The time is now to plan the safe resumption of life on Kaua‘i

Although it appears too soon to lift the lockdown on Kaua‘i (we must take counsel from our public health experts on this), it is not too soon to talk about how to do it. We must restart our civic life as soon as it is safely possible. To do this, we must figure out how to reopen Kaua’i in a COVID-19 infected world while avoiding reinfection and another lockdown.

The purpose of this paper is to spark community dialogue to find the best possible way to move forward safely. The specifics may change because the best available knowledge changes daily, but the principles should remain the same.

To prevent our island from being reinfected as we reopen, we must do two things:

1. Establish a process to prevent reintroduction of the virus by rigorously screening tourists, inter-island travelers and returning residents.

2. Establish an early warning system that will immediately detect screening failure and do strenuous contact tracing of the virus-carrying travelers and their contacts to prevent spread.

An effectively designed and enforced visitor screening and quarantine system will be our first line of defense. Without it, Kaua’i will risk the high human and economic costs of reinfection.

Under today’s existing locked down conditions, visitors, travelers from other islands and returning residents are still coming to Kaua‘i and we cannot legally stop them. The numbers are small, but it takes only one infected traveler to seed viral spread, and recent reports indicate that some travelers are not abiding by the 14-day quarantine.

Even if we initially intend to reopen Kaua‘i for residents only (an appropriate Phase I), if word gets out that Kaua’i has contained the virus, the numbers of travelers could grow quickly and overwhelm our screening, quarantine and healthcare systems.

Thus, we must be ready at the beginning of any reopening to register and test all incoming travelers before they leave Lihu‘e Airport (or Nawiliwili Harbor if cruise ships are allowed to return, not a good idea).

To do this, we will need a sufficient stockpile of rapid COVID-19 tests.

Those who test positive must go into isolation in a hospital or in a hotel prepared to handle such guests. Those who test negative will be asked to sign a consent form agreeing to abide by a quarantine to protect against false negatives.

They will also be quarantined in a hotel. The consent form will inform them that any violation of the quarantine will result in substantial fine and return to their home at their cost. All visitors will be charged a COVID—19 prevention fee covering the costs of quarantine and enforcement. As as been successfully done in many parts of the world, Kaua’i should require tracking apps for all travelers.

An early warning system to detect whether the virus has slipped through Kaua‘i’s screening process will be very similar to the system of detection and spread prevention in place now—only better, with more available testing and more effective quarantine protocols added to our present system of mandatory masks, prohibition of gatherings, and safe delivery of services.

South Korea, Taiwan and Iceland have proven that widespread testing is necessary to preventing the spread of the virus. Based on the interview of South Korean infectious disease expert Dr. Woo-Ju Kim, widespread testing means making tests easily available to anyone showing one of the symptoms—sore throat, cough, fever, loss of taste and smell, difficulty breathing and for the elderly, fatigue, loss of appetite and mild body aches. It would also encompass the DOH’s expanded criteria of testing anyone who had contact with persons with the disease or suspected of having the disease. It would also be available to anyone who wanted a test and was willing to pay for it.

Kaua‘i must also upgrade its quarantine and isolation policies by requiring that quarantine and isolation be conducted outside the home. If it is not safe for healthcare and first responders to be housed in their homes, it is not safe for COVID-infected persons or residents returning from travel to be isolated or quarantined in their homes—especially if there are kupuna or essential workers who are part of the household.

An infected employee at McDonalds in Kona started a viral cluster not only at work, but also at home where there were many others living, making it clear that to prevent community spread, quarantine and isolation need to be done outside the home.

Kaua’i has a unique opportunity to contain the novel coronavirus. We are able to control our borders much better than anywhere else in the country.

We have a small population of caring, courageous and creative citizens who care about each other and are pulling together despite huge challenges. We have responsible, caring leaders; we owe Mayor Kawakami and team our gratitude.

What we don’t have is time to spare. We must act quickly to ensure that the virus is contained before more economic damage is done to our families and businesses. As soon as the virus is under control, we must reopen the island in phases with stringently enforced screening and quarantine requirements to keep us all safe and to lay the foundation for successful economic recovery.

•••

JoAnn Yukimura is a former mayor and councilmember who has served her community for many years. She can be reached at jyukimura@gmail.com.

22 Comments
  1. Steve Lauryn April 23, 2020 3:16 am Reply

    The Mayor was recently quoted as saying he has a team of 60 working on reopening and economic recovery. It would be great to hear what progress and efforts have been made toward procuring testing equipment and supplies. Everyone talks about testing shortages—no one is talking to us in hard numbers about the adequacy of current supplies, future supply needs, the need for PCR vs. serologic (antibody), current testing capacities vs. ideal percentages, etc. There are self tests being developed that could be a big help. Also, where are the contact tracing teams, and which county (or state) departments will be in charge? Are we reaching out to the airlines to develop testing protocols? Opening the local economy is only a small part of recovery. The island’s largest single employer is a hotel. We have to figure out safe ways to get the larger engine going again, and that means a visitor testing program that probably involves pre-itinerary and prior-to-boarding testing starting at mainland airports. Planning and coordination should have started by now, and will require coordination between public health experts, HTA and HVCB, the transportation and hospitality industries and island leadership. …You’re right, JoAnn—the one thing we don’t have a lot of is time.


    1. JoAnn Yukimura April 23, 2020 11:01 pm Reply

      Thank you for your comments, Steve. I am not advocating opening now. I am not advocating a big opening. I am advocating a SAFE opening when the public health officials and the mayor decide its time. I am concerned that unless we are doing the planning now, we will not be ready. We need a committee of stakeholders (airports, airlines, visitor industry, hotels, police, department of health, mayor’s office, governor’s office, epidemiologists, medical professionals, and informed committed citizens) to develop in detail an impeccable system of screening, spread prevention and enforcement. Not only does the committee need to design the systems, they need to make sure we have access to enough test kits, enough contact tracers, and whatever else we will need to do effective implementation. I think we should start small, but because we cannot legally stop people from traveling, we need to be ready for a surge of travelers that might happen. Otherwise we risk reinfecting the island.


  2. Bernard Markowicz April 23, 2020 3:17 am Reply

    Mahalo for your comprehensive article. As you pointed out, planning for a return to a sense of normalcy on Kauai in a post-COVID world is necessary. Your article appears to advocate for a high degree of isolation, with particular emphasis on returning residents. Before advocating for one direction or another, it is critical that we understand clearly the economic and social impacts of isolation on our Island, on our citizens, on their ability to earn a living, on the sustainability of businesses on the Island, on the prices we pay for food and material needed to maintain our infrastructure and on the ability of our Government to maintain our roads and bridges and to provide social services to the members of our population in need.

    Your focus on isolating returning residents away from their Kauai homes is odd and unsupported by science. The proven measures for reducing corona virus infections are social distancing, testing and contact tracing. Reasonable measures such as temperature checks and rapid testing can be conducted on returning residents when arriving back on Island, but residents must be treated fairly as contributing and tax-paying members of our community. Social distancing measures in place are effective and must be enforced equally for all.


    1. JoAnn Yukimura April 24, 2020 9:44 pm Reply

      Thank you for your comments and concerns. After the first week of COVID-19 infection in the State, the DOH reported that 80% of the infections were from returning residents. My suggestion that returning residents be quarantined outside the home is based on concern for the safety of others in the household, especially kupuna, who are more vulnerable, and essential workers who will go out to work in the community every day and could thereby contribute to the spread of the virus if they get infected. In South Korea where they are getting a handle on the virus, they provided separate lodging for those under quarantine. This was also advocated by Hawaii based doctors: https://www.civilbeat.org/2020/04/hawaiis-hotels-can-help-lead-the-fight-against-this-pandemic/ It would really help to have rapid testing, but even that could provide a false negative–a situation where a person is infected but it doesn’t show on the test. Perhaps the quarantine period will be shortened if public health experts certify that so many negatives within a certain period of time will be sufficient to indicate that a person is safe. Thanks for your thoughts and for allowing me to share mine.


  3. Everythingisawesome April 23, 2020 5:20 am Reply

    “it takes only one infected traveler to seed viral spread”
    Too much “science” being pulled from movies here.
    History shows we had 21 cases. 20 travelers already brought the virus here and there is NO community spread, and zero deaths. None. Protect those at risk and get on with life.


  4. Everythingisawesome April 23, 2020 6:00 am Reply

    If a flight arrives and even one passenger tests positive, every passenger, crew member and item of cargo would be considered infected according to your plan. Cargo is easy to dis-infect. What will you do with the people? How is your “plan” any better than the current 14 day quarantine? Do you honestly think anyone would agree to come vist, or even take a mainland trip under your totalitarian plan??


  5. mina April 23, 2020 7:42 am Reply

    Joanne, you need to have a long chat with Kauai’s Chief of Police about how much trouble they’re already having with Covid restriction and curfew violations. If this virus does get loose with the huggy/kissy nature of Kauaians, it will wipe out 80 percent of the people on this island, including you. When someone points a gun at you and says, “Your money or your life,” that’s not the time to be thinking it over. This virus is a loaded weapon, and it’s killing people not just giving them the sniffles. It’s been found to cause permanent lung and heart damage in patients who survive, and they continue to carry the virus after recovery. Tread very carefully here. Our mayor is erring on the side of caution, which is a wise decision.


    1. Everythingisawesome April 24, 2020 10:21 am Reply

      “how much trouble they’re already having with Covid restriction and curfew violations”
      If it is true that the rules are not being followed, and there is still no spread, then the rules are not what is preventing the spread and are, at best, a waste of time and effort.
      To be clear, they are a waste of time and effort.


    2. JoAnn Yukimura April 25, 2020 9:33 pm Reply

      Agreed, Mina. I am not advocating opening up the island right now. That should be determined by the Mayor and the Department of Health. All I’m saying is that because reinfecting Kaua’i is like putting a gun to people’s head–i.e., people coming into Kaua’i with the virus (could be out-of-state visitor, a returning resident or someone from the other Hawaiian islands) are disease vectors who could cause others to die–when we decide to restart our economy and resume civic life on Kaua’i, we need to be ready to screen incoming travelers and detect those with the virus to prevent reinfection and another lockdown.


  6. RG DeSoto April 23, 2020 9:20 am Reply

    Anything you say, JoAnn.
    RG DeSoto


  7. Joe Public April 23, 2020 11:46 am Reply

    Really care what she has to say…The savior of Hurricane Iwa.


  8. Rev Dr Malama April 23, 2020 1:11 pm Reply

    Thanks Joanne, I’m in… as long as you respect my rights to disagree with you and add a few insights and suggestions?
    First of all, I believe that life is resuming…. taking a deep breath on a beautiful, spring day on Kauai! A favorite saying from a mentor of mine is “the difference between anxiety and excitement is in the breath “…
    Many Hawai’ian words have the root HA which alone means LIFE!
    Nature is being revived by the time out of over tourism that has terrorized our earth, water and sky for way to long sooo, yeah a new nonprofit hui designed to protect the environment would interest me and others to block premature lifting of emergency mandates for a serious length of time.
    A hui or umbrella group of Kupuna, Kahuna, doctors, lawyers, PhD and scholars at any age for our Kauai Covid TASKFORCE to organize and designate already established nonprofits a crucial role in leading us step by step into a new now!
    I completely agree with you that many more tests are needed but I want the input from some of our local private Doctors regarding the move to establish an open source of economic development…
    Mahalo KE AKUA for the Ha!


  9. Peter Eacott April 23, 2020 2:16 pm Reply

    Some great ideas. Possibly we could require all travelers coming onto the Island require a test showing no virus withing 48 hours of their flight – let’s keep the fight and quarantine off the Island (and Kauai costs down). The airlines have worked with Kauai for years making certain dogs/pets are healthy and had their shots – why not people. New technology to determining anyone in a crowd that has a higher than normal temperature with thermal cameras, etc, must become the norm.
    I completely agree as to home quarantine – it does not work – it endangers us all – we need a humane solution there. We also need to impress upon everyone how important it is to stay out of the public sector the instant you do not feel well. Public awareness is essential.
    The biggest threat we face (I feel) is from Cruise ships – they do not enhance our island life – we must find a way to stop them – even if it takes public protests on the docks. The surfers stopped the Super Ferry we can stop the cruise ships.
    Bravo to everyone involved in maintaining a safe environment here on Kauai – our Mayor is to be commended.


  10. Judie Hoeppner April 23, 2020 2:35 pm Reply

    Lots of great suggestions, JoAnn. In spite of the revenue that tourist bring, I am astounded by the selfishness of tourist who insist on coming at this time and especially those who refuse to honor the 14 day quarantine. It would be wonderful to do a soft re-opening for residents only. Imagine driving through Kapaa for shopping in 15 – 20 minutes rather than 60 – 90 ! And being able to go out for meals. And having the pools and parks re-opened. How fantastic it will be to enjoy the parks that we used to take for granted!


  11. Robert Rosen April 23, 2020 8:55 pm Reply

    Thoughtful and spot on Joann. Thank you I had suggested that we contact our sister city in Taiwan…do you know anything of that from your time as mayor? I imagine they have a lot of testing capacity and seemingly not much curent need…availablilty of 15 min tests at airport/resorts are going to be necessary I imagine. Detect and trace is the only way…how can we afford another shut down?
    It is heartbreaking to see the long term small businesses on Island closing their doors..we need local employment or the exodus we will see is of younger people for opportunity.


  12. Jay April 23, 2020 8:55 pm Reply

    Strike a deal with the airlines that they test all passengers with instant test prior to their departure to Kauai, then open it up!!!

    Wait much longer people will die of mental health issues, heart disease, drug overdose, suicide, alcoholism, etc.

    Plus it’s just a matter of time before people can’t take it anymore and take to the streets, it’s not if… but when …


  13. Lee Jackson April 24, 2020 9:40 am Reply

    My wife and I have had a second home on Kauai since 2001, and are planning on coming to our beautiful island full time very soon. We have paid taxes for 20 years, and totally respect the traditions and the ways on Kauai. While I know every one of us remains very concerned about Covid-19 virus, everybody on-island should be MUCH more concerned about the draconian, and likely unconstitutional items mentioned in this op-ed. Visitors to the Hawaiian Islands spent $17.75 billion in 2019. The ECONOMY of Kauai is tourism, PERIOD. Nobody will put up with the restrictions suggested here. Tracking apps? Testing ALL incoming travelers? With what resources? Plus 60% of homes on-island are owned by people as second homes or vacation rental. You destroy real estate values with rules like this and you can bet on countless and endless lawsuits against the state and the county. Nobody wants Kauai or the citizens harmed in any way but like all Pandemics, this too will end as immunity spreads, and a vaccine is found. There is no testing of visitors for seasonal flu? Why? It would be impossible. Instituting reckless and dangerous policies like this, proposed by a lifelong politician would be a dreadful mistake, and most sensible folks know that. In Ms. Yukimura’s failed bid to be Mayor again in 2018 she talked about the kind of entrepreneurial spirit and know-how needed in the Mayor’s office. No entrepreneurial spirit or “know how” here. These kind of remarkably naive suggestions will put ALL residents of the Garden Isle at a disadvantage, because if tourism goes away, you will have a lot more to deal with. Consider soaring poverty, job losses, tax revenue needed for social services and infrastructure gone, the potential for increases in crime, and many additional unintended consequences. My wife and I embrace the aloha from the wonderful people, places and traditions on Kauai, and are adamant on protecting and keeping everything cherished and sacred there. While her service to Kauai is admirable, the recommendations being made by the former Mayor and seemingly lifetime council member, are impractical, likely unenforceable, and probably unconstitutional.


    1. Jeff S. April 24, 2020 1:49 pm Reply

      Well spoken Mr. Jackson. My wife and I are 10 years away from doing the same thing. I’d like to buy you a beer.


    2. Steve L. April 24, 2020 7:33 pm Reply

      Mr Jackson, I think a chill pill is in order for many of us about now. Testing is going to be part of life no matter where you live or where you want to go on planet earth—for another year or more. I’m not sure about JoAnn’s idea of extending 14-day quarantines out to the horizon, because we want to balance cocooning ourselves with getting folks back to work again. And we have to figure out ways to safely get visitors back. But testing protocols for visitors will surely be a big part of enabling the transition to regular economy for this island.


  14. manawai April 24, 2020 2:06 pm Reply

    This reminds me of the Andy’s Gang TV show (black & white days) and the line, “Plunk your magic twanger, Froggy!” That’s what we need here.


  15. Lee Jackson April 28, 2020 6:37 am Reply

    Just for the record I am chilling like a villain. The reality is the hard working lower income earners won’t be for long. 14 day quarantines are absurd, and many physicians have already come out against it. Vitamin D and activity is crucial to maintaining good health. AG Barr has already warned states about over regulation like this, and you can be assured he will come after Kauai if they continue these draconian measures. “Getting back to work” there means tourism, period. Hospitality accounts for 1/5 of all the jobs on Kauai.


  16. Rev Dr Malama April 29, 2020 11:04 am Reply

    After a week of more prayer, listening to the people of Kauai and those responding to your letter JoAnn, I must humbly say that the demands you make that we must do this and that are more than shocking to a free and educated society.
    Not one mention of reopening our public and private schools and libraries, museums and entertainment venues….
    The worry that I have is that lives are being forever damaged by unseen/unreported abuse from domestic violence and addictions of many substances and devices from the lockdown and unreasonable suspension of life, liberty and freedoms that many of us, boomers now in the majority living or visiting on Kauai have paid dearly our whole lives for…. suddenly our community is under a huge blow that reflects the way the past and present administration has NOT TAKEN RESPONSIBILITY FOR!
    I NOW SEE THE NEED FOR CIVIL DISOBEDIENCE TO BE ABLE TO GET MY FREEDOMS BACK AND MAINTAIN THE ONES WE ARE ALL BARELY ABLE TO HOLD ON TO RIGHT NOW.
    JOINING TOGETHER ON MAY DAY ON KAUAI TO DEMAND THE POLICE AND MILITARY STAND DOWN FROM THE UNNECESSARY CONTROL TACTICS THAT ARE INCREASINGLY WORRISOME.


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