New Molokai COVID Case

By Catherine Cluett Pactol

A new COVID-19 case was confirmed on island last Friday, according to officials. The resident contracted COVID while on Oahu before the interisland quarantine was reinstated on Aug. 11, said Molokai Councilmember Keani Rawlins-Fernandez in a social media announcement.

“The person’s name will not be released to the public. The person has given contact information for those who could have been exposed. Contact tracers are trying to get a hold of those people on Molokai now,” said Rawlins-Fernandez Friday.

The state Dept. of Health had yet to publicly acknowledge the case as of Sunday.

This is the third case for Molokai; the other two were in April, linked to a Friendly Market Center employee who traveled to Las Vegas.

Heidi Taogoshi, Public Health Nursing supervisor with the Dept. of Health’s Maui branch, said Maui County has 24 dedicated contact tracers, including four on Molokai, with more being trained to work across the county. She discussed the process of contact tracing during a Thurs-day virtual meeting held by Rep. Lynn DeCoite and Sen. Kalani English.

“From the time we get a confirmed case, we get notified, we contact that case, we educate them on how to safely isolate, figure out their infectious period, help identify any close contacts that they had and notify those contacts to educate them on how to quarantine to watch their own health and if they develop symptoms, we also test them,” said Taogoshi.

Molokai residents raised concerns two weeks ago, after two people who were working on Molokai as essential workers tested positive after their return to Oahu. DeCoite said essential workers “are not exempt, they are rather under a limited quarantine,” which means they can go from their workplace, to their lodging, and to the airport. However, the two individuals did visit several Molokai businesses.

DeCoite criticized DOH officials during the virtual meeting for what she called a lack of transparency surrounding the incident, saying residents are in an “uproar.” No official information about the cases was released to the Molokai community, aside from what was discussed during the virtual meeting.

“We were able to do the full contact tracing and investigation,” shared Taogoshi about the essential workers. “They have since completed their isolation [on Oahu]. All contacts were notified. The businesses that could have been potentially affected were also notified, more as a courtesy — based on interaction, no one needed to be quarantined, but they were notified as a heads up.”

Taogoshi said “close contacts” are identified as those that have been in contact with a confirmed case within a distance of six feet apart for 15 minutes or longer, with or without a mask. She ex-plained the infectious period of a confirmed case is also taken into consideration when assessing risk.

“If you pass somebody [COVID-positive] in passing, we don’t consider that a close contact that would require quarantine and monitoring,” she said.

No close contacts were determined associated with the two essential workers on Molokai.

“What we were told as part of the investigation, is that the individuals were at a remote job site, they were already on somewhat of a quarantine where they went from their remote job site to the hotel; food was being shipped in,” Taogoshi continued. “So the few times they did go out for necessities, they were wearing a mask, and the establishment had their own requirement of all people coming in to wear a mask so that criteria of being six feet or less for 15 minutes or more is what we are following.”

But DeCoite was not satisfied.

“That’s why a lot of people on Molokai [are] in an uproar, because we were given the least amount of information and all they want to know… we’re not even asking who the person was, [but] where is the contact tracing [to] pinpoint on exactly where the individual was, what time, what place… and when does that come out to this community?” DeCoite said. “Allow the community to say, ‘I was there at that time the individual was there, I might want to get that test, I might want to consider that.’”

Along with strict confidentiality required for contact tracing, health officials are limited by what information a COVID-positive person discloses to investigators and what can then be released to the public.

“If there’s a person and they tell us, ‘I was singing real loud at this place,’ that’s like, high risk to all those people and… we would post, ‘This guy had high exposure to this restaurant at this time,’ so all the residents that were there, could contact us and we will try to quarantine you and try to track you,” explained Dr. Lorrin Pang of the Maui District Health Office. “But if the case doesn’t tell us what he was doing or says, ‘I was real quiet,’ we can’t just release to the public, ‘He was at this place but he was real quiet,’ because they’re going to say, ‘Well, who was this?’”

DeCoite said Molokai residents aren’t asking for identities, just to stay informed.

“I think we need to be more transparent to tell people, ‘OK, we did the investigation, we know this is where the person was at, the businesses has been notified,’ and then for public record, ‘The businesses have sanitized those areas,’” she said. “Because now you’re putting fear into one community that doesn’t know what’s happening, over individuals who were careless and reck-less not… to go from work to lodging and back. That is our problem. That’s why this community is upset. They don’t have answers.”

To report a suspected quarantine violation on Molokai, call the Maui Police Dept. at 808-244-6400 or email MPDquarantine@mpd.net. The Police Dept. reported last week that since March, officers have issued 1,069 citations for rules and orders violations across the county, 56 of which were on Molokai.

Regardless of the circumstances, Taogoshi shared with residents what’s involved in the contact tracing process.

“It is very time consuming,” she said. “[Investigators] are making contact with somebody who might be really sick at the time if they’re symptomatic, they might be scared, they might be up-set, it takes a while for investigators to build their trust, and they need to build that trust in order to gain their cooperation. They ask questions like who they had contact with and were they symptomatic at the time, they figure out the infectious period, you look at the setting and the context, if they were masked, if they were taking precautions?”

Pang said for every case, there might be 100 contacts. And the rate at which COVID-19 goes undetected is high.

“We know for every case that comes through our system, there’s somewhere between 5 and 44 cases that we don’t know about,” he said. “In adults, 25 percent will get COVID but never get sick. In children, 75 percent will never get sick…. So why are we focusing on being well? If you’re sick with these symptoms, guarens [you have it]. But if you’re not sick, you still spreading. That’s why we have this outbreak. People spread before they’re sick, or people spread who never get sick…. So you see what kind of uphill battle we have.”

He said researchers are still learning more about COVID all along.

“New information shows that particles can be so small that if you just breathe, they come out. If you speak, they come out farther. If you shout or sing, they really move,” Pang said.

Gov. Ige has extended travel quarantine requirements through the end of September for both transpacific travel into the state, as well as interisland travel.

Taogoshi said travel quarantine only applies to the person who travels.

“The rest of the household can go to work, go about their day, as long as that person who trav-eled is asymptomatic,” she said. For those required to quarantine due to exposure to a COVID-positive person, the same rule applies.

“Only the person in direct close contact with confirmed case has to quarantine… stay in your own bedroom and bathroom and rest of household can work,” she said.

DeCoite said those who test positive for COVID will usually be sent to their homes to quarantine in isolation, unless they have symptoms that require hospitalization. If quarantining at home isn’t possible due to large household size or no available private bedroom and bathroom, “the DOH has made arrangements for limited number of rooms on Molokai for those people.”

Currently Molokai General Hospital and the Molokai Community Health Center are both offering COVID-19 testing. Pang said if you think you’ve been exposed, you need to wait at least five days — known as the incubation period — to be tested.

Rawlins-Fernandez said she’s received an outpouring of support from fellow residents wanting to help the person who was COVID-positive and anyone who needs it.

“While I do not know the name of the patient or who may have been exposed, community members have been reaching out to me wanting to extend help to those now being required to self-isolate by going grocery shopping or running other errands,” Rawlins-Fernandez shared on her Facebook page. “These are such beautiful expression of love and support! I welcome anyone in self-isolation to contact me confidentially at (808) 260-5967 and I’m happy to connect those needing this type assistance with those wanting to provide this assistance.”