One on Maui tests negative for coronavirus
Number of tests likely to go up with arrival of kits, expanded criteria
One person on Maui has tested negative for the novel coronavirus in one of the first samples to be sent to the state lab on Oahu, a state health official at the COVID-19 Joint Information Center said Tuesday afternoon.
The person was among three people whose samples were recently sent to the State Laboratories Division in Pearl City on Oahu. Two others were from Oahu and Hawaii island.
“They completed testing on those specimens, and they’re negative,” said Myra Ching-Lee, epidemiological specialist with the state Department of Health’s Disease Outbreak Control Division.
Ching-Lee said that the person on Maui met the expanded testing criteria released last week but that the specific points that prompted the testing –international travel, respiratory symptoms and/or exposure to a known case — would likely not be released.
Hawaii, which received test kits last week after originally getting defective ones from the Centers for Disease Control and Prevention, is now one of 40 states that has been authorized to do testing, Health Director Dr. Bruce Anderson said Tuesday during a news conference and media tour of the lab facility in Pearl City.
Prior to receiving three samples from Maui, Hawaii island and Oahu, the state had done tests on two individuals that came back negative.
“We can now turn over the results very quickly,” Anderson said. “We actually were able to, in a few hours, get the results back last week when we had our first testing experience. So that’s a huge advantage for us. Normally, it would take about a week or so for us to send a sample to Centers for Disease Control and get the results back.”
As the virus that originated in China has spread to other countries and states in the U.S., including to people with no history of travel to China or contact with a known case, the CDC expanded testing criteria Thursday. It now includes people who have traveled to China, Iran, South Korea or Italy, which are all under Level 3 travel health notices that advise against all nonessential travel, as well as Japan, which is under a Level 2 notice that advises practicing enhanced precautions.
Testing can also take place if someone exhibits:
• Fever or signs/symptoms of lower respiratory illness, such as cough or shortness of breath, as well as close contact with a laboratory-confirmed COVID-19 patient within 14 days of symptom onset.
• Fever and signs/symptoms of a lower respiratory illness requiring hospitalization, as well as a history of travel from affected geographic areas within 14 days of symptom onset.
• Fever with severe acute lower respiratory illness, such as pneumonia or acute respiratory distress syndrome, requiring hospitalization and without alternative explanatory diagnosis, like the flu, as well as no identified source of exposure.
Dr. Edward Desmond, administrator of the State Laboratories Division, said the first part of the testing process involves collection of a nasal or oral swab, which are both recommended. The samples are transported to the lab to undergo a testing procedure of about three to four hours.
“We can detect a very small amount of the virus by amplifying its nucleic acid, its genetic material, and detect it using quite a sophisticated instrument, which we’ve had for quite a while in our Laboratory Preparedness and Response Branch,” Desmond said.
Anderson said that a person with symptoms can’t just ask for a test; they would first have to go to their physician, who could order a test if other illnesses have been ruled out and COVID-19 is suspected.
Because of the new criteria and the arrival of test kits, Anderson said Hawaii will likely start seeing a rise in the number of people under investigation.
“Don’t be alarmed — it doesn’t mean we’re seeing a lot more disease here,” he said. “It means we’re doing more tests, and there are more people under investigation because of this expanded criteria.”
Anderson said that if a test turns up negative, the state will consider it as that. However, if it comes out positive, the sample would be sent to the CDC for additional confirmation, though the state will act as if the test was definitively positive.
The director added that the Health Department doesn’t charge for the tests, so cost “shouldn’t be a barrier for any physician or others needing this test done.”
Ching-Lee said that if a test for someone on Maui came out positive, health officials “would do contact tracing on the case’s contacts and ensure their health care provider took precautions, and they would monitor those people as well.”
If a resident were to get the disease, they would be quarantined at home, Gov. David Ige said during the news conference. The Department of Health would contact the person several times a day to make sure they were isolated and at home. If someone needed medical services, they would be taken to a hospital, which is capable of providing isolated care.
Anderson also said that the state is looking for facilities on all islands that could provide quarantine or isolation for visitors who have the virus but don’t need hospitalization.
“We’re looking for places where people could get the wraparound services they need, meals and housekeeping and other things,” Anderson said.
“The people who have homes here, as is the case all over the country, they’re generally isolated or quarantined in their home where they’re comfortable and compliance is usually very, very good,” he said.
Anderson said the state wants alternatives for potentially sick visitors besides just keeping them in a hotel room. It would need to be a place away from the public where health care workers can provide support without getting sick themselves. He said they haven’t yet found a facility that meets the criteria.
With the number of tests likely to rise in the future, the state also will have to start working with private labs, which the CDC is allowing to do testing as well. Private labs must send their first positives to the state’s lab to help ensure accuracy.
Desmond said that the state lab is capable of testing 200 to 250 samples per week; private labs would be able to help if the number of tests becomes overwhelming.
Ige said the state is not focusing on any specific populations at this time, even as the fatality rate among seniors with COVID-19 has been much higher. Rather, they are relying mainly on primary care physicians, who are meeting with and evaluating patients on a daily basis, to identify candidates for testing.
“If someone is not feeling well, then the recommendation is to call your physician or your primary care doctor and give them the history and then schedule an appointment,” Ige said.
* Colleen Uechi can be reached at email@example.com.