Hawai´i Considers Return to Lockdowns, Discusses Health Passes Amid Surge

As the coronavirus continues to surge in Hawai´i, straining medical resources and threatening the unfettered movement of people and commerce, Governor David Ige said nothing is off the table.

That includes another mandatory lockdown.

“Is a lockdown on the table? Yes, if the number of cases continues to grow exponentially as it has in the last 10 weeks,” Ige told reporters on Monday, Aug. 23. “We will have to take action to limit and ensure that the hospitals aren’t overrun.”

The City and County of Honolulu requested, and received, permission from the state to cancel all social events that include more than 10 people indoors and 25 people outdoors. Mayor Rick Blangiardi announced the decision prior to the governor’s press conference Monday. It is an action Ige said his administration fully supports.

Acceptable social gatherings across the state have receded to 10 people indoors and 25 outdoors, while restaurant and bar capacity has been rolled back to 50%. Ige said he has been in discussions with major airlines, which have agreed to spread the message that now is not the time to visit Hawai´i. How precisely and vigorously the airlines will disseminate that information was not made clear on Monday.

“It is not a good time to travel to the islands,” the governor said. “Restaurant capacity has been restricted, there is limited access to (rental) cars, and we know that the visitors who choose to come to the islands will not have the typical kind of holiday that they expect when traveling to Hawai´i.”

Still, nearly 25,000 travelers touched down in the state on Sunday, Aug. 22, a number that has been surpassed on almost every day this month.

Beyond asking airlines and the visitors they taxi to Hawai´i to hold off, the state is requesting that its own residents limit both intrastate and interstate travel to business purposes and medical necessities only. The Department of Health (DOH) has tied the majority of community spread of coronavirus to island residents who travel to the mainland, catch COVID-19 then return home.

Cutting down travel, both within Hawai´i and without, limiting social interactions, wearing face coverings religiously and paying particular attention to hand hygiene will allow the state to “bend the curve” within a couple of weeks, Ige asserted.

But asking residents to voluntarily bear the burden of COVID restrictions, a strategy this administration has turned to in recent weeks, does not appear to be working. At all.

Coronavirus tallies continue to rise. As of Monday, Hawaii’s 14-day average is 671 new cases daily, with a troubling test positivity rate of 8.3%. Just a few weeks ago, one day characterized by 671 reported cases would have shattered the state’s pandemic record.

Hospitalization tallies on each of the past 10 Mondays have increased, according to DOH Director Dr. Elizabeth Char. And as the numbers have increased, hospital resources have all but vanished, swallowed up by the toll the pandemic has taken primarily on Hawaii’s unvaccinated population.

As of Sunday, 392 individuals were hospitalized as a result of COVID infection. A total of just 49 of those, or 12.5%, were breakthrough cases involving vaccinated individuals. Since the pandemic began, 564 COVID-related deaths have been reported across all islands. Char said that only three of them involved fully-vaccinated patients.

“Our hospitals are at capacity. Our ICUs are full,” Ige said Monday. “We are initiating surge plans in every facility.”

While supplemental healthcare workers from the mainland have been arriving throughout the Hawaiian Islands over the last week, there is an as of yet undefined breaking point at which healthcare facilities will simply become unable to supply the demand.

The state’s top backup plan is some variation of retrofitting a large space, such as a convention center, to care for additional patients. The challenge, Ige said, is that the Delta variant is surging in every single state across the country. He does not believe that the federal government could and/or would fund the cost of healthcare expansion to the degree necessary to make that plan a reality, including adding more crucial healthcare personnel, which Hawai´i can neither produce or fund on its own.

State health and government officials say they are hopeful that higher vaccination rates will make the need for massive healthcare expansion a moot point. That hope was buttressed Monday, when the US Food and Drug Administration (FDA) granted full use authorization to the Pfizer vaccine for individuals aged 16 and older. Ige and Char said the decision could pull some of Hawai´i’s unvaccinated population, currently sitting on the fence about inoculation, toward the idea of getting the shots.

Nearly 1 million residents throughout the Hawaiian Islands are either fully vaccinated or have started the vaccination process, equaling a total of 70.3% of the population.

The FDA’s decision on the Pfizer vaccine — which previously operated by way of an emergency use authorization, as the Moderna and Johnson & Johnson vaccines continue to do — has opened the door for entities to issue vaccination mandates. Such a mandate already exists for state and county employees in Hawai´i, requiring they either offer proof of inoculation or submit to once weekly testing, often at their own expense. The University of Hawai´i issued one of its own on mandates Monday. The Associated Press reported the Pentagon will order more than 1 million US troops to receive the shots, as well.

Health passes, like those that have been issued in the cities of New York and San Francisco, are also likely to become more common in the wake of the FDA’s declaration. The passes vary from place to place, but essentially require full or partial vaccination to participate in certain activities, such as dining indoors.

Ige said his administration has had discussions about implementing a health pass, both internally and with the business community. Some business owners are interested but want a statewide mandate as a show of solidarity and support, while others say they are on the brink of collapse and such a rule could result in their closures.

Beyond that, many businesses are struggling to hire full staffs. Additional mandates could complicate those hiring efforts, the governor said.