COVID-19 Daily Update: Travel to Korea, Japan Remains at Level 2

This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses. Note the spikes that adorn the outer surface of the virus, which impart the look of a corona surrounding the virion, when viewed electron microscopically. A novel coronavirus virus was identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China in 2019. PC: Alissa Eckert, MS; Dan Higgins, MAM. Content provider: CDC/ Alissa Eckert, MS

The State Department of Health has set Level 2 (Exercise Increased Caution) for travel to Japan and South Korea. No travel restrictions are in place. Still the department recommends that for certain high risk groups (older adults and those with chronic medical conditions), postponing of non-essential travel should be discussed with a healthcare provider. Before you travel, check out Travel Advisory and Alerts for your destination(s) at www.travel.state.gov/destination.

Quarantine

There is no one in Hawaiʻi under mandatory quarantine at this time. The most recent passenger arriving in Hawaiʻi with travel to Hubei province completed their 14-day quarantine with no symptoms on Feb. 22.

Feb. 20 marks last day anyone exposed to the Japanese visitor might develop symptoms

Feb. 20 was the last day that any individual who might have been infected by exposure to the visitor would be expected to show symptoms. At this time, there is no indication of transmission of illness related to the visitor from Japan who traveled to Hawaiʻi (Jan. 28 to Feb.6) and upon returning home to Japan was subsequently confirmed with COVID-19. To date, the Department of Health’s investigation has not yielded anyone who may have had prolonged, close contact with the visitor.

Cruise ships

American passengers from the Diamond Princess cruise ship have been flown to bases in California and Texas for quarantine for 14 days. These actions are under federal authority and, at this time, the Department of Health does not have information on the passengers who are Hawaiʻi residents.

The Department of Health has been notified of at least four Hawaiʻi residents who were passengers on the Westerdam cruise ship (Holland America) and have returned home. DOH is in contact with these individuals and was advised that the cruise passengers are not at risk and do not pose a risk to others.

CDC laboratory test kits

Currently, all laboratory testing to confirm COVID-19 is being conducted at the CDC laboratory in Atlanta, Georgia. The test kits sent to state laboratories, including Hawaiʻi, had an issue with negative control primer probe sets included in each kit. New test kits are being developed by the CDC. It is estimated that Hawaii may be ready to conduct testing in early to mid-March. DOH has offered to be a beta-tester for the new kits to ensure they work properly. If Hawaii becomes a beta-tested, it means our state may have earlier access to the testing process.

Per CDC guidance, laboratory testing to confirm COVID-19 is conducted only for individuals who meet the criteria of a Person Under Investigation (PUI) such as symptoms of respiratory illness (fever, cough or shortness of breath) and travel to China within the past 14 days.

To date, there have been no samples sent to CDC from Hawaiʻi because no individuals have been identified who meet the CDC criteria for testing.

No cases of COVID-19 identified in Hawaii at this time

Currently, there are no cases of COVID-19 identified in Hawaiʻi. DOH is actively preparing for possible cases and working with state, county, and federal partners including the medical community in Hawaii. The following summary as of Feb. 23 shows the number of individuals being monitored or under quarantine because of their recent travel to China. These individuals were identified through screening by federal officials at the Daniel K. International Airport. These numbers fluctuate often as travelers arrive, depart, or begin and end their self-monitoring with supervision by DOH.

COVID-19 Summary of Numbers as of Feb. 23, 2020
(updated as new information becomes available)

Of the 58 individuals who are self-monitoring with public health supervision, 52 are on Oʻahu, 4 are on Hawaiʻi Island, 1 is on Maui, and 1 is on Kauaʻi.

Confirmed: Meets CDC criteria and positive test result received from a certified laboratory.

Person Under Investigation (PUI): Meets CDC criteria for investigation and testing pending.

Quarantine: Individuals are required to remain in a designated location and separated from others. They are actively monitored by Department of Health staff. Quarantine is enforceable by law.

Monitoring: Individuals voluntarily remain at home and refrain from work, school, gathering places, and public transit. They communicate daily with Department of Health staff.

Screening of arriving passengers at Daniel K. Inouye International Airport in Honolulu

Foreign nationals who have been in mainland China within the last 14 days are being denied entry into the U.S. This includes not only people with a China passport, but all foreign nationals per Department of Homeland Security guidance. The exception is U.S. citizens, legal permanent U.S. residents or their immediate family.

Enhanced screening procedures are in place at Daniel K. Inouye International Airport to help keep the public and traveling community safe. An additional feature is the non-contact thermal temperature scanners that are used for incoming passengers from China. Airport passenger screening continues to be conducted by federal authorities from the Centers for Disease Control and Prevention (CDC) and Customs and Border Protection (CBP). For additional information on the airport screening process submit a media request to CDC.

Preventing the spread of misinformation and disease

The Department of Health is committed to sharing information as it becomes available. People are urged not to spread misinformation or inaccurate statements that are not confirmed, and keep updated and informed on the situation. Everyone can help prevent the spread of respiratory illness with these everyday actions.

• Wash your hands often with soap and water for at least 20 seconds.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Avoid close contact with people who are sick.
• Stay home when you are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Clean and disinfect frequently touched objects and surfaces using a regular household
  cleaning spray or wipe.

Wearing Masks

A mask can be effective if you are ill and can prevent the spread of your illness. A mask is not effective to wear when you are well and want to protect yourself from someone who is ill.