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Contact tracing on Maui meeting need; more testing likely on horizon

Dr. Lorrin Pang, Maui District health officer, said at a news conference Wednesday at Maui Memorial Medical Center that there will be a renewed emphasis on testing and sequential testing. County of Maui / ALAN FUKUYAMA photo

Contact tracers in Maui County are “not overwhelmed” and increased testing may be on the horizon in the battle to contain the COVID-19 pandemic, Maui County Health Department officials said Wednesday.

“We continue to act on positive cases immediately upon notification,” said Public Health Nursing Supervisor Heidi Taogoshi at a county news conference at Maui Memorial Medical Center.

This is in stark contrast to the situation on Oahu, where the triple-digit daily new cases have overwhelmed contact-tracing efforts and generated criticism and staffing changes.

There are 24 contact-tracing investigators on Maui with 28 members of the National Guard assisting. An additional 12 temporary staffers will be hired at the beginning of September, Taogoshi said. UH-Maui College has been assisting with office space, phones and furniture to help contact tracers.

Contact tracers have made 1,200 calls in the past week, she said.

Positive cases identified by testing activates the contact tracing team. Dr. Lorrin Pang, Maui District health officer, said the Health Department has the machines to test samples but is currently out of test kits and is awaiting resupply.

“We and Oahu are kinda convinced now that we should test a lot, widely, comfortably with a quick turnaround,” he said. “Two tests, three days apart are terrific . . . better than a single test, just one time.”

He noted that testing is not perfect but would be effective if done sequentially in places like prisons and homeless centers. The outbreak at Roselani Place offered an example of the gaps in testing.

The outbreak at the independent living facility in Kahului involved about 20 staffers and residents and was reported last week. The initial source was a resident returning from Maui Memorial Medical Center.

Hospital and Roselani officials said that the resident tested negative multiple times, including the day before discharge. However, the resident had come in contact with hospital workers, who had the virus, and tested positive after returning to Roselani.

Taogoshi said that testing is “quite complex” and that results could depend on the method of testing. The antigen test was used at Roselani; the other types of testing are antibody and polymerase chain reaction or PCR.

“No test is 100 percent,” she said. “A lot of it depends on the quality of the sample collected, the timing of it from exposure to the time they are infectious.”

So an individual might test negative in one method and turn up positive in another or get different results with the same method at different times, she said. Pang said that different tests can pick up the virus at different levels.

“When the person first gets infected, it’s so low, it’s growing,” he said of the virus. “It is going to take three days for any test to pick it up. . . . Whatever sample you give, it evolves over time, so that at five days and certainly by seven days anything can pick it up.”

In the Roselani case, it is possible that the person had just gotten infected and showed multiple negative tests before testing positive, he said.

“We’ve seen this repeatedly, and it’s a little baffling to patients, (who say) ‘I was negative yesterday.’ Yeah, but it’s grown in you enough for us to pick it up,” Pang said. “That’s why we repeat.”

Maui County Mayor Michael Victorino said “the big bugaboo” now is that the county doesn’t have sufficient supplies to expanded testing. “If you went to everyday testing, we would run out pretty quickly,” so the county is doing less frequent testing to stretch out the resources, he said.

Maui County reported eight new cases Wednesday, bringing the overall count to 311 (including three cases on Molokai and none on Lanai). The Health Department said Wednesday that the Maui County cases are tied to clusters at Roselani and Maui Memorial Medical Center.

On Wednesday, there were a total of 277 new cases statewide and two deaths, Oahu men with underlying health issues and hospitalized. One was 50 to 59 years old; the other was 60 to 69 years old.

The statewide death total is now 51 with seven on Maui.

There were 245 new cases on Oahu, 23 on Hawaii island, one on Kauai and one diagnosed outside of Hawaii.

The total number of cases in Hawaii is 7,260 with 6,626 on Oahu (one case was removed due to updated information), 243 on Hawaii island, 56 on Kauai and 24 diagnosed outside of Hawaii.

While some speakers at the news conference expressed optimism for dealing with COVID-19, Victorino also expressed his frustration at some public complaints.

“There is a lot of people out there who like to criticize,” he said while removing his mask so as “not to mince” his words. “Sometimes, it is frustrating to hear all the negativity that goes on out there. Lot of experts, lot of Monday morning quarterbacks out there.

“I’m telling you like it is. And I know some people don’t like it . . . but really, I’m tired.”

Pointing to health, National Guard and county officials at the news conference, he said, “these people work hard, they put their lives on the line, they put their careers on the line, they are doing so much great work.”

* Lee Imada can be reached at leeimada@mauinews.com.

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