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In Hawaii, trying to revive tourism while keeping locals safe

Hawaii’s success in keeping COVID-19 in check is not just about its geography -- it's had some of the firmest restrictions, including a statewide mask mandate and, until recently, a 14-day quarantine rule for all arriving tourists. But those restrictions have also crushed its economy. Hawaii Lt. Gov. Joshua Green, and Dr. Thomas Lee, of the University of Hawaii, join Stephanie Sy to discuss.

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  • Judy Woodruff:

    As states grapple with how to keep their economies afloat, while controlling the spread of COVID-19, Hawaii is uniquely positioned.

    It's had one of the lowest case counts and positivity rates in the country, and that's not just because of its geography.

    Stephanie Sy reports on what the state has done to protect its population and what's it doing now to reopen to tourism.

  • Stephanie Sy:

    Hawaii's success in keeping COVID-19 in check is not just about its geography.

    It's had some of the strictest restrictions, including a statewide mask mandate and, until recently, a 14-day quarantine rule for all arriving tourists. Violators have been arrested. But its restrictions have also crushed its economy.

    In October, Hawaii had the highest unemployment rate in the country at more than 14 percent. Now the islands are implementing a new policy to try and revive tourism, while keeping locals safe. It allows travelers who can prove they have gotten a negative COVID test within 72 hours of travel to forgo that 14-day quarantine period.

    Lieutenant Governor Joshua Green joins us now from the Aloha State.

    Dr. Green, thanks so much for joining us.

    So, what is the balance you're trying to achieve between risk to the public from COVID-19 and risk to your economy at this point in the pandemic?

  • Lieutenant Governor Joshua Green, Hawaii:

    Well, the balance we're trying to achieve is keeping people alive and safe, while also restoring those parts of life which are necessary, such as having a job, being able to pay one's rent, to pay for food. These are the challenges.

    And I come at it from a health care perspective. I'm an E.R. physician on the weekends and lieutenant governor by the weekdays. So, I see both perspectives. We have been lucky, because we have been able to keep our accounts relatively low and, at the same time, come up with some policies based on our isolation to begin to open up.

  • Stephanie Sy:

    Well, let's talk about the policy that you implemented on October 15. You want to reopen to tourism. I understand that, as far as the job losses in your state. They have been significant.

    How is the policy going a month-and-a-half in?

  • Lt. Gov. Joshua Green:

    It's exceeding expectations. It's actually working very well.

    We actually have fewer cases of COVID now, fewer people in the hospital now than we did before we started Safe Travels. But we were averaging 103 people in our hospital at that time. We're now down at 55 in our hospital. We had an average case count of 90 people positive in the state per day. Now we're down to 75.

    And our positivity rate was 2.8 percent when we started Safe Travels. It's now down at 1.8 percent. We're at 85 percent mask wearing in our state. Excellent numbers. We get to 95 percent, we won't even have to talk about travel restrictions. But when you're in 85 percent in your state, when you limit extensive travel with a pre-test, you can actually keep your numbers really low.

  • Stephanie Sy:

    And have you seen jobs return? Are tourists coming back en masse? And is there a point at which you would be concerned that too many people are coming again?

  • Lt. Gov. Joshua Green:

    We normally were getting 30,000 people a day traveling to Hawaii.

    When we instituted the lockdown, the quarantine, we dropped 99.6 percent, so functional zero, right? It's now crept back up to between 10,000 and 12,000 people coming back per day, and we immediately restored jobs. It was actually shocking; 29,000 out of our 125,000 jobs, at least, at least, returned. We're starting to think it might be closer to 50,000, which is a very big return quickly.

    We're watching very carefully with the extra travel that occurs around Thanksgiving, that occurs around Christmastime. And if we can keep that negative test in advance and do some additional testing periodically here, we think we can keep the lid on.

  • Stephanie Sy:

    But you have had some resistance to the Safe Travel policy.

    I know that the mayor of Kauai, he did see a slight rise in cases, relative cases, that was connected to tourism. And they have now instituted, at least on Kauai, that 14-day quarantine period again.

  • Lt. Gov. Joshua Green:

    Yes. And we respect all of our mayors.

    We have four counties and four mayors, of course, and their policy recommendations don't fall on deaf ears. The reality of the numbers were, they were still small. You have to remember, Hawaii has the lowest rate of COVID in the country. And then Kauai has the lowest rate of COVID in Hawaii.

    But they have somewhat limited health care resources. As an E.R. doctor, I can tell you that we are mindful about people ending up in the hospital. Kauai only had seven hospital admissions in seven weeks. So they're being ultra-safe, ultra-protective, but that's OK, too.

  • Stephanie Sy:

    Lieutenant Governor of Hawaii Dr. Josh Green, thank you so much for joining us.

  • Lt. Gov. Joshua Green:

    You bet.

    Best wishes for the holidays.

  • Stephanie Sy:

    Even with relatively low transmission, more than 240 people have died from COVID-19 in Hawaii.

    For more, we turn to Dr. Thomas Lee, co-chair of the Hawaii Pandemic Modeling Work Group and an assistant professor of epidemiology at the University of Hawaii at Manoa.

    Dr. Lee, thanks for joining us.

    You know, the CDC has advised people not to travel if they don't have to. Is there really such a thing as a safe travel policy right now?

  • Thomas Lee:

    The one thing for everyone to remember is that, with any disease, there's no such thing as reducing the risk completely to zero.

    So, even with COVID, with the great advances in screening and testing and what we know about the disease, those have all contributed to reducing overall risk of transmission and spreading the disease on to — to a level where policy-makers have felt safe enough to reopen travel.

    But we have definitely reduced it to a point where it's much safer, relative to disease transmission in other parts of the world.

  • Stephanie Sy:

    Hawaii's geography obviously makes it unique in its ability to perhaps keep the virus out. People are only arriving by plane. But you have also done other things on the island, Dr. Lee, such as making sure there are places to isolate COVID-exposed people. Talk about some of those measures.

  • Thomas Lee:

    We have dedicated facilities to assist our residents and those traveling to our islands, a place to isolate and quarantine safely and not worry about economic consequences.

    And, also, the big impact for that is that reduces future risk of transmission. In Hawaii, there are a lot of multigenerational households, and it's hard for those households to isolate and quarantine safely. So, by reducing those infected cases, by putting them in a safe place, where they are taking care of in these quarantine and isolation facilities, that further reduces potential for cluster situations.

  • Stephanie Sy:

    Is there a threshold, Dr. Lee, where you would see positivity rates rise, where you would encourage a science-based lockdown or more restrictions to again be put in place on the islands?

  • Thomas Lee:

    It's really not just one or two or three or even five metrics that might determine whether or not a policy decision must be made.

    It's looking at all the data points on a holistic level and looking at the trends over time. And one of the things to remember is that, for these decisions and metrics to be looked also at a county level, because Hawaii is unique. We have other outer islands, neighbor islands that differ slightly in their needs and their capacity.

    So, it's really these — looking at all the metrics on a daily and weekly level to really determine whether or not policy changes must be enacted.

  • Stephanie Sy:

    Dr. Thomas Lee with the University of Hawaii at Manoa, thank you so much for joining us from Honolulu.

  • Thomas Lee:

    Of course. Thank you for having me.

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