[Closed - new thread started] Will Hawaii Open by [OCTOBER???] [Please use this thread for all Hawaii Coronavirus discussions]

[DeniseM]

I'm not worried about catching it from someone who lives in Hawaii - I'm worried about sitting next to PigsDad on the plane!

 

[T_R_Oglodyte]

Here's is something that I don't see anyone factoring in: You know who is eager to jump on a plane and go to Hawaii ASAP? Risk Takers. People who are less concerned about the Coronavirus, and may be cavalier about taking any precautions against catching it - or passing it. I don't want to sit next to that person on the plane. YMMV

I'm not sure I would agree with that at all Denise. I offer myself as a counter example. I am definitely in the cautious crowd - not obsessively so. But definitely adhering to protocols to minimize potential exposure. And when we resume travel, Hawaii is the FIRST place we would head to. And that's in large measure because Hawaii would be a low risk destination. And I would feel even more comfortable, knowing that I would not be bringing the virus with me. I feel incredibly more nervous about our MX travel reservations next Feb as compared with Hawaii in August.

****************

But I think the whole thing is breaking down anyway, at least on the mainland. Until recently it was the so-called red staters and right-wingers who were generally decried for not practicing social distancing. Now the George Floyd demonstrations have swmped things like Memorial Day at Lake of the Ozarks by orders of magnitude.

We now have medical professionals saying that social distancing isn't necessary during the George Floyd demonstrations. I think it's going to be very hard for government and medical professionals to say that the right of assembly is suspended except in circumstances where we concur with the politics.

After months of pleading for social distancing, health officials support protests. Seattle Black Lives Matter warns of dangers

Infectious disease experts at the University of Washington say the protests are "vital to the national public health." The local branch of Black Lives Matter is being far more cautious, and has published a safety guide for protesters.

www.seattletimes.com

 

[DeniseM]

I also think Hawaii is a very safe destination (at least for now), but personally, I wouldn't consider leaving the country. However, even with a safe destination, I'm quite concerned about the spread of C-19 on airplanes. It's going to be really interesting to see what happens when travel opens up, but we will wait and see how things go, before we get on another airplane. YMMV

 

[Yellowfin]

Then the question is will you ever travel again? Even if you wait for a vaccine, it is never effective on everyone and you will not know if you are immune or not. Not to mention, we may have something else to worry about at that time.

 

[DeniseM]

I would not get on an airplane under the current conditions, so only time will tell. However, we own a vacation home in another state that we can drive to, so we do have that option.

 

[T_R_Oglodyte]

However, even with a safe destination, I'm quite concerned about the spread of C-19 on airplanes.

I would be particularly worried if the plane carried passengers who just spent a week in social gatherings, with people tightly packed together, screaming, shouting, hyperventilating, and doing all manner of other activities that have been identified with superspreader events, except all of these events have been occurring on a massive scale. If the risks are as great has have been painted by medical professionals, over the next three to four weeks we should see a surge in corona virus cases that will make March and April look like child's play.

That is if the risks are as great as we have been told they are. If the outbreak doesn't occur, the credibility of the case for protective measures ought to collapse. And if it does occur then officials can say, "We told you so."

 

[DeniseM]

Hawaii coronavirus cases rise by 9 to total 664; tally includes 3 older infections, officials say | Honolulu Star-Advertiser

Hawaii Department of Health officials said today that the state’s tally of coronavirus cases has risen to 664, up nine, including three older infections that had not been counted previously.

www.staradvertiser.com

There are 5 new cases on Oahu, which is a bit of an increase, and no new cases on the other islands. I wonder if any of the new cases were at the unscanctioned beach parties last weekend? I also wonder of the military bases are included in the totals?

 

[csodjd]

Here's is something that I don't see anyone factoring in: You know who is eager to jump on a plane and go to Hawaii ASAP? Risk Takers. People who are less concerned about the Coronavirus, and may be cavalier about taking any precautions against catching it - or passing it. I don't want to sit next to that person on the plane. YMMV

I think that's true about people that say they won't wear a mask, and I've advised many of my clients that they don't want to have those people as patients because they are the ones least likely to be taking precautions generally, and pose the greatest risk.

I'm not sure that extrapolates to people that will take a COVID test and fly for 6 or more hours with a face mask. Those are people simply believing that, with proper care and precautions, the risk is not substantial and that it's too easy to allow fear to become irrational. I believe in caution and care. But not in allowing fear to control me. If I did, the fear of terrorism alone would stop me from traveling.

 

[csodjd]

I would be particularly worried if the plane carried passengers who just spent a week in social gatherings, with people tightly packed together, screaming, shouting, hyperventilating, and doing all manner of other activities that have been identified with superspreader events, except all of these events have been occurring on a massive scale. If the risks are as great has have been painted by medical professionals, over the next three to four weeks we should see a surge in corona virus cases that will make March and April look like child's play.

That is if the risks are as great as we have been told they are. If the outbreak doesn't occur, the credibility of the case for protective measures ought to collapse. And if it does occur then officials can say, "We told you so."

I believe it is more complex than that, because those engaging in that behavior are also on the low risk side of the spectrum for complications and hospitalization from COVID. They are generally younger, for one thing, and that alone will offer considerable protection.

That said, it appears we ARE seeing a surge of considerable note in several states. See https://www.worldometers.info/coronavirus/country/us/ and note Texas, Florida, Arizona, Michigan (can that data be correct, 5300 new cases today?, Arkansas, and a few other states). Wednesday, 20k new cases in the US. Yesterday, 22k. Today, 28k so far. Is that the beginning of a new wave of cases? We're now 2 weeks out from Memorial weekend.

 

[slip]

Hawaii coronavirus cases rise by 9 to total 664; tally includes 3 older infections, officials say | Honolulu Star-Advertiser

Hawaii Department of Health officials said today that the state’s tally of coronavirus cases has risen to 664, up nine, including three older infections that had not been counted previously.

www.staradvertiser.com

There are 5 new cases on Oahu, which is a bit of an increase, and no new cases on the other islands. I wonder if any of the new cases were at the unscanctioned beach parties last weekend? I also wonder of the military bases are included in the totals?

The military bases are not included in the totals. Also, in the past when there were clusters, they usually said where the clusters were from on the island.

 

[csodjd]

I also think Hawaii is a very safe destination (at least for now), but personally, I wouldn't consider leaving the country. However, even with a safe destination, I'm quite concerned about the spread of C-19 on airplanes. It's going to be really interesting to see what happens when travel opens up, but we will wait and see how things go, before we get on another airplane. YMMV

View attachment 21713

I'm scheduled to fly in August. Chose to pay for First, even though my status would likely get me upgraded from economy, because I wanted to be sure and to have a window seat. I see possibly two people, one next to me and one behind me, that would be potential spreaders. I don't view that as high risk. I did read that it is best to keep your air flow on max, which blows airborne virus straight to the ground. Also, airplanes I believe operate with negative pressure, so the air is actually quite clean.

 

[T_R_Oglodyte]

Also, airplanes I believe operate with negative pressure, so the air is actually quite clean.

Minor nit - cabins are positive pressure (otherwise the passengers would asphyxiate). But the point is the same - they are positively vented, by HEPA-filtered air being pumped into the cabin.

 

[T_R_Oglodyte]

I believe it is more complex than that, because those engaging in that behavior are also on the low risk side of the spectrum for complications and hospitalization from COVID. They are generally younger, for one thing, and that alone will offer considerable protection.

They might be on the low side for complications, but wouldn't they still be carriers and transmitters? And perhaps even more lethal because they wouldn't know they were carriers and wouldn't take precautions to prevent infecting others.

 

[csodjd]

They might be on the low side for complications, but wouldn't they still be carriers and transmitters? And perhaps even more lethal because they wouldn't know they were carriers and wouldn't take precautions to prevent infecting others.

What I was referring to was what might show up in the data as a result of protests and parties at the pool. Because "new cases" is not a reliable measure since it is dependent on testing (and the risk that politics is resulting in under reporting as is reported in Florida and Georgia), the best data for an outbreak is hospitalizations. But, if the exposure is not across a normal spectrum of the community, that too may under count because young infected people are less likely to require hospitalization than an older person. I was not referring at all to the risk of infection from them. Only looking at data to determine the impact of careless behavior during protests and in locations like we all saw in the Ozarks.

That said, no, not more "lethal." Lethal is not a function of the nature of the person that infects you. We know it is a function of the health and physiology of the person being infected. Diabetic? Suppressed or hyperactive immune system? Obese? Age.

But I believe, myself, that outcome is also related to the viral load at time of infection. I believe the reason so many seemingly healthy health care providers were infected and got sick was the high viral load of their initial infection which overwhelmed their otherwise healthy immune system, allowing the infection to "win." That is, the immune system was too far behind and could not control the viral replication. I believe many (all?) of the asymptomatic cases arise where the person was infected but with a sufficiently small viral load that their immune system was able to get out in front of and suppress the infection before the virus replication was sufficient to cause symptoms. Those with weak immune systems or comorbidities (especially vascular related) could handle less initial viral load. But, that's my theory. So, under my theory, to protect ourselves, we not only want to try and avoid infected people, but we also want to minimize viral load even if there are infected people around. For instance, being outdoors or in open spaces -- much less virus density in the air. Talking instead of yelling or singing -- much less virus density in the air. In an airplane, keep your vent on high -- that will greatly reduce the ability of virus buildup in the air around you. Small area with poor ventilation -- lots of virus accumulation in the air, and high risk of exposure to large viral load.

 

[T_R_Oglodyte]

What I was referring to was what might show up in the data as a result of protests and parties at the pool. Because "new cases" is not a reliable measure since it is dependent on testing (and the risk that politics is resulting in under reporting as is reported in Florida and Georgia), the best data for an outbreak is hospitalizations. But, if the exposure is not across a normal spectrum of the community, that too may under count because young infected people are less likely to require hospitalization than an older person. I was not referring at all to the risk of infection from them. Only looking at data to determine the impact of careless behavior during protests and in locations like we all saw in the Ozarks.

That said, no, not more "lethal." Lethal is not a function of the nature of the person that infects you. We know it is a function of the health and physiology of the person being infected. Diabetic? Suppressed or hyperactive immune system? Obese? Age.

But I believe, myself, that outcome is also related to the viral load at time of infection. I believe the reason so many seemingly healthy health care providers were infected and got sick was the high viral load of their initial infection which overwhelmed their otherwise healthy immune system, allowing the infection to "win." That is, the immune system was too far behind and could not control the viral replication. I believe many (all?) of the asymptomatic cases arise where the person was infected but with a sufficiently small viral load that their immune system was able to get out in front of and suppress the infection before the virus replication was sufficient to cause symptoms. Those with weak immune systems or comorbidities (especially vascular related) could handle less initial viral load. But, that's my theory. So, under my theory, to protect ourselves, we not only want to try and avoid infected people, but we also want to minimize viral load even if there are infected people around. For instance, being outdoors or in open spaces -- much less virus density in the air. Talking instead of yelling or singing -- much less virus density in the air. In an airplane, keep your vent on high -- that will greatly reduce the ability of virus buildup in the air around you. Small area with poor ventilation -- lots of virus accumulation in the air, and high risk of exposure to large viral load.

Good points. So if the transmission is through carriers who don't require hospitalization (or even detection), allowing a couple of cycles, increasing hospitalizations would likely appear in about four to six weeks.

 

[JIMinNC]

Here's is something that I don't see anyone factoring in: You know who is eager to jump on a plane and go to Hawaii ASAP? Risk Takers. People who are less concerned about the Coronavirus, and may be cavalier about taking any precautions against catching it - or passing it. I don't want to sit next to that person on the plane. YMMV

That's one opinion. Another is that it is the logical thinkers who do not get caught up in the irrational fear. The health risk to a younger (<40) person is insignificant, and on the order of the health risk of driving to the airport.

Kurt

Even for those of us who are somewhat older, the sheer numbers - like those discussed by @csodjd in post #460 above - show that the probability of any one person contacting the virus on trip to Hawaii is relatively low. It's not zero, of course, so there is some risk, but I don't see deciding to fly somewhere makes someone a big risk taker given the real probabilities involved here. A significant percentage of the confirmed cases, and an even more significant percentage of the deaths worldwide have come from 1) nursing and elder care facilities, 2) high density lower income housing, 3) high density workplaces like meat processing facilities, 4) healthcare workers, and other similar situations where people live or work in close proximity. If you are not involved in settings like those, the risk of contracting the virus is even less than the raw stats might indicate. I have read nothing about major outbreaks tied to air travel (isolated cases yes, but major outbreaks have not been traced there as far as I have been able to find). So it doesn't seem to me that someone has to be a big risk taker to evaluate the numbers objectively and then conclude that travel is an acceptable, reasonable risk.

 

[JIMinNC]

But I believe, myself, that outcome is also related to the viral load at time of infection. I believe the reason so many seemingly healthy health care providers were infected and got sick was the high viral load of their initial infection which overwhelmed their otherwise healthy immune system, allowing the infection to "win." That is, the immune system was too far behind and could not control the viral replication. I believe many (all?) of the asymptomatic cases arise where the person was infected but with a sufficiently small viral load that their immune system was able to get out in front of and suppress the infection before the virus replication was sufficient to cause symptoms. Those with weak immune systems or comorbidities (especially vascular related) could handle less initial viral load. But, that's my theory. So, under my theory, to protect ourselves, we not only want to try and avoid infected people, but we also want to minimize viral load even if there are infected people around. For instance, being outdoors or in open spaces -- much less virus density in the air. Talking instead of yelling or singing -- much less virus density in the air. In an airplane, keep your vent on high -- that will greatly reduce the ability of virus buildup in the air around you. Small area with poor ventilation -- lots of virus accumulation in the air, and high risk of exposure to large viral load.

I've often wondered about just this very point myself. Could the amount of virus each person is exposed to be a key variable that determines how severely they are impacted? Taking it one step further, if exposure does indeed result in some level of future immunity, did we make a mistake by keeping people completely locked down and thus limiting the number of people that get those low dose infections, thus leaving more people susceptible to more serious infection in the future?

 

[PigsDad]

I've often wondered about just this very point myself. Could the amount of virus each person is exposed to be a key variable that determines how severely they are impacted? Taking it one step further, if exposure does indeed result in some level of future immunity, did we make a mistake by keeping people completely locked down and thus limiting the number of people that get those low dose infections, thus leaving more people susceptible to more serious infection in the future?

I read a couple of articles (sorry, don't have references right now) that were theorizing the same basic concept that you and @csodjd mentioned regarding viral load and its affect on contracting CV-19 and the severity of a resulting infection (or of even getting an infection). Very interesting, and correlates with how many other infections caused by viruses "work", for lack of a better word. I would even take it a little step further beyond the last question you raised in this post: are people who are getting low dose exposures to CV-19 developing a level of immunity to the infection? Isn't that the basic concept behind vaccines? I'm sure all of this is being looked at and tested, and it will be interesting when the studies come out with verified results.

Kurt

 

[csodjd]

I've often wondered about just this very point myself. Could the amount of virus each person is exposed to be a key variable that determines how severely they are impacted? Taking it one step further, if exposure does indeed result in some level of future immunity, did we make a mistake by keeping people completely locked down and thus limiting the number of people that get those low dose infections, thus leaving more people susceptible to more serious infection in the future?

That raises a veritable pandora's box of uncertainties, which starts with the question, is the immunity dose-dependent? Do you get more immunity (longer, or stronger) from more disease? The goal of a vaccine is to impart a known immunity, both in terms of how long it lasts and how complete it protects you. They can titrate and experiment with vaccines to find the best outcome. But if you're looking for natural immunity, if it is dose-dependent, that's problematic. You have all kinds of degrees of immunity and nobody knows what they have or don't have.

I'm no immunologist, and it's been many years since I had my course in immunology. I can deal intellectually with the concept of viral load as it relates to pathological response. But how that then relates to immunity is beyond my reach. It's just fraught with uncertainty.

 

[csodjd]

Good points. So if the transmission is through carriers who don't require hospitalization (or even detection), allowing a couple of cycles, increasing hospitalizations would likely appear in about four to six weeks.

Give or take. About 10 or so days to symptoms. Typically another 5-15 before they require hospitalization.

 

[csodjd]

Even for those of us who are somewhat older, the sheer numbers - like those discussed by @csodjd in post #460 above - show that the probability of any one person contacting the virus on trip to Hawaii is relatively low. It's not zero, of course, so there is some risk, but I don't see deciding to fly somewhere makes someone a big risk taker given the real probabilities involved here. A significant percentage of the confirmed cases, and an even more significant percentage of the deaths worldwide have come from 1) nursing and elder care facilities, 2) high density lower income housing, 3) high density workplaces like meat processing facilities, 4) healthcare workers, and other similar situations where people live or work in close proximity. If you are not involved in settings like those, the risk of contracting the virus is even less than the raw stats might indicate. I have read nothing about major outbreaks tied to air travel (isolated cases yes, but major outbreaks have not been traced there as far as I have been able to find). So it doesn't seem to me that someone has to be a big risk taker to evaluate the numbers objectively and then conclude that travel is an acceptable, reasonable risk.

Or put more simply -- though there were many infected people flying all over the place, we've not heard of any airplanes full of people catching it, or even of significant clusters (10 people near a sick person or something like that). But the tracing on that would be difficult, so not hearing of it doesn't mean it hasn't happened.

 

[Yellowfin]

Hawaii coronavirus cases rise by 9 to total 664; tally includes 3 older infections, officials say | Honolulu Star-Advertiser

Hawaii Department of Health officials said today that the state’s tally of coronavirus cases has risen to 664, up nine, including three older infections that had not been counted previously.

www.staradvertiser.com

There are 5 new cases on Oahu, which is a bit of an increase, and no new cases on the other islands. I wonder if any of the new cases were at the unscanctioned beach parties last weekend? I also wonder of the military bases are included in the totals?

Most likely they are not related to those parties since it takes much longer from the transmission until the data becomes public.

 

[Yellowfin]

It seems that the virus is becoming less prevalent in the United States, not just in Italy. I think Hawaii will have to take this into consideration.

“All signs that we have available right now show that this virus is less prevalent than it was weeks ago,” said Dr. Donald Yealy, the chair of emergency medicine at UPMC.

Yealy further said, among people who test positive, “the total amount of the virus the patient has is much less than in the earlier stages of the pandemic.”

“We see all of this as evidence that COVID-19 cases are less severe than when this first started,” he said.

“Your risk of getting into a car accident if you go back and forth across the turnpike in Pennsylvania is greater than your risk of being positive for asymptomatic COVID-19 infection,” he said. “This should give you some reassurance that the risk of catching COVID-19 … from someone who doesn’t even know they have the infection, in our communities, is very small.”

Pa. doctor says coronavirus has become ‘less prevalent’ and isn’t making people as sick

Dr. Yealy said there's less chance of getting it from someone who's asymptomatic than of having an accident on the turnpike.

www.syracuse.com

 

[DeniseM]

Lots of good points made above. But my risk tolerance is low, so I will sit back and let others blaze the trails, and evaluate the results, before I get on an airplane. again. YMMV

 

[rickandcindy23]

Still getting on an airplane in August to Maui, if Hawaii will permit us to go 8/23-9/6. I will not go and quarantine for the entire trip. Just hoping Hawaii opens up. We both had coronavirus 3/1 for about 5-6 days, start to finish, and we have immunity because we were tested. But if I am a carrier, I could hurt others, so I will still always wear a mask. I have N-95 masks Rick had to buy as an EMT. They bought their own back then. We have a full box of those things and a partial box.