OLD/Closed General Discussion Thread: C-19/Hawaii. Will Hawaii re-open Oct. 15th? (+ NEW POLL)

[csodjd]

Regardless the reason, according to the New York Times the tests are too sensitive and they report 10 times more infected people than they should.

<In Massachusetts, from 85 to 90 percent of people who tested positive in July with a cycle threshold of 40 would have been deemed negative if the threshold were 30 cycles, Dr. Mina said. “I would say that none of those people should be contact-traced, not one,” he said. >

Your Coronavirus Test Is Positive. Maybe It Shouldn’t Be. (Published 2020)

The usual diagnostic tests may simply be too sensitive and too slow to contain the spread of the virus.

www.nytimes.com

That's not correct. The issue they raise is contagious, not infection. They assert that the sensitivity and yes-no nature of the tests results in people that are not able to spread the disease because their viral load is too low being flagged and treated as if they are contagious.

"But yes-no isn’t good enough, he added. It’s the amount of virus that should dictate the infected patient’s next steps. 'It’s really irresponsible, I think, to forgo the recognition that this is a quantitative issue,' Dr. Mina said. ... The PCR test amplifies genetic matter from the virus in cycles; the fewer cycles required, the greater the amount of virus, or viral load, in the sample. The greater the viral load, the more likely the patient is to be contagious."

In other words, using "infected" as opposed to "contagious" as defining "positive" leads to treating some non-contagious people as if they are contagious.

From a public health/epidemic control standpoint, it seems to me its is safer to assume anyone with evidence of the virus in them is contagious, and be wrong by over-quarantining, rather than the converse, which results in failing to quarantine some that should have been because they WERE in fact contagious, especially at a point in time where there are no effective treatments. As treatments arise there is room to take more risk by increasing the number of false negatives.

There is also the rather notable problem that, as of now, nobody knows what viral load indicates contagious.

 

[DannyTS]

That's not correct. The issue they raise is contagious, not infection. They assert that the sensitivity and yes-no nature of the tests results in people that are not able to spread the disease because their viral load is too low being flagged and treated as if they are contagious.

"But yes-no isn’t good enough, he added. It’s the amount of virus that should dictate the infected patient’s next steps. 'It’s really irresponsible, I think, to forgo the recognition that this is a quantitative issue,' Dr. Mina said. ... The PCR test amplifies genetic matter from the virus in cycles; the fewer cycles required, the greater the amount of virus, or viral load, in the sample. The greater the viral load, the more likely the patient is to be contagious."

In other words, using "infected" as opposed to "contagious" as defining "positive" leads to treating some non-contagious people as if they are contagious.

From a public health/epidemic control standpoint, it seems to me its is safer to assume anyone with evidence of the virus in them is contagious, and be wrong by over-quarantining, rather than the converse, which results in failing to quarantine some that should have been because they WERE in fact contagious, especially at a point in time where there are no effective treatments. As treatments arise there is room to take more risk by increasing the number of false negatives.

There is also the rather notable problem that, as of now, nobody knows what viral load indicates contagious.

I understand what your point is but this is not what Dr. Michael Mina, an epidemiologist at Harvard said. According to him, these people should not be quarantined, contact traced etc. Here is my layman interpretation. If you had a mild case of Covid 3 months ago or were completely asymptomatic and you were never tested, if you have a cold now and get tested for Covid you have a good chance of getting a positive result. That cannot be right and it is very relevant in the context of this thread because a lot of people will not be let in even if they put nobody in danger.

 

[csodjd]

I understand what your point is but this is not what Dr. Michael Mina, an epidemiologist at Harvard said. According to him, these people should not be quarantined, contact traced etc. Here is my layman interpretation. If you had a mild case of Covid 3 months ago or were completely asymptomatic and you were never tested, if you have a cold now and get tested for Covid you have a good chance of getting a positive result. That cannot be right and it is very relevant in the context of this thread because a lot of people will not be let in even if they put nobody in danger.

You would have A chance, but what you mean by a "good" chance I don't know. Highest false positive rates in studies have been in the 5% area. I've not seen a study of, say, 100 people that had confirmed COVID 3 months earlier to see how many test positive today using various test modalities. It would be interesting information.

 

[DannyTS]

You would have A chance, but what you mean by a "good" chance I don't know. Highest false positive rates in studies have been in the 5% area. I've not seen a study of, say, 100 people that had confirmed COVID 3 months earlier to see how many test positive today using various test modalities. It would be interesting information.

The false positives of 5% were measured by using the same tests and methods so they mean nothing in this context. You say 5%, they say if you only did 33 reiterations, you would eliminate 90% of those that tested positive so you clearly have a very different view than these specialists.

 

[melissy123]

This is good news!

As tourism’s relaunch nears, details of traveler testing program still being hammered out

The Hawaii Tourism Authority says the state risks jeopardizing its image if the relaunch is pushed back again.

www.hawaiinewsnow.com

Hawaii’s lieutenant governor on Monday dismissed calls from county leaders calling for stricter protocols before the state implements its pre-travel testing program next week, saying many of their concerns ― including those surrounding inter-island travel ― were ‘fear-based.’

 

[critterchick]

Yes......each island can have it's own set of rules or additional rules.....that's what makes HI confusing at times.....

I thought that Mayor Kawakami asked Ige to approve the second test. I took it to mean that he can't impose it unilaterally.

 

[csodjd]

New cases in Hawaii appear to be falling. Save for one day, where there was a cluster in Hawaii County, the number of new cases has gone down over each of the past six days with 69 yesterday and 52 today (though there were far fewer tests on Sunday). Positivity at 2.6% for the past week. The 7-day average new cases is at 94.

 

[cman]

I thought that Mayor Kawakami asked Ige to approve the second test. I took it to mean that he can't impose it unilaterally.

Correct. Ige is expected to decide on the mayor's requests later this week. Kauai has ordered 15k rapid test kits and Maui has ordered 30k. I doubt that they would have done so without some assurance that their request for an additional arrival request would be approved. If the mayor's proposals are approved, those going for a 7 day vacation will have to be confined to the resort for the first 3 days of their trip. That's ridiculous. They may as well just stay closed. The lack of pushback from the locals with regard to these additional requirements, gives me the impression that the locals are fine with the reduction of tourism.

 

[HGVC Lover]

The lack of pushback from the locals with regard to these additional requirements, gives me the impression that the locals are fine with the reduction of tourism.

I believe you are correct.....our family and local friends living on the Big Island are not really missing tourists......they have the island mostly to themselves and are enjoying it that way....many tourism jobs are low paying and most locals do not work in tourism.....

 

[csodjd]

Correct. Ige is expected to decide on the mayor's requests later this week. Kauai has ordered 15k rapid test kits and Maui has ordered 30k. I doubt that they would have done so without some assurance that their request for an additional arrival request would be approved. If the mayor's proposals are approved, those going for a 7 day vacation will have to be confined to the resort for the first 3 days of their trip. That's ridiculous. They may as well just stay closed. The lack of pushback from the locals with regard to these additional requirements, gives me the impression that the locals are fine with the reduction of tourism.

I just read that the Governor denied the request by Kauai for an arrival test. The Mayor said they will look to utilize their 15k rapid tests in another way to help control the virus on the island.

 

[cman]

This is getting more confusing by the day.

Big Island opts out of pre-travel testing program | Honolulu Star-Advertiser

Hawaii island Mayor Harry Kim said he is opting out of the state’s pre-travel testing program starting on Oct. 15, which means mainland visitors going to the Big Island still will be required to quarantine for 14 days.

www.staradvertiser.com

 

[HGVC Lover]

This is getting more confusing by the day.

Big Island opts out of pre-travel testing program | Honolulu Star-Advertiser

Hawaii island Mayor Harry Kim said he is opting out of the state’s pre-travel testing program starting on Oct. 15, which means mainland visitors going to the Big Island still will be required to quarantine for 14 days.

www.staradvertiser.com

It is only getting started.....there is more to come....that's is one of the reasons why 50% of all people who move to Hawaii move back from where they came in the first 3 years....they cannot get use to how it is done in Hawaii...

 

[ljmiii]

This is getting more confusing by the day.

IMHO, not so much confusing as tragic. Gov. Ige, Lt. Gov Green, and the Hawaiian Mayors are being forced to steer between Scylla and Charybdis. If Hawaii was an independent country like Aruba it could erect a quarantine barrier that affected all incoming travelers, set mandatory testing and quarantine rules for nations and US states that differ based on COVID-19 infection rates, set its own unemployment and travel industry relief policies, etc. But it's not so it can't.

It has been at least six months that I first said I do not envy Gov. Ige his choices. I still don't.

 

[csodjd]

IMHO, not so much confusing as tragic. Gov. Ige, Lt. Gov Green, and the Hawaiian Mayors are being forced to steer between Scylla and Charybdis. If Hawaii was an independent country like Aruba it could erect a quarantine barrier that affected all incoming travelers, set mandatory testing and quarantine rules for nations and US states that differ based on COVID-19 infection rates, set its own unemployment and travel industry relief policies, etc. But it's not so it can't.

It has been at least six months that I first said I do not envy Gov. Ige his choices. I still don't.

They are working hard to try and figure out how to limit or come as close as possible to eliminating the introduction of new infections from travelers. While a worthy tactic and goal, zero isn't a plausible or realistic outcome. Even if nobody gets into Hawaii carrying the virus (also not realistic), just the addition of more people onto the islands will likely increase the spread.

I only hope behind the scenes they are also working hard to expand the capacity of Hawaii's medical system to manage and care for a higher number of cases. And in between those two, improving the testing and contact tracing capabilities.

 

[PearlCity]

This is getting more confusing by the day.

Big Island opts out of pre-travel testing program | Honolulu Star-Advertiser

Hawaii island Mayor Harry Kim said he is opting out of the state’s pre-travel testing program starting on Oct. 15, which means mainland visitors going to the Big Island still will be required to quarantine for 14 days.

www.staradvertiser.com

Oh my what a mess. I live on oahu and im confused.

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[ljmiii]

I only hope behind the scenes they are also working hard to expand the capacity of Hawaii's medical system to manage and care for a higher number of cases.

Hey...good news for a change!

The Queen's Health Systems Completes Construction of New Infectious Disease Unit at The Queen's Medical Center - Punchbowl - News Story

www.queens.org

 

[klpca]

Oh my what a mess. I live on oahu and im confused.

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That makes me feel better because I am so confused.

 

[csodjd]

That makes me feel better because I am so confused.

I think I have it. Starting Oct 15, you can come from outside Hawaii to anywhere but the Big Island with no quarantine by testing negative ahead of time. But you can't go from Oahu to the other islands and cannot go to the Big Island at all without a 14-day quarantine.

I wonder if you can go from Oahu to, say, Maui, via LAX, with a one night stay in Los Angeles (where you get tested), and avoid quarantine in Maui?

 

[klpca]

I think I have it. Starting Oct 15, you can come from outside Hawaii to anywhere but the Big Island with no quarantine by testing negative ahead of time. But you can't go from Oahu to the other islands and cannot go to the Big Island at all without a 14-day quarantine.

I wonder if you can go from Oahu to, say, Maui, via LAX, with a one night stay in Los Angeles (where you get tested), and avoid quarantine in Maui?

I am confused about if/when/how the mayors can override the governor. I figure that I have a bit of time before we have to decide. We are supposed to be starting on Kauai then onto Oahu unless one of the mayors nixes the plan.

 

[PearlCity]

I am confused about if/when/how the mayors can override the governor. I figure that I have a bit of time before we have to decide. We are supposed to be starting on Kauai then onto Oahu unless one of the mayors nixes the plan.

Its because the governor said that he wont approve a second test but then said mayors can opt out if they dont like it. I dont think he thought mayors actually would. But the big island mayor already didnt get reelected, and hes getting older so he doesn't really care about political popularity and opted out.

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[PearlCity]

I think I have it. Starting Oct 15, you can come from outside Hawaii to anywhere but the Big Island with no quarantine by testing negative ahead of time. But you can't go from Oahu to the other islands and cannot go to the Big Island at all without a 14-day quarantine.

I wonder if you can go from Oahu to, say, Maui, via LAX, with a one night stay in Los Angeles (where you get tested), and avoid quarantine in Maui?

Ha probably but you have to quarantine until you get results. That is interesting!

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[Tamaradarann]

False positives in the RNA/DNA tests are rare, especially in someone that's not had COVID. And, of course, they don't implicate any health concerns or concern of spread. So it's an inconvenience. Anyone getting a positive would be well advised to test a second time (like Trump did, for instance) to confirm, if they have no reason to believe it's accurate (i.e., no symptoms, no known exposure to a person with COVID, no "risky" behavior in the prior 1-2 weeks). Most false positives have come from people that were retesting post-COVID and some elements of viral genetic material were picked up, or with antigen tests that are not quite as accurate.

Ok, it seems everyone is confused about whether or not the mayors will implement a second Covid test when people land on their island. It seems like the 2 most major islands, Oahu and Maui, will not be implementing a second test. However, if the island of Hawaii and/or Kauai do implement a second test for flights from the Continental US or a neighbor island how will they deal with all the passengers and crew on the plane where someone on the plane tests postive. I would assume if they are having a second test it will be for all passengers and crew on the plane since crew can be just as contagious as a passenger. By the way does anyone know if military and crew are going to be required to be tested starting October 15th?

 

[klpca]

Ok, it seems everyone is confused about whether or not the mayors will implement a second Covid test when people land on their island. It seems like the 2 most major islands, Oahu and Maui, will not be implementing a second test. However, if the island of Hawaii and/or Kauai do implement a second test for flights from the Continental US or a neighbor island how will they deal with all the passengers and crew on the plane where someone on the plane tests postive. I would assume if they are having a second test it will be for all passengers and crew on the plane since crew can be just as contagious as a passenger. By the way does anyone know if military and crew are going to be required to be tested starting October 15th?

Ige has already turned down the second test for Kauai so so now we just wait to see if Kauai opts out. https://www.thegardenisland.com/202...-denies-countys-proposed-second-test-program/

On a personal level I just want to know because we are planning to quarantine for two full weeks at home before we travel and I would hate to quarantine for nothing.

 

[Tamaradarann]

Ige has already turned down the second test for Kauai so so now we just wait to see if Kauai opts out. https://www.thegardenisland.com/202...-denies-countys-proposed-second-test-program/

On a personal level I just want to know because we are planning to quarantine for two full weeks at home before we travel and I would hate to quarantine for nothing.

The article says that Kauai doesn't know what it will do. However, it is still unstated with all the emphasis on testing and/or quarantining passengers coming to Hawaii what will be done to address the members of the military and crew that come/return for all the islands. Do they have to be tested or quarantined?

 

[csodjd]

The article says that Kauai doesn't know what it will do. However, it is still unstated with all the emphasis on testing and/or quarantining passengers coming to Hawaii what will be done to address the members of the military and crew that come/return for all the islands. Do they have to be tested or quarantined?

I believe Kauai has not reported a single new case in the last 7 days. If that‘s their bar, they will have to join the Big Island and opt out of allowing anyone onto the island without a mandatory 14-day quarantine, virtually assuring the end of their tourism industry and turning it into a residents-only island.