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

[PearlCity]

Is there any evidence at all that people breaking quarantine have been responsible for a material rise in COVID incidence in Hawaii? Since breaking quarantine doesn't actually cause any illness at all, before getting all bent out of shape that it may and does occur, it's helpful to know if it has had an adverse impact at all.

Actually yes as a resident I know of people who caught it from other returning residents or out of state relatives who traveled here and broke quarantine -especially during the recent oahu spike. Now has any resident gotten it from a non related tourist breaking quarantine? It is difficult to say because in reality we haven't had many tourists come. There is a lot of fear amongst residents because historically all "diseases" in Hawaii have been brought in from travelers. Like DeniseM states itll be interesting to see what happens. I agree with you its probably unlikely that there will be transmission on the ground once a tourist arrives, but i am concerned about folks on the airplane. It was reported that they did find a person arriving on Kona who tested positive on the ground after arrival. One could say its only one person- but was that person wearing a mask in flight? What now about others sitting around them? Was contact tracing done? The other thing is that while yes prior to Oct 15th we had 1000-1500 people arrive untested the flights were nearly empty. It doesn't seem to be the case now. What is spread like on the planes now for such a long flight?

I think no one really knows how this will play out, we'll have to wait and see.

I want to add im not picking i fight. I find your posts informative and interesting. Just wanted to provide another viewpoint from a resident.

Sent from my SM-G973U1 using Tapatalk

 

[DannyTS]

I'm not aware of any reliable data that 90% of positives are actually negative. But clinical tests must always be evaluated along with clinical findings and patient history. I would view a positive test result very differently coming from someone that said they had COVID 45 days ago, someone that said they've never had it and feel fine, but both their parents are currently sick from it, and very different again from someone that said they have a fever, feel lousy and have a cough. Medicine doesn't live in a vacuum.

So looking back to the issue, Hawaii travel, you have a sub-set of the population that itself has lower risk, you have pre-travel testing which will find many asymptomatic cases, but not all. You have masks and distancing, which will greatly reduce transmission from those that ARE infectious. So, will travel result in uncontrolled community spread? We can surmise now, probably not, but will know for sure in a month or so.

I think this was shared before

https://www.nytimes.com/2020/08/29/health/coronavirus-testing.html

 

[csodjd]

I think this was shared before

https://www.nytimes.com/2020/08/29/health/coronavirus-testing.html

View attachment 27635

I'm familiar with that article and the concepts. It underscores that a positive/not positive outcome fails to recognize that what's really going on is more gray and should be more akin to probably positive, almost certainly positive, etc. Their conclusion is that SOME of the positives probably are not infectious because they're being safe and not sorry. But, as they point out, the yes/no threshold varies by test maker. Reasonable minds might differ on how many cycles is the "best" or "right" answer. If I was an obese diabetic, I'd prefer that they have some false positives over false negatives.

The fact is, ~220,000 have died and about 8M have had the disease... so there is PLENTY of not false positive out there!

 

[csodjd]

Actually yes as a resident I know of people who caught it from other returning residents or out of state relatives who traveled here and broke quarantine -especially during the recent oahu spike. Now has any resident gotten it from a non related tourist breaking quarantine? It is difficult to say because in reality we haven't had many tourists come. There is a lot of fear amongst residents because historically all "diseases" in Hawaii have been brought in from travelers. Like DeniseM states itll be interesting to see what happens. I agree with you its probably unlikely that there will be transmission on the ground once a tourist arrives, but i am concerned about folks on the airplane. It was reported that they did find a person arriving on Kona who tested positive on the ground after arrival. One could say its only one person- but was that person wearing a mask in flight? What now about others sitting around them? Was contact tracing done? The other thing is that while yes prior to Oct 15th we had 1000-1500 people arrive untested the flights were nearly empty. It doesn't seem to be the case now. What is spread like on the planes now for such a long flight?

I think no one really knows how this will play out, we'll have to wait and see.

I want to add im not picking i fight. I find your posts informative and interesting. Just wanted to provide another viewpoint from a resident.

Sent from my SM-G973U1 using Tapatalk

Viewpoints from residents are helpful. Boots on the ground, so to speak.

At the end of the day, it's more about complying with masks, social distancing, staying out of risk locations (bars, etc.), and washing hands. Chris Christy is a CASE STUDY. As he said, he spent 7 months complying and even though he was in New Jersey, where it was quite prevalent, he avoided COVID. Then he let his guard down and attended the WH and the Trump debate prep without precautions, and got COVID. His point was that, in his experience, the precautions protected him.

So, even if some tourists come carrying the virus, if they, and we, and you, do the right things... it will likely be harmless error. Don't do the right things, and the virus will find you.

 

[geist1223]

This is fascism.

No this is the idiots being controlled for the greater good.

 

[DannyTS]

I'm familiar with that article and the concepts. It underscores that a positive/not positive outcome fails to recognize that what's really going on is more gray and should be more akin to probably positive, almost certainly positive, etc. Their conclusion is that SOME of the positives probably are not infectious because they're being safe and not sorry. But, as they point out, the yes/no threshold varies by test maker. Reasonable minds might differ on how many cycles is the "best" or "right" answer. If I was an obese diabetic, I'd prefer that they have some false positives over false negatives.

The fact is, ~220,000 have died and about 8M have had the disease... so there is PLENTY of not false positive out there!

SOME?

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.

 

[Tamaradarann]

This is fascism.

If you will, I'd prefer to call it law enforcement. There are laws that I agree with and others that I don't agree with. In over 70 years of living I have never been arrested so I would suggest that in general I do obey the law. I do agree with testing for the coronavirus and using the results to protect infection from spreading throughout the population. Enforcement of the quarantine laws is part of that effort. I don't agree with the enforcement of the laws that has prevented people from walking on the beach in Hawaii or siting with the family members they live with. I guess one could call a Police Officer stopping me from doing so fasicm. The potential for the enforcement of those laws would prevent me from doing it.

 

[MULTIZ321]

Hawaii again welcoming visitors; Here's everything
you need to know.

The Points Guy - Maximize your travel.

Maximize your travel.

thepointsguy.com

Richard

 

[csodjd]

SOME?

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.

Yes some. That's like saying 85-90% of the people that were not actually infectious would have been deemed negative if the threshold was adjusted. Duh. We are dealing with measures of certainty. Akin to a confidence interval in statistics.

As a corrollary, you'd also be increasing the false negatives -- you'd have people coming back negative that were still infectious if the cycles are changed. Bottom line is, it is set where it is set because people that are experts in the field believe it is the most appropriate cut-off point. Unless your broad experience as a PhD in PCR testing indicates they are wrong, your opinion is not really very important. We all recognize that in the absence of clinical findings, a positive results means you are PROBABLY positive, and a negative means you are PROBABLY negative.

If the goal is keeping residents of Hawaii safe, or anyone else, false positives are not a big concern. False negatives are. End of discussion.

 

[Tamaradarann]

Here's an interesting look at who arrived yesterday. This doesn't include inter-island flights/passengers, just those coming from mainland US. According to the Lt. Gov., about 1400 of those had to quarantine, with about 300-400 of those 1400 being because they didn't have their test results yet. (Not clear to me where the 502 Crew fits into that, not tested and not quarantined?)

View attachment 27623

Thank you for posting this most interesting breakdown of the October 15th arrivals. To me it reveals much more than just a return of tourists. My thought is that only the Pleasure/Vacation and the Honeymoon numbers reveal an opening up of Hawaii to tourists which is 3236 out of 8219 which is about 40%. Certainly more of some of the other categories came because there was no longer a quarantine required with a negative pre-boarding test. If the infection numbers do go up significantly it certainly can't be blamed solely on Tourists!

There were about 800 who arrived on October 15th who didn't get tested, but now must be quarantined. Some of those that are required to be quarantined will violate the quarantine. Furthermore, others may do their best to try to quarantine but they will have impediments. They will be living in quarters with other people who don't have to quarantine, but the traveller could have brought infection into the residence. Those people will go out into the public. Also, people may come to visit that residence and get infected.

As amy 241 said social distancing, wearing masks and large groups of people together are certainly major spreading factors; however, there are other factors which led me to put forth the thought about the escorted quarentine to an isolated guarded faciltiy to prevent the spread.

 

[csodjd]

As amy 241 said social distancing, wearing masks and large groups of people together are certainly major spreading factors; however, there are other factors which led me to put forth the thought about the escorted quarentine to an isolated guarded faciltiy to prevent the spread.

I'm reasonably certain that would violate the constitution. There's this "due process" thing that prevents the government from locking you up in a jail without a hearing, without a bail hearing, etc.

 

[critterchick]

There were about 800 who arrived on October 15th who didn't get tested, but now must be quarantined. Some of those that are required to be quarantined will violate the quarantine. Furthermore, others may do their best to try to quarantine but they will have impediments. They will be living in quarters with other people who don't have to quarantine, but the traveller could have brought infection into the residence. Those people will go out into the public. Also, people may come to visit that residence and get infected.

As I understand it (not very well, lol), if you test positive, your whole party goes into quarantine. Or were you talking about people who are staying with residents that aren’t subject to quarantine?

 

[geist1223]

I'm reasonably certain that would violate the constitution. There's this "due process" thing that prevents the government from locking you up in a jail without a hearing, without a bail hearing, etc.

Actually you can be locked up in jail without any type of hearing. So if you get arrested and locked up on a Friday Night and the courts are closed if you can not post bail you will most likely sit there until Monday.

Also there are a variety of court decisions over the past 100 years concerning public health actions which are different from criminal actions.

 

[DannyTS]

Yes some. That's like saying 85-90% of the people that were not actually infectious would have been deemed negative if the threshold was adjusted. Duh. We are dealing with measures of certainty. Akin to a confidence interval in statistics.

As a corrollary, you'd also be increasing the false negatives -- you'd have people coming back negative that were still infectious if the cycles are changed. Bottom line is, it is set where it is set because people that are experts in the field believe it is the most appropriate cut-off point. Unless your broad experience as a PhD in PCR testing indicates they are wrong, your opinion is not really very important. We all recognize that in the absence of clinical findings, a positive results means you are PROBABLY positive, and a negative means you are PROBABLY negative.

If the goal is keeping residents of Hawaii safe, or anyone else, false positives are not a big concern. False negatives are. End of discussion.

I agree with most of what you said. At the same time, my comment was in the context of how many travelers to Hawaii can spread the virus and the number seems to be many times lower than what was said.

The false positives are also important to know because otherwise you end up with people who died of other causes inflating the number of covid 19 deaths. Like 220k.

 

[csodjd]

The false positives are also important to know because otherwise you end up with people who died of other causes inflating the number of covid 19 deaths. Like 220k.

There is no credible evidence that the number of DEAD around the world is materially inflated due to "false positives." That's a talking point by those that wish to deny the science and/or minimize the seriousness of the disease. Certainly there are false positive test results. In most cases that's in asymptomatic people (see Nick Saban). But when test results are correlated with clinical findings by infectious disease specialists and ER doctors, considering lung CT scans, O2 saturation, loss of smell and taste, history, and related signs and symptoms, the fact is that many are diagnosed with COVID irrespective of test results. If one believes that the number of deaths attributed to COVID is untrue and is actually far less I'd say that person is just revealing their view that COVID is a hoax, or not real or important, a view entirely rejected by all credible science around the world. I'm pretty sure most of the world, from Iceland to New Zealand, did not all get together and decide to shut down their economies and order their citizens to stay at home because of American politics or a medical hoax.

False positives are a concern in all of medicine because they lead to otherwise unnecessary testing and medical costs, and human costs in stress, anxiety, fear. False negatives are a concern because they lead to often avoidable death.

Here is an article discussing the evidence that, in fact, many more have died of COVID than are attributed to it, but discussing the various challenges with coming to definitive conclusions.

How many people has the coronavirus killed?

Researchers are struggling to tally mortality statistics as the pandemic rages. Here’s how they gauge the true toll of the coronavirus outbreak.

www.nature.com

 

[slip]

We drove down Kalakaua after grocery shopping today. It the first weekend with traveling with no quarantine with a negative test. It was a little busier. These were taken at about 2:30pm this afternoon. It has been a cloudy day and the trade winds aren’t blowing. Sounds like they won’t return until Thursday. Waves were pretty big today too.

 

[Tamaradarann]

As I understand it (not very well, lol), if you test positive, your whole party goes into quarantine. Or were you talking about people who are staying with residents that aren’t subject to quarantine?

I was talking about staying with residents that aren't subject to quarantine since they never left the island.

 

[DannyTS]

There is no credible evidence that the number of DEAD around the world is materially inflated due to "false positives." That's a talking point by those that wish to deny the science and/or minimize the seriousness of the disease. Certainly there are false positive test results. In most cases that's in asymptomatic people (see Nick Saban). But when test results are correlated with clinical findings by infectious disease specialists and ER doctors, considering lung CT scans, O2 saturation, loss of smell and taste, history, and related signs and symptoms, the fact is that many are diagnosed with COVID irrespective of test results. If one believes that the number of deaths attributed to COVID is untrue and is actually far less I'd say that person is just revealing their view that COVID is a hoax, or not real or important, a view entirely rejected by all credible science around the world. I'm pretty sure most of the world, from Iceland to New Zealand, did not all get together and decide to shut down their economies and order their citizens to stay at home because of American politics or a medical hoax.

False positives are a concern in all of medicine because they lead to otherwise unnecessary testing and medical costs, and human costs in stress, anxiety, fear. False negatives are a concern because they lead to often avoidable death.

Here is an article discussing the evidence that, in fact, many more have died of COVID than are attributed to it, but discussing the various challenges with coming to definitive conclusions.

How many people has the coronavirus killed?

Researchers are struggling to tally mortality statistics as the pandemic rages. Here’s how they gauge the true toll of the coronavirus outbreak.

www.nature.com

I will make it simple. If the whole US population tested (false) positive, you would have a huge number of registered Covid deaths. The number of false positive results does matter. It should not but unfortunately it does due to the way the deaths are counted.
You do the math. So far 8,000,000 people tested positive in the US. About 1% or 80,000 of those would sadly die every year because of sickness, age or both. If 90% of them are false positive, you can easily see how up to 72,000 deaths can be added erroneously.

Please keep it light with the "hoax" argument, neither very constructive nor very original. I did not say that the virus is not dangerous. If you do not like my argument fine with me.

 

[Tamaradarann]

[Not appropriate and really off-topic. Let's try for some courteous conversation.]

 

[csodjd]

I will make it simple. If the whole US population tested (false) positive, you would have a huge number of registered Covid deaths.

That’s nonsensical. If they were FALSE positives, by definition they did not die from COVID. You cannot be both a false positive for COVID and infected with COVID.

 

[LannyPC]

I haven't really followed this rather lengthy thread. So is there any news as to when HI will end the 14-day quarantine requirement and/or the mandatory 72-hr. pre-arrival Covid test?

 

[DannyTS]

That’s nonsensical. If they were FALSE positives, by definition they did not die from COVID. You cannot be both a false positive for COVID and infected with COVID.

I am trying to understand your point of view. According to the NYT 90% of those that test positive should actually be in the negative column and not be quarantined, contact traced etc. If any of those 90% die, don't you agree that none should be considered a Covid 19 death? The evidence show that all those that die are all bundled together in the statistics, the 10% and the 90%.

I think you are just trying to play with words. I am using false positive in the sense of the 90%. I think the NYT is pretty clear. If you want to use another term I am fine with that but the conclusion is the same, those 90% should not be considered Covid deaths.

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

 

[csodjd]

I am trying to understand your point of view. According to the NYT 90% of those that test positive should actually be in the negative column and not be quarantined, contact traced etc. If any of those 90% die, don't you agree that none should be considered a Covid 19 death? The evidence show that all those that die are all bundled together in the statistics, the 10% and the 90%.

I think you are just trying to play with words. I am using false positive in the sense of the 90%. I think the NYT is pretty clear. If you want to use another term I am fine with that but the conclusion is the same, those 90% should not be considered Covid deaths.

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

I'm trying to understand YOUR point of view. The goal is to keep Hawaii and its residents safe from COVID as much as possible and, within reason, reduce the number of people with an infection from coming in. Errs on the side on false positives does that. Errs on the side of false negatives does not. You are advocating a position that would increase the chances of a false negative in order to reduce the chances of a false positive. That's contrary to keeping anyone, or anywhere, safe from COVID. Your point of view appears to be that the safety of Hawaii should be compromised in order to help ensure we don't have the inconvenience of false positives. You're entitled to your view. I'm hoping when I visit Hawaii it will be very unlikely I will cause, or be the victim of, the spread of COVID.

 

[DeniseM]

I haven't really followed this rather lengthy thread. So is there any news as to when HI will end the 14-day quarantine requirement and/or the mandatory 72-hr. pre-arrival Covid test?

The 72 hour testing just started 3 days ago, so I certainly wouldn't expect anything to change for months. Hawaii does not have the medical infrastructure to take care of an out of control pandemic, so they are going to be cautious. I wouldn't expect anything to change until everyone has access to a vaccine. You guys that want to argue about this - don't bother - not interested.

 

[DannyTS]

I'm trying to understand YOUR point of view. The goal is to keep Hawaii and its residents safe from COVID as much as possible and, within reason, reduce the number of people with an infection from coming in. Errs on the side on false positives does that. Errs on the side of false negatives does not. You are advocating a position that would increase the chances of a false negative in order to reduce the chances of a false positive. That's contrary to keeping anyone, or anywhere, safe from COVID. Your point of view appears to be that the safety of Hawaii should be compromised in order to help ensure we don't have the inconvenience of false positives. You're entitled to your view. I'm hoping when I visit Hawaii it will be very unlikely I will cause, or be the victim of, the spread of COVID.

What exactly you say I was advocating? Did I say Hawaii should change the tests or anything like that? NO. Going back to what you said, 3-5% positive rate for those that land in Hawaii without a test is WRONG and others told you the same. I think you have nuanced your answer after that but bottom line is that it cannot be 3 or 5% that are contagious, very, very far from that. This is all I said.