After months of little to no COVID-19 activity on Kauai, a swift upswing in cases that has persisted for two weeks is shaking up the way local officials set rules for businesses and public activity.
Kauai officials blame a convergence of problems for the recent spike on the Garden Island, including new variants circulating in the community, slightly relaxed tourism COVID-19 testing protocols and a growing sense of complacency.
“I think a byproduct of keeping Kauai safe for so very long tends to let people relax,” Mayor Derek Kawakami said Friday in an interview. “In some sense that may have been a big factor.”
The county has responded by tightening local restrictions aimed at preventing the spread of COVID-19, including limiting indoor gatherings to five people and outdoor gatherings to 25.
However, in a nod to concerns about economic impacts, restaurants were allowed to stay open as long as they seat fewer people at tables, and sports events may continue as long as they adhere to safety protocols.
Kauai’s recent surge began in mid-April and swelled within the span of 10 days, taking Kauai from the lowest to the highest weekly average of new cases per 100,000 people among all island counties to 10.5 new cases per 100,000 people.
There’s also been a major shift in how COVID-19 cases on the island typically emerge, according to the cluster report from the state Department of Health. The island saw mostly travel-related cases last year. Now, nearly all new cases have been acquired within the community, within households or sometimes via restaurants or concerts.
The overall figures remain relatively low compared with the more populated islands — 305 cases have been confirmed on Kauai since the pandemic began more than a year ago. But locals are eager to keep it that way and even the smallest increase creates a groundswell of concern.
Until recently the island maintained some of the tightest COVID-19 travel restrictions despite concerns about the effect on tourism.
On April 5, the county stopped requiring an extra COVID-19 test upon arrival and opted into the state’s baseline rule that all out-of-state travelers must take a molecular COVID-19 test within 72 hours of their last Hawaii-bound flight.
Dr. Janet Berreman, the Kauai district health officer, said that may have fueled coronavirus activity along with the fact that two highly transmissible variants have been found.
“When we opted back into Safe Travels in the beginning of April we understood that we were likely to see a resurgence in cases and it would probably take one to two incubation periods, two weeks,” she said. “Pretty much like clockwork we began to see an increase in cases and they rose very rapidly over 10 days.”
However, she acknowledged that most cases were spread locally.
“Kauai has sustained community transmission of COVID-19, which we never had before. We knew it was possible and it happened more quickly than we expected it to,” she said.
Between April 5 and May 2, COVID-19 infections were documented among three visitors and 88 Kauai residents — and 80% of those were community-acquired, according to the DOH Cluster Report.
The state health department’s Laboratories Division is still analyzing test samples to determine how prevalent the variants may be on Kauai.
Other metrics offer clues as to why COVID-19 cases have ticked up on the island: the number of people observed wearing masks outdoors has dropped from 94% to 69% since March, according to the Department of Health.
Despite new guidance from the Centers for Disease Control and Prevention permitting people to skip masks in certain outdoor situations, Hawaii has maintained its mandate that requires face coverings when within 6 feet of distance of other people.
Since October, Kauai law has required everyone 5 years and older to wear a face covering indoors or outdoors if they come within 6 feet of people they don’t live with.
Berreman said many ignore it due to COVID-19 fatigue and a false sense of security as the pace of vaccinations improved and numbers remained low for months.
“I’m not surprised that wearing masks has gone down. I think it is too soon,” she said.
Kauai currently leads all other counties in the race to vaccinate its population, with at least 60% of its population having received at least one COVID-19 shot.
Kauai moved back to the stricter Tier 3 designation on the COVID-19 scale but was able to relax some rules thanks to contact tracing that pinpointed problem areas, Kawakami said.
“It identified areas that weren’t sources of infection that our old Tier 3 really would have put restrictions on,” Kawakami said. “It allows us to apply restrictions to where we see the biggest risks.”
Most children who tested positive for COVID-19 didn’t get it at school but rather within their own households, according to case investigations.
Berreman also found no evidence of transmission at sports events in the last month so those were allowed to continue. In the prior version of Kauai’s Tier 3, sports were not allowed.
Under the new Kauai rules, indoor gatherings are limited to five people and outdoor gatherings allow up to 25. Restaurants must seat no more than six people per table.
Even events that abided by state and county COVID-19-related rules were affected, according to the DOH.
Two Lihue restaurants — Rob’s Good Times Grill and Troy’s Bar — were found to be likely exposure sources for some people who tested positive.
Then, local officials found evidence that people who were infectious attended a drive-in concert in Lihue held April 24 and a Brunch Babes performance at the Sheraton Kauai Coconut Beach Resort on April 17 and 18.
Both events followed COVID-19 guidelines, but officials encouraged everyone who was there to get tested.
Kawakami said certain events are permitted on the island as long as organizers submit documentation of a plan to prevent COVID-19 transmission.
Things may be leveling off, Kawakami said. Kauai recorded an average of seven new cases per day last week, and 1.8% of all people tested on the island for the virus had positive COVID-19 results.
Berreman has noticed some changes — more people are wearing masks, people are canceling events and there’s a “renewed interest” in getting the COVID-19 vaccines, she said.
“Our community is a resilient one, and I think because we’ve been faced with disasters in the past I have to thank them for the immediate response that is occurring,” Kawakami said.
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