All incoming trans-Pacific travelers who wish to opt out of Hawaii’s 14-day quarantine will need to show proof that they had a negative molecular-based COVID-19 test result within 72 hours of their travel, Gov. David Ige announced at a press conference Wednesday at the Daniel K. Inouye International Airport.

The option for travelers to avoid quarantine goes into effect Aug. 1.

The current mandatory quarantine for all trans-Pacific travelers was put into effect 13 weeks ago.

“We are now ready to begin the process to return our economy in a safe and healthy way,” Ige said.

Maui Mayor Mike Victorino, who attended the press conference along with the other county mayors, supported the move.

“People want to come to safe destinations and Hawaii is considered a safe destination. Let’s keep it that way,” he said.

The program is similar to one adopted by Alaska earlier this month, which removed its quarantine for those who show negative test results.

Lt. Gov. Josh Green, who is leading the development of the program, recognized that the implementation of the program will be complicated.

“This is not a silver bullet, but it is another part of a multi-layered system to complement comprehensive (contact) tracing capacity, and complement screening people for temperature and thermal screening — that will make the difference,” he said, noting more details will be clarified in the coming weeks.

In Alaska, some travelers are tested at the airport upon arrival. Those with negative tests within five days of arrival are retested at the airport and asked to minimize their physical interactions until they receive a second negative test result.

Hawaii’s plan, which is still under development, may not go that far to include testing at the airport. The number of travelers coming to Hawaii is too immense to take that on, Ige said.

“The whole notion of testing upon arrival just doesn’t work for our state,” Ige said. “It would take testing capacity away from our state. The volume of visitors we get in Hawaii is about 10 times the visitors arriving in Alaska.”

Hawaii continues to face economic fallout after months of shutdowns and thousands of people are unemployed. Officials said a pre-travel test option for travelers will allow Hawaii’s largest industry, tourism, to reopen.

Because the program will likely lead to an increase in travelers to Hawaii, Ige said officials expect to see more coronavirus cases, but Hawaii hospitals are equipped with the capacity to handle new infections.

According to Green, about half of the state’s ICU beds are in use and 17% of ventilators are in use. As of Wednesday, only 23 people were hospitalized in Hawaii for COVID-19, six of whom are in the ICU and three of whom are on ventilators, according to Department of Health Director Bruce Anderson.

In response to questions about how and where people will be tested prior to coming to Hawaii, Ige and Green said they are still establishing relationships with businesses to streamline the process. CVS Pharmacy is still a potential partner in the endeavor, Green said.

Green recognized that some people may try to take advantage of the new system, and added, “We do expect fraud, and we have a strong attorney general to deal with that fraud.”

A University of Hawaii Economic research organization article published earlier this month outlined a similar pre-boarding test proposal, which said such screen testing in departure cities in addition to temperature and COVID-19 symptom screening would remove about 80% to 90% of infectious passengers from flights to Hawaii.

But some have questioned the effectiveness and value of such testing, because even the molecular-based tests may not catch everyone infected.

Dr. Sarah Park, Hawaii’s state epidemiologist, said last week at a state Senate committee meeting that she wouldn’t necessarily trust negative test results from travelers.

Anderson, who specializes in epidemiology, said infected people will go through a pre-symptomatic period when the virus isn’t developed enough to be detected by molecular-based tests. That period could be days long, he said. Then there’s the possibility that a person could become infected after they get tested, within the three days before they travel to Hawaii.

“It truly is a point-in-time test and intended for diagnostic purposes, and we’ve adapted it to be for screening and other uses, which is not what it is intended for,” Anderson told Civil Beat after the press conference. “But the truth is it’s all we’ve got. There isn’t anything else out there that is confirmed to give you a good, reliable indication of whether you’re infected with covid. Our tools are limited.”

Under federal guidance when the outbreak began, the Hawaii Department of Health initially directed that only symptomatic patients be tested because of the limited number of testing equipment and supplies. It has since expanded its testing criteria to include the close contacts of confirmed cases, whether or not they have symptoms.

As an example, the department tested dozens of residents and staff at Oahu’s largest nursing facility when a nurse fell ill, he said.

The U.S. Food and Drug Administration has also expanded its policy to allow the use of molecular-based testing for people considered to have an elevated risk for the virus, according to Anderson.

Still, in light of the growing rates of infection in some states such as California, Florida and Arizona, people in those states wishing to travel to Hawaii could have a hard time getting a test as resources are prioritized for patients and essential workers most in need, Anderson said.