The City and County of Honolulu is planning to hire between 250 and 500 contact tracers to supplement state efforts to tamp down COVID-19 on Oahu.

Mayor Kirk Caldwell said on Wednesday that those tracers would add to 10 positions the Department of Health approved last week to trace the virus among city employees and their contacts. He plans to use CARES Act money to make it happen. He didn’t say how much it would cost but said the tracers would be making “a living wage.”

The additional tracers would feed information into the state’s system “so we know where the virus is and what we need to do,” the mayor said.

A population of Oahu’s size calls for 350 to 450 contact tracers, the mayor said. For the state, he said it should be around 500.

“We’re nowhere near that,” he said. “And we do need to build our capacity. We want to be part of the solution. We don’t want to complain or blame at this point. It’s: What do we do?”

Vice Admiral Jerome Adams, US Surgeon General gives an elbow bump to Mayor Kirk Caldwell at the conclusion of the COVID-19 surge testing press conference held at Leeward Community College parking lot. August 26, 2020
Mayor Kirk Caldwell and U.S. Surgeon General Jerome Adams teamed up to provide surge testing on Oahu. Cory Lum/Civil Beat/2020

Caldwell said that his administration would send a letter asking the state for approval for the hires. However, DOH spokeswoman Janice Okubo said on Wednesday afternoon that the city doesn’t require the state’s permission.

“The DOH does not need to approve Honolulu’s request,” she wrote in an email, adding that DOH just asked that the city coordinate its contact tracing activities with the DOH.

Caldwell is taking contact tracing into his own hands after months of lamenting a lack of action by the state. Honolulu doesn’t typically engage in health-related matters because it doesn’t have a health department.

The mayor didn’t specify what he envisioned for the hiring process for the contact tracers. The University of Hawaii has already trained people on how to be contact tracers, but the mayor said many of those trainees only want to work part-time.

“For us, we need a more aggressive team of people,” he said.

He said he has considered the idea of working with established call centers, like those that do polling.

“We’re going to explore all options to expand this capacity,” he said. “Every contact tracer we get is one step to a different outcome than what we’ve had in the past.”

The city’s contact tracers would either work under the newly established Office of Economic Revitalization or with Emergency Medical Services’ Jill Omori, the city’s infectious disease officer, and city physician Melanie Lee, according to Caldwell’s communications director Alexander Zannes. Either way, the city would still be working in coordination with the Hawaii Department of Health, he said.

“The logistics are not definitive at this point,” he said.

Tracing Will Accompany Testing

As of now, the state will be handling the contact tracing for positive cases that emerge through the U.S. Department of Health and Human Services surge testing program, Zannes said.

Vice Admiral Jerome Adams US Surgeon General demos swab test in nostril by rotating the swab five times around the entrance of the nostril during COVID-19 surge testing conducted at Leeward Community College. August 26, 2020
U.S. Surgeon General Jerome Adams demonstrated the COVID-19 nasal swab test available for free in Honolulu. Cory Lum/Civil Beat/2020

On Wednesday, DHSS’s drive-thru surge testing kicked off at Leeward Community College and in Kaneohe where cars were lined up in traffic, sometimes for over an hour. The mayor acknowledged “we need to do a better job of traffic flow.”

U.S. Surgeon General Jerome Adams, who is overseeing the operation, said it will continue running for “at least 14 days.” There is capacity to provide up to 5,000 tests per day for free, officials said.

Officials are encouraging Honolulu residents to visit to find a testing location and register for an appointment.

Patients are instructed to self-swab and hand their sample to a health care worker on site. The specimens are being sent to FDA-approved labs in California and patients are expected to receive results via email within three days, Adams said. The so-called “PCR test” has an over 90% accuracy rate, according to Adams.

While new guidance from the federal Centers for Disease Control and Prevention indicates that tests are not needed for those who don’t have symptoms, Adams is encouraging everyone on Oahu to get tested.

“There is a lot of misinformation out there about what the CDC put out,” Adams said.

He said the CDC’s recommendation merely means to prioritize those with symptoms. However, in a place with escalating case numbers like Honolulu, he is urging widespread testing.

Islandwide Shutdown Returns

As of 12:01 a.m. on Thursday, Oahu’s latest Stay at Home, Work From Home order goes into effect. It mandates the shutdown provisions that were in place in March with nonessential businesses ordered to close. Restaurants can only provide takeout. Grocery stores will remain open, as will in-person religious services.

“With all the measures we’ve taken, and all the pain and suffering that we’ve created, we have not seen the results we hoped for,” Caldwell said. “And for me, and I’m not a doctor, I think it confirms the spread of this disease throughout our community. It’s everywhere, in our homes as well as our workplaces. And so it’s going to take a little longer to tamp it down.”

Vice Admiral Jerome Adams US Surgeon General and Mayor Kirk Caldwell during COVID-19 surge testing press conference held at the Leeward Community College parking lot. August 26, 2020
Mayor Kirk Caldwell is not budging on his shutdown order, despite frustration from residents. Cory Lum/Civil Beat/2020

In the next two weeks, if case numbers drop, the mayor said he would look to reopen things again, including exercise in parks. Under the current order and continuing through the new one, parks, beaches and hiking trails are closed. That’s despite scientific evidence showing green spaces are relatively safe places during the pandemic and can help boost physical and mental health.

Despite major blowback from the community, the mayor is not backing down.

“It’s very difficult to break up a large group of people,” Caldwell said.

“We opened up parks, and it got out of hand over time. You would go to the beach, you would see people all over the place, in large groups, under tents, close together. I believe it would’ve been an impossible situation to break up those groups at that point. So shutting down everything is a way to reset, so when we open up, we don’t go back to large groups again. I can promise you, as mayor, we are not going to allow that to happen.”

Caldwell said he might require permits for tents at beach parks that would allow police to arrest the permittee if too many people crowd under it.

Regarding residents who were angered after receiving criminal citations for seemingly benign activities, the mayor said the city is doing what is necessary.

“Let’s say we did nothing, and people walk into parks, and more people walk into the parks, and they didn’t enforce. You have 100 people gathering in a park, and you have the virus spread. What happens in a park, they take home,” he said.

Caldwell suggested that people might say “‘I was only walking my dog.’ Someone else is going to say ‘I did this, I did that.’ What are the police officers supposed to do? How do they pick and choose? Then someone writes a story that they’re racial profiling because they’re citing certain people and not others. So bright line, everyone gets cited, no matter who you are, your age, your race, your religion, your orientation, you’re all cited.”

Despite Caldwell announcing the order as a done deal on Tuesday, Gov. David Ige delayed approval of the order until Wednesday afternoon.

The city and state had a disagreement over how long it should last, according to Caldwell – a delay he called “not necessary.” The DOH wanted it to be 28 days. The mayor wanted it to be two weeks.

In the end, Ige agreed to two weeks. The mayor said he hopes that’s all it takes.

“Just like the surgeon general, I am hopeful that this extraordinary measure we’re taking will result in a better outcome because it worked once before, back in March,” he said. “So, I believe it will work again.”

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