Now that it’s here, what do we do?

We learned through the governor that coronavirus has come to Kauai. As of Saturday, March 14th, there were two identified cases, and both were visitors. It is one more wakeup call. It is not a time to panic, but it is the time for action by each of us. It is also a time for us to learn from countries and locations that have kept the virus under control.

If we do nothing, experts are saying over and over that the disease caused by this virus will very quickly overwhelm our hospitals and caretakers as it has in other places. They also keep repeating that it is possible to slow the rate of spread down dramatically.

An article in the March 13th issue of Time magazine describes how Hong Kong, Taiwan, and Singapore have been so successful in keeping their numbers and deaths down. Singapore and Taiwan are islands. All three are very close to China, with heavy traffic back and forth.

Despite their closeness to China and the fact that they had cases early in this epidemic, they took very rapid and decisive actions and have at this time very little evidence of spread. The steps they took included:

• They rapidly instituted widespread testing for the virus, with careful follow up of contacts and isolation protocols;

• Put social distancing in place; streets became empty, all mass gatherings were canceled, and schools and many non-essential businesses closed;

• Had tight border controls and screening procedures.

Our Island has proved its resilience before. I remember when FEMA came after Iniki. They were amazed at the way we all pulled together to recover. This time we need to pull apart at least for now. And we can do it. Now that cases have been identified on Kauai despite the limited testing, we need to put the social distancing in place today. I apologize for repeating some of these ideas. Just days ago it seemed we might have time, but now we need to take action.

• Recommendations in many of the cities and states affected are that anybody who can work from home, should. All mass events, group meetings, team sports should be canceled. I applaud the County for the actions they have taken regarding county parks and the convention center.

• Looking at the sweeping measures taken by mainland cities in the last two days, I believe we should do the same. Government agencies should call for the closing of restaurants, bars, entertainment venues. Restaurants might do as New York is doing and stay open for take-out which better protects all involved. All private sector and government employees that can work from home or released for several weeks should be allowed to do so.

• New York, LA, and Seattle have become ghost towns while our towns are filling with tourists taking advantage of cheap flights. I have seen $99 one way tickets from Seattle. Seattle is the American epicenter of this epidemic. New Zealand and Australia have both put in place mandatory two weeks of self-isolation for anyone entering their countries. Canada has just shut its borders to all non-citizens. We are probably more vulnerable than these countries with our limited hospital resources. I believe that we should strongly discourage tourists from arriving by plane for at least two weeks if not longer, and we should end the cheap fares now. Everything we read says slow down the spread. Opening the doors to those that may be sick is not a good way to slow the spread.

• CDC says, if coronavirus is in your community, the distance between people you interact with within the community should be far enough to avoid droplets, meaning 6-10 feet. Hugging and handshakes should not be part of our culture at this time.

• Great handwashing needs to happen all day long. Droplets can stay on surfaces such as doorknobs for days. Try not to touch your face.

• Anybody who is sick, particularly sick with a cough or fever, should self-isolate.

• Protect the kupuna. This virus is more dangerous for those over 60 and particularly dangerous for older people if they have other medical conditions. Limit visits to the elderly. Consider setting up Skype to stay in touch.

• If ill with cough or fever, call your doctor’s office for instructions, don’t just walk in.

• Try to stay home for the next several weeks.

• While you are staying home, make sure that you get sun and fresh air. Add fruits and vegetables to your diet. Do whatever it takes to remain healthy. The healthier you are, the better the chance that you can handle the infection well.

• The State and the private health sector need to ramp up testing yesterday. We cannot identify and isolate if we don’t test. Wilcox Hospital deserves special thanks for being among the first in the nation to put in place drive through testing. You will need to call your physician’s office for information about referrals for the test.

• I also suggest that the college kids returning from the mainland self-quarantine for 2 weeks. I know it’s hard when you return home to Hawaii, but please stop hugging your friends.

Italy, with its overwhelmed medical care system, should be our wake up call. Once this virus is established it rapidly spreads. This may be the most important time in all of our lives to just stay home.

We can slow this down, and we all have a major role to play.

This column represents a sharing of information. No content on this column should ever be used as a substitute for direct medical advice from your doctor or other qualified clinicians.

•••

Lee A Evslin, MD is a Board Certified Pediatrician and Fellow of The American Academy of Pediatrics. He was a former healthcare administrator on Kauai and periodically writes a column for the Garden Island.

15 Comments
  1. Charlie Chimknee March 17, 2020 4:56 am Reply

    Infrared video cameras recording people arriving at the airport with fever to isolate them before they leave the airport and spread the virus.

    Other countries are using thee cameras to identify people with fever.


    1. rain March 17, 2020 8:25 pm Reply

      wow interesting they can do that nowadays


  2. Merci Schon March 17, 2020 8:07 am Reply

    My only hope is that you stop cruise ship passengers from getting off the ship!


  3. Emily March 17, 2020 10:02 am Reply

    Dr. Evslin, Thank you so much for providing such important information and advice. How can we encourage airlines to stop offering these low fares?


  4. RG DeSoto March 17, 2020 3:20 pm Reply

    Frankly, I’m sick of the fearmongering perpetrated on those from Fauci in DC to Evslin and the local politicians/bureaucrats here at home.
    All this for an affliction that world wide currently has 108,526 active cases, 94% of whom are in mild condition and 6% in serious or critical condition. That’s out of 7,700,000,000 (7.7 billion) people on earth. Of a grand total of 198,229 cases worldwide 7,965 have died.
    In the US the total number of cases to date is 6,456 with 109 resulting in death…that’s out of a population of 329,406,378. Of all the current US cases only 12 are in serious or critical condition. Pull back from your narrow, myopic perspective and consider that the probability of any given individual contracting Covid-19 and dying are virtually zero.
    People in vulnerable age and health groups need to be very cautious…but this applies to all kinds of diseases, not just Covid-19.
    By contrast, tuberculosis, an ancient disease much ignored these days, killed nearly 1.6 million people in 2017. Where’s the panic over this?
    The danger of this disease has been massively oversold…for what? Are we to shut down our lives, economy or stay home from the work that gives us the means to feed, clothe and house ourselves?
    RG DeSoto


    1. Kauaidoug March 18, 2020 11:54 am Reply

      Unbelievable, DeSoto. But one thing I do think about visitors here is they should leave because this is one emergency help for visitors we cannot afford! Any visitor in our hospital for care could be reducing the help for one of us. I have heard the refrain from more than once from visitors is “


    2. jake March 18, 2020 12:34 pm Reply

      How’s that gift shop of your’s doing, RG?


    3. Ginger Doll March 19, 2020 4:02 am Reply

      Interesting how RG talks like Trump just days ago. Nothing to worry about folks, says Trump, while shaking hands with everyone in sight.
      What is it about the majority of Republicans who think the threat is exaggerated?
      It must be their continuing faith in their fearless leader who has told 15,000 lies while in office.
      The Trump cult is alive and well.


      1. Your neighbor March 22, 2020 11:57 am Reply

        Just get ready for 5 more years, darling. Trump will be elected in a landslide.
        Bet on it


  5. jake March 17, 2020 5:43 pm Reply

    Kauai’s borders will not close. The lust for the tourism dollar outweighs the value of human life on Kauai. Shop owners and tourism business would rather kill themselves or members of their families for that almighty dollar. About the only thing Kauaiians can do now is to take a good look at your loved ones. Remember them. Remember the good times, because in two weeks, they may be starving for oxygen with viral induced pneumonia, and they won’t survive. You will lose them. You will lose your parents, your siblings, your spouses, your childrens, aunts, uncles, cousins, and your best friends if the virus doesn’t suffocate you first. Yeah, you will have made some money with your lei shops and bogus Hawaiian ancient art carvings, but you’ll either be very much alone, or dead. Close Kauai’s borders now. Shut down tourism. Save your families and save yourselves.


    1. spooky March 17, 2020 10:11 pm Reply

      so spooky , you should write a sci-fi novel with an imagination like that


    2. Da Shadow March 18, 2020 6:38 am Reply

      easy for you to say “shut down tourism” when your livelihood doesn’t depend on tourism.
      consider those of us who work for a living before saying such silly things.

      and maybe also consider the fact that this virus is no more deadly, overall, than the flu strains that hit each season.


  6. Jesse March 17, 2020 6:03 pm Reply

    “Now that it’s here, what do we do?” Get to the mainland as fast as possible before Hawaii is cut off from airlines and container ships. Hawaii’s the easiest place in America to shut off. Run.


  7. George March 18, 2020 5:28 pm Reply

    How many people need to die that would make you happy?


  8. commonsense March 19, 2020 12:30 pm Reply

    Wow Jake! You have quite the imagination. That is some pretty doomsday stuff. Fortunately, that scenario will not happen. While people should take this seriously, we don’t all need to stop our lives and do everything that is being forced upon us. Be smart, be cautious, be courteous and limit exposure. The new ‘Curfew’ being forced is redundant at best. With bars and restaurants being closed, what difference does it make if a few people are traveling on our streets? They aren’t gathering in large groups. This is unnecessary and is stoking more fear and paranoia.


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