To Mayor Kawakami and the County Council:
Please reconsider the plan to reopen the island to tourists with anything less than the Centers of Disease Control recommended guidelines for quarantine.
The implementation of a three-day quarantine is insufficient to protect the people of Kaua‘i. Be clear, this is three days from their last uncontrolled, high-risk behavior — which is getting on a plane and traveling through an airport. This is the date from which quarantine should be considered. The Centers for Disease Control has been quite clear about quarantine required to detect greater than 90% of cases. It requires 10 days. See tgilinks.com/3nsLXlq
Quarantining for seven days with a negative test within 48 hours of the time of planned quarantine discontinuation results in an estimated 88% to 95% detection rate. They specifically state that quarantine cannot be discontinued earlier than after day seven.
Why then do we believe that we should implement a standard different than this? This will result in an extreme influx of highly-contagious people into our population. Don’t ignore the recommendations of the most-knowledgeable scientists in infectious disease in our country.
We only have to look at the Hawai‘i Department of Health Hawaii data website to understand how ill-advised this idea is: tgilinks.com/3sdju6v
Specifically, if we look at the trajectory of cases per hundred thousand population, we were on an identical trajectory as the County of Maui between early November and Nov. 22. When we closed the island, our case numbers per population went down from five to the values between 0.4 and the current value of 1.8. Maui’s has gone up to a current level of 18.5, some 10 times our number of daily new cases. Why is that? Because they opted to leave the island completely unprotected from the tourist influx.
Yes, many of our cases are due to residents traveling between islands and from the mainland. They should be required to quarantine exactly the same as anyone else coming onto the island. Look at the data on this graph and decide which island you want to live on. It’s not Maui and it’s not O‘ahu, and we should not be mimicking their ridiculous “Safe Travels program.”
As we are faced with the introduction of a more-contagious variant of coronavirus in large parts of the country, we need to consider this: Being 50% or 70% more contagious does not mean that 50% or 70% more people are going to get it over a month’s time.
It means that each infected person is more likely to infect a greater number of people. That change becomes exponential over the incubation. Currently the (entire) state of Hawai‘i has an estimated infection growth rate of 1.11, meaning that for each person that is infected they will infect 1.11 other people. If that new strain has a transmission rate that is 50% higher, and we assume a six-day infection-generation time, we will have over 7.5 times the number of infections in a month as we do with the current strain. That is also 7.5 times the number of dead.
We are an isolated community with limited resources. Those resources will become more limited as the supply chain and transportation industry is strained by worker shortages due to deaths and infections.
Already, areas as wealthy as California are rationing oxygen to the ill and discouraging EMTs from transporting those patients who they don’t believe have a good chance of survival. Understand what that means. The person making a decision about whether or not you get treatment is not a physician, it is someone with EMT training. EMTs are not trained to make those decisions. They are trained to provide emergency care and transportation.
Why, as the rest of the country records record numbers of infections, do we want to encourage them to come to Kaua‘i? Even if the three-day quarantine found 50% of the cases that traveled to the island, what do we do with those people? They are here for the duration of their infection competing for the limited medical resources of the island! Meanwhile, the other 50% are interacting with the population without a clue as to their infectivity. And we have to convince the resident population that we are “keeping the safe.”
It is time to make the decision necessary to safeguard this island! Implement a quarantine policy based on medical science, or we will all suffer the consequences.
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James Hoskinson, DVM, is a resident of Kilauea.
