HONOLULU (AP) – On the rural island of Kauai in Hawaii, where expansive white sand beaches and dramatic seaside mountains draw visitors from all over the world, local residents spent the first seven months of the pandemic sheltered from the viral storm.
Early and aggressive local measures coupled with a strict statewide travel quarantine kept Kauai’s 72,000 residents largely healthy – the island had only 61 cases of coronavirus from March to September. But on Oct. 15, the state launched a pre-travel test program to revive Hawaii’s decimated tourism economy.
Kauai went from having no infections to at least 84 new cases in seven weeks. The wave sparked community transmission and led to the island’s first – and so far only – COVID-19 death: Ron Clark, who worked as a tour driver for decades.
Despite Hawaii’s cautious attempt at reopening allowing travelers who tested negative for COVID-19 before flying to the state bypass quarantine regulations, the Kauai peak illustrates how difficult it is to maintain public health – even on a remote island – when economic recovery depends on travel. . Kauai officials have decided that the cost of a vacation in paradise is too high for now.
Clark got COVID-19 in November and died about 10 days later. At the age of 84, he worked until he contracted the disease, most recently transporting pilots and crew members to and from the airport. Flight crews are exempt from state testing and quarantine regulations.
The day after Clark’s death, Kauai officials said they would opt out of the state’s testing program and that visitors would be quarantined for another two weeks regardless of whether or not they test negative for COVID-19 before arriving.
Kauai officials say the single testing program has not done enough to protect the people who live there. With just nine ICU beds and 14 fans, the island’s health care system could quickly become overwhelmed by a major outbreak, Kauai Mayor Derek Kawakami said.
To avoid such a scenario, Kawakami proposed a mandatory second test for all passengers after arrival. His plan would include a brief quarantine while people waited for their second result.
“We think a negative test is a good prerequisite for getting on board,” Kawakami said. But “once you land on Kauai … (travelers) should be able to cool off for three days.”
But the proposal was rejected by state officials, with Democratic Governor David Ige saying the plan should be locally funded and administered.
After the Gulf of Kauai, the State Department of Health traced most of the October and November cases on the island to returning residents and tourists who brought in the virus despite the pre-flight testing program.
JoAnn Yukimura, a former Kauai mayor and friend of Ron Clark for more than three decades, said his death shocked the community and she constantly remembers “he’s alone in the hospital. … How lonely it must have been to die. “
“Ron’s death may seem such a minor matter to outsiders,” Yukimura said. But it “hit us hard because we haven’t gotten used to death and disease on Kauai – and we never want to get that.”
Before the pandemic, Hawaii welcomed about 30,000 tourists daily who spent nearly $ 18 billion last year.
In March, when the state imposed the two-week quarantine rule, tourist numbers and revenues plummeted. Attendance numbers have since risen with the testing program, but only to about a third of pre-pandemic levels.
On Kauai, 57-year-old Edwin Pascua has been unemployed from his job at a hotel bellhop since March and is concerned about contact with infected travelers, but would rather work.
“If precautions were taken, that would lessen all that,” he said. “I wouldn’t be that scared.”
Pascua and his wife, who work in the same hotel, can get by on unemployment benefits, but he knows people who “haven’t even gotten a check, one check for unemployment.”
Despite the new wave of infection and record deaths in mainland US, top Hawaii officials insist that the testing program works before the trip.
“The proof is in the pudding,” said Lt. Governor Josh Green of Hawaii. “Hawaii currently has the lowest COVID rate in the country because of this program.”
Hawaii has relatively low hospital admissions and death rates, but health experts said that because of the way COVID-19 builds up in the body over time, second tests for travelers would clear more infections.
Dr. Kapono Chong-Hanssen, an Indigenous Hawaiian physician who runs a community health center in Kauai, said the requirement for a single test “goes against the medical evidence.”
“We are starting to see these big gaps in the plan and I think it will be a matter of time before we pay the price,” he said.
According to the state health agency, there have been more than 380 travel-related infections in Hawaii since the testing program was launched.
The actual number of infections in the general population is believed to be much higher than what has been reported. Many asymptomatic people, who can still spread the disease, are not tested.
Dr. Ashish Jha, dean of the school of public health at Brown University, said travel restrictions for most places at this point of the pandemic are “either counterproductive or relatively useless” and can provide a false sense of security.
“There is some evidence that international travel bans are helpful in delaying things,” said Jha. But “unless you shut down your country completely and do it early, it’s pretty hard to use that as a strategy.”
Isolated by the ocean and largely protected by early restrictions, Kauai had done just that.
When the original quarantine rule was in effect, Kauai residents went to restaurants, schools were open, and locals spent their money in the community. That could happen again with Kauai’s reintroduction of the quarantine rule in the hope of the locals that the community will remain healthy.
Travel “introduces a steady stream of new infections,” said Dr. Janet Berreman, Kauai’s state health officer.
“This tsunami, if you will, of disease,” she said, “has crossed the mainland from east to west. We are just a little further west across a body of water. But everyone wants to come here for the holidays. “
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Associated Press writer David Koenig in Dallas contributed to this report.