VOICES: Base policy on science, mayor

To Mayor Kawakami and the County Council:

Please reconsider the plan to reopen the island to tourists with anything less than the Centers of Disease Control recommended guidelines for quarantine.

The implementation of a three-day quarantine is insufficient to protect the people of Kaua‘i. Be clear, this is three days from their last uncontrolled, high-risk behavior — which is getting on a plane and traveling through an airport. This is the date from which quarantine should be considered. The Centers for Disease Control has been quite clear about quarantine required to detect greater than 90% of cases. It requires 10 days. See tgilinks.com/3nsLXlq

Quarantining for seven days with a negative test within 48 hours of the time of planned quarantine discontinuation results in an estimated 88% to 95% detection rate. They specifically state that quarantine cannot be discontinued earlier than after day seven.

Why then do we believe that we should implement a standard different than this? This will result in an extreme influx of highly-contagious people into our population. Don’t ignore the recommendations of the most-knowledgeable scientists in infectious disease in our country.

We only have to look at the Hawai‘i Department of Health Hawaii data website to understand how ill-advised this idea is: tgilinks.com/3sdju6v

Specifically, if we look at the trajectory of cases per hundred thousand population, we were on an identical trajectory as the County of Maui between early November and Nov. 22. When we closed the island, our case numbers per population went down from five to the values between 0.4 and the current value of 1.8. Maui’s has gone up to a current level of 18.5, some 10 times our number of daily new cases. Why is that? Because they opted to leave the island completely unprotected from the tourist influx.

Yes, many of our cases are due to residents traveling between islands and from the mainland. They should be required to quarantine exactly the same as anyone else coming onto the island. Look at the data on this graph and decide which island you want to live on. It’s not Maui and it’s not O‘ahu, and we should not be mimicking their ridiculous “Safe Travels program.”

As we are faced with the introduction of a more-contagious variant of coronavirus in large parts of the country, we need to consider this: Being 50% or 70% more contagious does not mean that 50% or 70% more people are going to get it over a month’s time.

It means that each infected person is more likely to infect a greater number of people. That change becomes exponential over the incubation. Currently the (entire) state of Hawai‘i has an estimated infection growth rate of 1.11, meaning that for each person that is infected they will infect 1.11 other people. If that new strain has a transmission rate that is 50% higher, and we assume a six-day infection-generation time, we will have over 7.5 times the number of infections in a month as we do with the current strain. That is also 7.5 times the number of dead.

We are an isolated community with limited resources. Those resources will become more limited as the supply chain and transportation industry is strained by worker shortages due to deaths and infections.

Already, areas as wealthy as California are rationing oxygen to the ill and discouraging EMTs from transporting those patients who they don’t believe have a good chance of survival. Understand what that means. The person making a decision about whether or not you get treatment is not a physician, it is someone with EMT training. EMTs are not trained to make those decisions. They are trained to provide emergency care and transportation.

Why, as the rest of the country records record numbers of infections, do we want to encourage them to come to Kaua‘i? Even if the three-day quarantine found 50% of the cases that traveled to the island, what do we do with those people? They are here for the duration of their infection competing for the limited medical resources of the island! Meanwhile, the other 50% are interacting with the population without a clue as to their infectivity. And we have to convince the resident population that we are “keeping the safe.”

It is time to make the decision necessary to safeguard this island! Implement a quarantine policy based on medical science, or we will all suffer the consequences.


James Hoskinson, DVM, is a resident of Kilauea.

  1. Mikey January 10, 2021 6:48 am Reply

    Mr Hoskinson could not have articulated his comment any better. It is very obvious that our Mayor is controlled by the business owners and corporations. It is very disheartening to see the decisions that are being made. We are so close to distributing the vaccine in hope of slowing down the spread of the virus and the Mayor decides to allow a 3 day quarantine that we all know does not work. Doctors and scientists are begging people not to travel and are asking people to stay home. Why are we allowing people to fly here to party 🎉 when we are in the middle of a pandemic. I have two adult children who are firefighter paramedics in California and they cannot believe how reckless our Mayor and Governor are being as they see first hand how there is no facilities (hospitals) to transport Covid patients to. And if you are having a heart attack, or are involved in an auto accident good luck! Our numbers are in the 20’s right now just wait a few weeks from now we will have many more and for certain people will die.
    Mr Mayor at least have a contingency plan set in place to erect field hospitals and freezer trucks to store bodies. As you all have read California is asking families to bring ice to the mortuaries to help preserve bodies.

    We all know certain local politicians and their family’ enjoy running around the island posting pictures of them eating at establishments, getting their hair done getting their fingernails done etc. please get your S#%T together worry less about $$$$ and worry more about our people. Keep us safe!!!!

    1. Everythingisawesome January 11, 2021 2:19 pm Reply

      “It is very obvious that our Mayor is controlled by the business owners and corporations”

      How so? The mayor has made every legal, and illegal, effort to keep tourists, and visitor-owners, and their money off this island. How do those efforts favor or financially help business owners and corporations? Ask the Kauai Coffee Company. (Maybe not the best example…maybe online sales of coffee have increased since mainlanders can’t come to buy in person).

      The modified quarantine rules will add nothing to the number of tourists coming to “party”.

  2. Paulo January 10, 2021 9:18 am Reply

    Dr Hoskinson, I agree with you and have also commented about our short 3 day quarantine not being long enough. Mayor Kawakami is under pressure to find middle ground but we know 3 days in considerably too short for many cases of C-19 to show up on tests.

  3. Nicholas Moore January 10, 2021 10:37 am Reply

    I believe we should have medical professionals directing our course of action regarding travel to and from Kauai, including necessary quarantines, instead of politicians who appear to be taking the wrong course directing the safety of the citizens of Kauai.
    We cannot afford to fail and allow Kauai to follow the course of the other islands and the mainland. Just because businesses are losing money is not enough reason to jeopardize the lives of Kauai’s residents. I believe the value of life is more important than shuttling residents and visitors from outer islands and the mainland to and from Kauai..

  4. steven January 10, 2021 1:09 pm Reply

    If you are going to use your credentials, I think it is fair to limit your comments to your area of expertise.

  5. MarilynHawaii January 10, 2021 2:33 pm Reply

    Mutating strains from various global locations have proven to spread faster and easier than the original COVID-19. Are we ready to accept that multiple travelers are now bringing these strains of the virus to our island? I certainly am not. I’m 70, in a medically high risk group ,and have been virtually secluded for most of the time since March. I’m doing all I can to stay safe. But I still have to go out to buy groceries, pick up my mail and pump gas. I can’t do that in a vacuum.
    There are tourists everywhere. I don’t know who I can trust to be safe. Many residents aren’t wearing masks, let alone tourists who think/hope that Kaua’i is somehow magically exempt from the laws of Nature, since our numbers are so low compared to the rampaging deaths on the mainland.
    What is our percentage of cases in our Kaua’i population? How long until all of Hawaii catches up with the mainland?
    Remember when we had case numbers in the 20’s for a long time? That time is gone. We’re headed for 200 at exponential speed. The vast majority of people do not understand what this means in epidemiology. For those who do, please stop putting our lives at risk with this flawed plan!

  6. judi January 10, 2021 3:27 pm Reply

    We already have an increase daily of cases and we should revert to the 10 day quarantine. Makes no sense to change this for inter island travelers. Hold on Kauai to the rules which were working to keep the island safe. Please Mayor Kawakami take this under consideration before it is really too late.

    1. I saw a Vampire once January 12, 2021 12:00 am Reply

      Judi: Do you wear glasses? Because you sound like you know this quarantine rule. Just want to make fun of Derek.

  7. Robert S Weiner M.D. January 10, 2021 9:02 pm Reply

    This is an excellent analysis of the situation and should be heeded by people responsible for the welfare of the population. The risk of doing otherwise is way too high.

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