Hawaii is ready for its midpandemic tourism boom.
Starting on Aug. 1, tourists looking to visit Hawaii will be able to bypass the state’s two-week quarantine requirement for arrivals by getting a negative COVID-19 test within 72 hours before landing in the state. Visitors can also have their quarantines cut short if they receive negative test results during those two weeks. The same rules will also apply to residents returning to the islands. Hawaii won’t pay for the tests; travelers will have to handle that themselves before departure, though screeners will still administer temperature checks at airports. “We’re in deep discussions with national pharmacy agencies and labs to get everyone willing to participate on board,” Hawaii Lt. Gov. Josh Green told Honolulu Civil Beat. “We’re working through the details to get as much availability as possible. The level of detail is quite extraordinary, actually.”
With just 926 infections over the course of the pandemic, Hawaii has the lowest number of cases in the country. Its death toll stands at 18. The state did see relatively high spikes in cases around the beginning of the U.S. outbreak in March; most of those infections were travel-related. Since then, Hawaii has mandated that visitors quarantine themselves for 14 days upon arrival before venturing out. The restrictions have made travel to the state almost nonexistent, according to CNN, and cases have fallen dramatically. “If you look at the epidemic curve and trends in Hawaii, they’ve done a good job of really curbing the spread of coronavirus on the islands,” said Amanda Castel, an epidemiology professor at George Washington University. “They’re in a unique situation because, unlike being in the continental U.S., they actually can try to control movement in and out of the islands more easily.”
Local officials are still working out many of the specifics, though the plan is partially based on a similar program that Alaska implemented starting June 5. Alaska’s program currently requires people to take a test no more than 72 hours prior to departure and provide proof of negative results to screeners when they land. If someone is unable to receive results before arrival, screeners administer another test at the airport and instruct the visitor to minimize exposure to others. Visitors who don’t get tested before their trip also have to get one at the airport, and then self-quarantine until they get the results. They also receive a voucher for an additional test that they have to undergo sometime within seven to 14 days. Anyone who declines to go through these testing protocols has to self-quarantine for two weeks. (Alaska has been relying on voluntary cooperation as opposed to enforcement, however.)
News of Hawaii easing its regulations has jump-started the travel industry. Hawaiian Airlines, which has been focusing on cargo transportation and essential travel over the past few months, announced on Monday that it will be adding hundreds of weekly flights between Hawaii and the mainland in August. Local chambers of commerce are reporting that they’re also seeing an uptick in tourism bookings.
There’s some uneasiness around Hawaii relaxing the two-week quarantine. State lawmakers voiced their concerns at a briefing about the testing plans on Monday, pointing to the spikes in cases in cities across the mainland U.S. Castel, of George Washington University, also has doubts about whether testing is really an adequate substitute for a two-week quarantine. “There’s so many pitfalls with testing. We don’t have fantastic tests,” she said. “Testing only really reflects your prior exposure to that date, so it’s just a snapshot in time.” Indeed, a study from Johns Hopkins suggests that coronavirus tests may have at least a 20 percent false negative rate. And Castel worries that people are still at risk of exposure while making their way to Hawaii, after they’ve gotten the test. “When I say traveling on a plane, I’m thinking about the whole process. Like parking your car at the airport and taking the shuttle and going to check in and going through security and waiting by the gate. All those things increase your risk because you’re mixing with people from all over.”
Gary Slutkin, an epidemiologist who formerly worked for the World Health Organization, has similar concerns. While he notes that the scientific community still doesn’t know much about how the coronavirus spreads on planes, Slutkin points to incidents during the 2003 SARS outbreak, during which there were 40 flights that had probable cases of infected passengers spreading the disease to others. Studies found that travelers were at the highest risk if they sat within two rows of an infected person, though SARS transmission could still occur outside that radius. Slutkin points out that coronavirus may be even more concerning for air travel because even asymptomatic carriers can spread it, unlike SARS. In addition, SARS only infected about 8,000 people, while COVID-19 has afflicted about 10.8 million. “It’s a whole new game when you have people who are infectious when they’re not sick and there have been millions of cases already,” he said. Slutkin recommends that Hawaii “go the extra mile” by requiring that everyone—even those who took a test before flying—get tested shortly after arriving in the state. It’s worth it to be cautious, and a Mai Tai is just as delicious in a hotel room you can’t leave.