We need to learn from Alaska

Governor Ige and Lt. Gov. Green told our mayor and Dr. Berreman that our mayor’s safe-opening plan with one test before you fly to Hawai‘i and a second test after a shortened quarantine was not acceptable.

The governor stated that Kaua‘i and the other neighbor islands needed to let in all visitors who have a single negative preflight test with no quarantine.

This is despite a large number of physicians (including Dr. Fauci) stating that a single pretest will miss many infected travelers. Current data shows that a single test misses at least 30% of those who are infected because they are still in their incubation period and the tests are not sensitive enough to pick up the virus in the early days of an infection.

Alaska does a good job of collecting data. What is happening in Alaska should be a wakeup call for our state.

Similar to Hawai’i, Alaska is not contiguous with the rest of the mainland U.S. and, most importantly for our comparison, they opened up June 5 with essentially a single pretest and minimal quarantine requirements.

They had about 600 cases statewide at that time. In a little more than two months, they were up to 4,500 cases. They are now approaching 10,000 cases (four months after opening). But these are not the only disturbing statistics coming out of Alaska:

• The ethnic groups hit the hardest in terms of hospitalizations were Native Hawaiians and Pacific Islanders. Their hospitalization percentage was more than double any other group;

• Alaska has been screening arrivals at the airport with a test if they had no preflight test. They have screened 70,658 people in this fashion, and six per 1,000 passengers were found to have the virus. If they found six it means about eight to nine per 1,000 passengers probably have the virus because the tests miss about one third of people who are infected;

• So, if the travelers coming here were similar to Alaska, for every 1,000 people tested before they got on the plane, six would be found to have the virus and told to stay home, and about three would be missed and travel to Hawai‘i (possibly infecting people in the airport and the plane). If we start having 1,000 visitors per day, three per day might be infected, and that would mean 90 or so infected people a month possibly coming to our shores. A visitor might just infect a single person on the island, but when that person brings it home, the numbers can jump fast. We have very limited hospital capacity, and this level of infection could be a disaster for our island.

Conclusion: The governor’s denial of our mayor’s two-test plan could allow in 90 persons carrying COVID-19 per month. Not only are our kupuna at risk, but so is our Native Hawaiian population and anybody with other medical problems including obesity. We would change from being one of the counties that has remained one of the safest in the country to a county at risk for significant spreading of the disease.

We should also keep in mind that cases of COVID-19 are on the rise in 41 states, and deaths are increasing in 19 states (Boston Globe, Oct. 8).

This is not being “alarmist,” as some politicians in the state leadership have said. These are simply the facts about the risks of opening with a single test. And many of us feel that the state should not be telling the local mayors how to keep their county’s people safe.

All of the data for Alaska comes from the following websites: content.govdelivery.com/accounts/AKDHSS/bulletins/29f94f2; and adn.com/alaska-news/2020/04/06/covid-19-in-alaska/.

This column represents a sharing of information. No content on this column should ever be used as a substitute for direct medical advice from your doctor or other qualified clinicians.

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Lee A. Evslin, M.D., is a board-certified pediatrician and fellow of The American Academy of Pediatrics. He was a former health-care administrator on Kaua‘i and periodically writes a column for The Garden Island.