Hawaii health officials donated part of a large stockpile of rapid COVID-19 tests for the Big Island to screen arriving visitors at its two airports.

But now, the state Department of Health says they can be used only if the Big Island and its testing contractor replace them later, at a cost estimated at about $1 million, because the stockpile is not intended for airport screening. DOH spokeswoman Janice Okubo said Tuesday the health department was not aware of the county’s intentions for the rapid test kits, which are stored and distributed by the Hawaii Emergency Management Agency.

The HI-EMA is still accepting requests for the DOH stockpile of 720,000 rapid COVID-19 tests, which expire this month unless an analysis shows they are still giving accurate results. But the Big Island screening, which has turned up 123 positive cases since October and is credited by county officials for keeping down case numbers, is not among them.

“This is a piece of a bigger puzzle, which is the state’s overall testing strategy,” said Rep. Linda Ichiyama, who represents Moanalua, Salt Lake and Aliamanu on Oahu. “I have yet to see something that is comprehensive that goes to a larger question of what should we be using the kits for? I think the pressing expiration date of these 720,000 kits really pushes that question to the forefront.”

When state officials decided to welcome tourists back to the islands in October, Hawaii island officials came up with a plan to test visitors after they arrive. They directed approximately $2.8 million of federal coronavirus relief funding to the program. The money went directly to a contractor, Premier Medical Group, to run it, according to the Hawaii County mayor’s office.

When federal funding expired at the end of December, a private donor stepped in and gave upwards of $2 million to keep the program going, along with other community testing drives in underserved areas, according to Dr. Scott Miscovich, the president and founder of Premier Medical Group.

Kailua Kona airport baggage claim area
Two airports on Hawaii island have tested travelers upon arrival with a rapid COVID-19 test kit since October. Cory Lum/Civil Beat

When it became clear the state had a warehouse of kits about to expire, Miscovich and Hawaii County put in a request for a fraction of the stockpile and received two shipments, a total of 39,000 rapid test kits, in January.

But when Hawaii County returned with another request for 50,000 kits in February, the health department and HI-EMA changed course — this time, Hawaii County and Premier Medical Group would have to replace the kits.

UPDATE: HI-EMA, which distributes the tests on behalf of the health department, mistakenly sent them to the Big Island without DOH approval, Okubo said Tuesday. In fact, she said, the tests are meant for community use, not post-arrival testing. Initially, the department did not provide Civil Beat an explanation as to why it provided the kits for free.

The change came as a surprise to Miscovich.

“One reason we do feel we have a difference of opinion is that they (travelers) have exited the TSA checkpoint and technically they are not within the confines of the airports at that point,” he said. “But more importantly from my perspective, the program has proven to be extremely effective.”

From a pool of more than 70,000 post-arrival rapid tests conducted at both Big Island airports since in the fall, 123 travelers have tested positive to date, according to Miscovich and Hawaii County officials.

COVID-19 cases on the island have been relatively few, with an average of two new cases a day last week.

Program Is A Success, Big Isle Advocates Say

Big Island officials credit the airport COVID-19 rapid testing program for keeping the disease at bay.

“This test at the airport is a second protective layer to make sure we’re catching all the people we can and making sure that the other folks who come in are safe and can go out into the community and not quarantine,” said Cyrus Johnasen, spokesman for Hawaii County Mayor Mitch Roth.

All travelers tested upon arrival at Kona International Airport and Hilo International Airport must participate in the Hawaii Safe Travels program, which requires them to get a negative test before they fly if they want to skip the state’s mandatory 10-day quarantine. They must provide documentation from a Hawaii-approved laboratory partner that they took a COVID-19 test within 72 hours of the final leg of their flights.

Travelers may register and upload their negative test results to the Hawaii Safe Travels program online or bring a hard copy.

Those who opt to skip a pre-travel test must quarantine and are not offered a rapid test result upon arrival, Johnasen said.

Rapid tests like the BD Veritor tests used at the Big Island airports can yield results in 15 minutes. Despite some accuracy limitations, the rapid tests are cheaper than molecular tests and some believe they are key to fighting the pandemic, especially during emergencies. The U.S. Department of Health and Human Services shipped them to nursing facilities across the nation.

The COVID-19 rapid tests can produce results within minutes. Elijah Cacal, a Premier Medical Group team leader, analyzes rapid tests at Ellison Onizuka Kona International Airport. Courtesy Premier Medical Group

The approval process for the state’s stockpile of rapid testing kits involves various agencies.

The Hawaii Department of Health purchased the kits last year as a reserve for emergency use, and has since used them in long-term care facilities and to monitor other outbreaks such as the one on Lanai.

HI-EMA stores them in a warehouse and handles county requests and distribution.

Hawaii County Civil Defense, in partnership with former mayor Harry Kim and his successor Mitch Roth, contracted with Miscovich’s company to acquire and use the test kits.

Testing Rules For Hawaii Travel

Hawaii County is the only one in the state with a post-arrival test program. Last year, various post-arrival testing proposals from county mayors were shot down by Gov. David Ige, who said the state did not have the supply to test all visitors. But Hawaii County ultimately prevailed and launched its post-arrival test program in October.

“I give credit totally to Mayor Kim for standing his ground and pushing,” Miscovich said.

Today, visitors and tourists alike are still confused by the varying rules found island to island.

Hawaii County officials say they have no plans to change their airport program and will find funding to continue it.

Miscovich estimates it will cost about $1 million to purchase replacement tests to return to the state stockpile.

“We’re working with our donor and the Big Island in hopes they’ll have CARES Act money replenished,” he said, noting the donor made the contribution on the condition they remain anonymous.

According to Mayor Roth spokesman Johnasen, “We plan to continually fund it as long as we can because we’ve seen such great responses with our numbers. It would be hard to justify not doing it.”

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