr. Kapono Chong-Hanssen, who runs a Kauai community health center, said the single test requirement "goes against the medical evidence."
"We're starting to see these big holes in the plan and I think it's a matter of time before we pay the price," he said.
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There have been more than 380 travel-related infections in Hawaii since the testing program was launched, according to the state health department.
The real number of infections among the general population is believed to be far higher than what has been reported. Many asymptomatic people, who can still spread the disease, do not get tested.
The Associated Press contributed to this report.
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