COVID-19 Daily Update: State Launches Surveillance Initiative

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

Here is the latest from the Hawaiʻi State Department of Health regarding the novel coronavirus: 

Community Surveillance Initiative The Hawaiʻi 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 if such a spread when it 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 had recent travel to Washington State via Hawaiian Airlines. Healthcare workers exposed to the individual without proper precautions are being monitored for symptoms for 14 days.

Precautions for seniors

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. Avoid large crowds, wash your hands, and keep medications and groceries on-hand.

Public is advised to call 2-1-1 for information on COVID-19

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

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

• 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.

Second positive case on Oʻahu

On March 8, DOH tested a second presumptive positive test result for an elderly adult who is hospitalized in serious condition on Oahu. 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 Oahu 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 2 passengers) on the Grand Princess cruise ship that made port calls to Nawiliwili Harbor, Kauai on Feb. 26, Honolulu Harbor on Feb. 27, Lahaina, Maui on Feb. 28, and Hilo on Feb. 29. The ship is currently held off the coast of California and additional testing of all passengers and crew is pending. The Department of Health is working closely with the CDC to notify any passengers in Hawaii 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 Hawaii 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 Hawaii. It is anticipated that private and clinical labs in California and Hawaii may have testing capability in a few weeks.

COVID-19 Summary of Numbers as of March 10, 2020
(updated as new information becomes available)

Of the 52 individuals who are self-monitoring with public health supervision, 47 are on Oahu, 4 are on Maui, and 1 is on Kauai. 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.

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.

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

Foreign nationals who have traveled to mainland China and Iran within the last 14 days are being denied entry into the U.S. This includes not only people with a China or Iran 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 for passengers who have traveled to China and Iran within the last 14 days. 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).