Hawaii : DOH Investigating Confirmed COVID-19 Case Who Visited Maui & Oahu

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Yesterday, in Japan MOH Identifies 7 New Coronavirus Cases (n=37), we learned of one Japanese case who was diagnosed 7 days after returning from a a 10 day trip to Hawaii. He reportedly became symptomatic on February 3rd, while in staying in Oahu, but did not seek medical care until he returned to Japan.

Given the variable and often lengthy incubation period of the novel coronavirus, where and when this individual was infected is unknown.  Possibilities include before he left Japan, on the flight to Hawaii, and (far less likely) after he arrived in the islands. 

While great effort has been made to screen passengers coming from Mainland China for COVID-19, this illustrates The Limitations Of Airport Screening For Novel Coronavirus Cases.  Between a long incubation period, and the (now apparent) fact that the virus has been circulating at low levels outside of China for several weeks, some cases are going to get through.

It was never expected that these measures would keep all infected travelers from entering the country. At best, it was hoped it would delay or reduce COVID-19's introduction and slow its spread. And so far, that appears to have worked. 

Hawaii's DOH has issued advisories to the local healthcare community to be vigilant for possible cases.

HAWAI‘I DEPARTMENT OF HEALTH NOTIFIED OF CONFIRMED COVID-19 CASE WHO TRAVELED TO MAUI AND OAHU

Posted on Feb 14, 2020  

HONOLULU – The Hawai‘i Department of Health (DOH) was notified today by the Centers for Disease Control and Prevention (CDC) that an adult male who traveled to Maui from Jan. 28 to Feb. 3 and to Oahu from Feb. 3-7 has been confirmed for COVID-19. The individual is a Japanese national who developed severe symptoms, sought medical care, and was diagnosed and tested after leaving Hawaii and returning home to Japan.

The Department of Health was informed that the individual had no symptoms while traveling on Maui and developed cold-like symptoms with no fever while staying on Oahu. The department has begun an investigation and is working closely with state, federal and county officials. A medical advisory was sent out today to alert the healthcare community in Hawaii to be vigilant about possible cases.

“The Department of Health has been expecting and preparing for identifying a travel-related case in Hawaii because of the widespread outbreak in China and other areas of the world. The state is more than ready with aggressive control and prevention measures as we work closely with our medical community and response partners,” said Health Director Bruce Anderson. “We are committed to keeping the public fully informed and will continue to provide updates as this situation unfolds.”

“The individual had no symptoms while on Maui and was not contagious,” said Dr. Sarah Park, state epidemiologist. “There is no increased risk on Maui from possible exposure. On Oahu, the individual had cold-like symptoms with no fever. I have alerted physicians that it’s possible that cases may surface sometime before Feb. 21 because the onset of illness is generally within 14 days.”

While traveling on Oahu, the individual stayed with his wife at a timeshare at the Grand Wakikian by Hilton Grand Vacations. The individual did not seek medical care in Hawaii and may have worn a mask during parts of his travel. DOH was informed that the individual wore a mask during his flight back to Japan. Using an mask when you are ill can protect others from becoming infected.

The Department of Health is committed to sharing information as it becomes available. People are urged not spread misinformation or inaccurate statements that are not confirmed, and keep updated and informed on the situation. Everyone can help prevent the spread of respiratory illness with these everyday actions.

• Wash your hands often with soap and water for at least 20 seconds.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Avoid close contact with people who are sick.
• Stay home when you are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Clean and disinfect frequently touched objects and surfaces using a regular household
• cleaning spray or wipe.
• Get your flu shot. With current seasonal influenza activity, it is likely there will be confusion as persons with influenza will exhibit similar signs and symptoms such as fever and cough. We strongly recommend residents 6 months and older protect themselves against flu by receiving the seasonal influenza vaccination.

For information on the 2019-nCoV outbreak, including information for clinicians and public health professionals, visit the following websites.

health.hawaii.gov/docd/advisories/novel-coronavirus-2019/www.cdc.gov/coronavirus/2019-ncov/index.htmlwwwnc.cdc.gov/travel/notices/watch/novel-coronavirus-chinahttps://hidot.hawaii.gov/coronavirus/
Call Aloha United Way’s 211 hotline for information by phone, Monday through Friday from 7 a.m. to 5 p.m.