COVID-19 Daily Update: Symptomatic People Should Call Before Going to Medical Facility

This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses. PC: Alissa Eckert, MS; Dan Higgins, MAM. Content provider: CDC/ Alissa Eckert, MS

The following highlights were provided by the Hawaiʻi COVID-19 Joint Information Center at the end of the day for March 12, 2020. Maui Now has added information where appropriate.  A comprehensive Maui specific update is available HERE.

DOH advises people who think they may have symptoms of COVID-19 to contact their healthcare provider in advance of going to a medical facility.

• Tell your provider about your symptoms and any recent travel. Healthcare providers will discuss any possible cases of COVID-19 with DOH to determine if testing is needed. Consider utilizing tele-health services, if available. Avoid traveling or leaving home if you are sick, except for visiting your doctor after contacting them in advance.

No Direct Incoming Flights to Hawai‘i from Europe

The Hawai‘i Department of Transportation confirmed there are no direct, incoming flights from Europe to the US. The 30-day federal ban on flights from Europe except the United Kingdom begins Friday, March 13, at midnight.

Extended Hours for Public Calls to AUW 2-1-1 on COVID-19

Aloha United Way has extended its public call center hours to 7 a.m. to 10 p.m., seven days a week. For more information or questions about COVID-19:

• Call 2-1-1 from any location in the state
• Text 877-275-6569
• Email info211@auw.org
• Visit health.hawaii.gov/covid19 or coronavirus.gov

Media Reports on Canadian Visitor to Hawai‘i

The Hawai‘i Department of Health has reached out to its federal partners regarding media reports of a Canadian visitor who, upon return to Canada, was confirmed positive for COVID-19. DOH has not received any information on this individual at this point.

Tours Temporarily Suspended at Kalaupapa National Historical Park

DOH has temporarily suspended tours to Kalaupapa National Historical Park until April 11, 2020 as a public health measure to protect the vulnerable population of patients. The department will continue to assess the situation to determine when the suspension can be lifted.

Community Surveillance Initiative

The Hawai‘i Department of Health is launching a statewide surveillance testing program to identify cases of community spread of the coronavirus. This additional layer of testing helps detect COVID-19 cases earlier, so that appropriate steps can be taken to contain the virus. About 200 COVID-19 tests will be conducted each week under the program. Samples collected for influenza testing from patients with respiratory symptoms will be randomly selected and also tested for COVID-19. These samples are collected by healthcare providers in doctor’s offices and other outpatient settings. The information will help responders understand the scope of the spread, if and when such a spread occurs.

Continued Contact Follow-Up

The Department of Health is conducting contact tracing and follow-up on the cases associated with the Grand Princess cruise ship, in addition to the traveler who recently flew from Hawai‘i to Washington State and back to Hawai‘i via Hawaiian Airlines. Healthcare workers exposed to the individual without proper precautions are being monitored for symptoms for 14 days.

Precautions for seniors

State health officials say seniors are at a greater risk for COVID-19, especially those who have underlying health conditions. Older adults and individuals with underlying health issues should avoid non-essential travel, including cruises. Neighbor island residents with scheduled medical treatment or follow-up care on O‘ahu should consult with their doctors. Seniors should avoid large crowds, wash their hands often, and keep medications and groceries on-hand.

World Health Organization (WHO) Reports

For the latest situation reports from the World Health Organization, visit who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports.

Second positive case on O‘ahu

On March 8, DOH tested a second presumptive positive test result for an elderly adult who is hospitalized in serious condition on O‘ahu. The individual felt ill on March 2 in Washington State and traveled home to Honolulu on March 4. The Centers for Disease Control and Prevention has been notified and trace back investigations are being conducted. The O‘ahu hospital has taken protective and preventive measures and is working with healthcare workers to ensure health and safety. Information is still being gathered and as more information becomes available, the public will be advised.

The first presumptive positive case was announced March 6. That individual was a passenger on the Grand Princess cruise in Mexico from Feb. 11-21. After arriving in Mexico, the individual traveled home to Honolulu with no symptoms. While home in Honolulu, the individual became ill on March 1, sought medical care and was tested on March 6. The individual is currently isolated at home and is being monitored daily by DOH. The department is conducting a detailed trace investigation to identify, notify, and provide guidance to all close contacts as quickly as possible.

Grand Princess cruise ship

To date, there have been 21 confirmed cases of COVID-19 (19 crew members and two passengers) on the Grand Princess cruise ship that made port calls to Nāwiliwili Harbor, Kaua‘i on Feb. 26, Honolulu Harbor on Feb. 27, Lahaina, Maui on Feb. 28, and Hilo on Feb. 29. The Department of Health is working closely with the CDC to notify any passengers in Hawai‘i and trace all close contacts.

The public is advised that exposure risk to tour operators and other hospitality services who interact with visitors on cruises is low. Companies should work on finding out which specific employees actually had close contact (close personal face-to-face contact for more than 10 minutes) with Grand Princess cruise passengers. DOH is contacting companies to gather this information. Companies are advised to notify their workers that there have been individuals from the Grand Princess cruise who were diagnosed with COVID-19 and the overall risk to hospitality workers is low.

State Laboratories Division testing

The Hawai‘i Department of Health is capable of conducting in-state testing for up to 250 individuals per week for COVID-19. Results can be ready within 24-48 hours of a sample being collected. This enhances the state’s prevention and mitigation response capabilities to further safeguard the health of people in Hawai‘i.

COVID-19 Summary of Numbers as of March 11, 2020
(updated as new information becomes available)

Of the 39 individuals who are self-monitoring with public health supervision, 34 are on Oʻahu, 4 are on Maui, and 1 is on Kauaʻi. These numbers fluctuate often as travelers arrive, depart, or begin and end their self-monitoring with supervision by DOH.

• Presumptive Positive: A presumptive positive result is when a patient has tested positive by a public health laboratory, but results are pending confirmation at CDC. For public health purposes, a presumptive positive result using the CDC test is treated as a positive.
• 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.

Guidance for schools and childcare programs

The CDC recently posted interim guidance for administrators of childcare programs and K-12 schools to plan, prepare, and respond to COVID-19. School closures have taken place in Japan and South Korea.  The University of Hawaiʻi has announced the transition to online classes beginning on March 23 after spring break. At this time, in-person courses are scheduled to resume Monday, April 13. The Hawaiʻi State Department of Education is working closely with the Hawaiʻi Department of Health on guidance and continues to provide DOE UPDATES ONLINE.

Business continuity planning

State and county agencies are actively preparing for continuity of business operations to deal with the potential impact of COVID-19. The goal is to enable ongoing operations during a public health emergency. To address concerns about workers who have traveled to China, DOH developed a list of frequently asked questions and answers to guide local businesses.

National travel advisories

Before traveling, review Travel Advisories and Alerts for destination(s) at www.travel.state.gov/destination. The State Department and the Centers for Disease Control and Prevention provide specific advice to travelers on their websites.

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.
• CDC does not recommend that people who are well wear a facemask to protect themselves from illnesses, including COVID-19. Keep in mind that supplies are limited and we need to make sure there are enough masks for our front-line health care workers. If you are sick then wear a mask to protect the people around you.
• Prepare for the possibility that people may want to stay home or may be asked to stay home to prevent the spread of illness.

• • If you have daily medication needs, have more than a week’s supply on hand and have as much on hand as your insurance will allow you to have.
  • Not everyone can afford to stock up on supplies or has the space to store them, but anything you can arrange in advance means one less inconvenience or one less trip to the store while you are sick.
  • Make family plans for the possibility of school or day care closures. Do some contingency planning in advance at the family level.

• Sign up for public notifications at health.hawaii.gov/news/covid-19-updates.

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

As a way to manage the spread of COVID-19 in the United States, foreign nationals who have traveled to China, Iran and certain European countries (except the United Kingdom) are currently being denied entry into the United States.

European countries included in the 30-day federal ban include: Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, and Switzerland. These restrictions do not apply to legal permanent residents, immediate family members of US citizens, and other individuals who are identified in the proclamation.

Enhanced passenger screening procedures at Daniel K. Inouye International Airport are in place for those who have traveled to these countries within the past 14 days. Airport passenger screening continues to be conducted by the Centers for Disease Control and Prevention and Customers and Border Protection.