Hawaii may be seeing the belated effect of large gatherings held over the past few weeks, but Department of Health officials said Friday there is no direct evidence as of yet.

Memorial Day weekend and the recent protest against racial injustice that attracted 10,000 people to Hawaii’s State Capitol are likely among the reasons why Hawaii is seeing a slight uptick in new COVID-19 cases, Lt. Gov. Josh Green said Friday.

“This is the time to recommit ourselves to wear masks and social distancing,” Green said. “We’re still waiting to see the effects of the nonviolent protests, which happened about seven days ago. I’d expect we’re going to see a small surge because of close communication and some spread from large gatherings.”

“I was proud of our people from a freedom of speech standpoint. But from an infectious disease standpoint, I am a little worried,” he added.

Lt. Gov.  Josh Green said he anticipates some cases to arise after the protests held last weekend. Cory Lum/Civil Beat/2020

Fifteen new cases were confirmed on Friday, the largest daily increase seen in the islands since mid-April. Elsewhere in the nation, Memorial Day festivities have been attributed to upticks in cases. 

Bruce Anderson, the director of the Hawaii Department of Health, said at a press conference Friday there is no evidence to date about coronavirus cases associated directly with the protests or around Memorial Day.

Other states have seen increases associated with that time frame, he said, “but at the same time other states are opening up business, there’s a lot more travel and people are getting out and about and there’s more opportunity for contact.

“Most of the gatherings that we were monitoring here were relatively small. People were respecting each other. No cases that I know of are associated with the protest.”

Virus Spread Among Families

One trend in Hawaii’s recent cases is becoming more clear: many diagnoses of COVID-19 have been among families. In mid-May, one cluster of infections involved seven people in an extended Oahu family. A string of cases in Kailua-Kona on the Big Island last month was later attributed to restaurant employees transmitting the virus to family and household members.

Ten of the 15 infections confirmed Friday were found as a result of contact tracing in one Waipahu household, Anderson told Civil Beat. In total, six children and four adults were found to be infected when an investigation was launched after one original case was confirmed.

“Now there are 11 people in one household who were confirmed cases,” Anderson said. “Fourteen people were living in the home with two bedrooms. It’s a very crowded situation, where it’s practically impossible to do physical distancing.”

These types of cases are a reflection of the state’s high prevalence of multi-generational housing, both state officials said.

To address the issue, Anderson said that DOH public health nurses have been conducting outreach across all islands as a public education effort. In cases where they see a high risk of transmission, they have swabbed adults and children to test them for the virus. Members of the Hawaii National Guard have also assisted in specimen collection in recent weeks, he said.

Dept of Health Director Bruce Anderson during Governor Ige’s press conference on April 8, 2020.
Department of Health Director Bruce Anderson said public health outreach workers have conducted an educational outreach effort, particularly in areas known to have extended family and multi-generational housing. Cory Lum/Civil Beat/2020

The teams of outreach workers, which include nurses, interpreters, epidemiologists and other staff from the DOH Division of Disease Control and Prevention along with the Hawaii National Guard, have knocked on doors to provide guidance and also assess high risk living situations.

Yesterday, for example, Anderson said he received negative results of swabs taken from more than a hundred people who lived in a neighborhood near Sand Island.

The Department of Health is focusing on low-income areas where multi-generational living is often the norm, Anderson said. Hawaii has twice the national rate of multi-generational households, according to estimates by the American Community Survey.

“We obviously want to bring the rates of disease down as much as we can in these areas,” he said. “We see this as a long-term focus area.”

Green said testing will be an important component of reopening the state to visitors, because of the many people who work in the hospitality industry.

He is proposing Hawaii adopt a mandatory COVID-19 test for incoming trans-Pacific travelers, similar to a new Alaska policy.

“Our multi-generational households could increase serious illness if our working class citizens end up spreading it to their parents or grandparents,” Green said. “It’s the reason that Hawaii has to go the extra mile to prevent cases from coming into the state.”

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