You can't have a better tomorrow if you are thinking about yesterday all the time. - Charles F. Ketterin To think too long about doing a thing often becomes its undoing. - Eva Young Time is free, but it's priceless. You can't own it, but you can use it. You can't keep it, but you can spend it. Once you've lost it you can never get it back. - Marvey Mackat

1. A CASE, IS A CASE, IS A CASE
Covid-19 Turning The Tide
Case Investigation – Contact Tracing – Sentinel Surveillance
Maximizing Effectivenes and Efficiency of Tools
Maui County is close to surpassing the number of COVID-19 cases from last year in just the
first two months of 2021. Maui Mayor Michael Victorino has said he will consider less
restrictions once the community reaches single-digit COVID-19 cases or less.
Victorino reduced dine-in capacity at restaurants to 30%, and the businesses are also required
to close their doors by 10 p.m.
Caleb Hopkins is the owner of Mala Ocean Tavern. He said the 10 p.m. closing time puts a
major dent on his sales. Hopkins said, It's costing us thousands of dollars every week,
thousands of dollars that we need so badly now in these times. We're doing the exact same
things at 10:01 if we were open, that we're doing at 8 p.m. Now, we're checking the COVID
count every single day and talking about it. It's just this constant stress in your life.”
Monday's COVID-19 case count on Maui was 28, Oahu had 21 cases, while Big Island had
two and Kauai had one case. Cases in the twenties may not seem like a lot, but for a county
with a population under 200,000, this puts Maui at a 2.7% test positivity rate. It is the highest
in the state.
The Maui Health System CEO Michael Rembis said the number of cases in the county are not
being reflected within the hospital. He said there is a decline in COVID patients. Rembis said,
“Three to four weeks ago, we had 20 patients a day in the hospital. Today, we have seven.
That's a significant decrease.”
Contact tracers with the state's department of health said many of the new cases were
transmitted within households. They are working to contain the spread within those family
members.
The health department also noted one cluster at Maui Community Correctional Center. The
Department of Public Safety said there are 24 active COVID cases at MCCC. They continue
to do health checks twice a day for staff and inmates. Mayor Victorino was not inclined to
remove inmate cases from the county's count in order to ease restrictions.
Victorino said, “A case, is a case, is a case.
Cases on Maui may be isolated to certain locations but the consequences extend to the
community.
Source: Maui's daily COVID case count surpasses Oahu for the first time By Max Rodriguez,
KHON2 News, February 22, 2012 <https://www.khon2.com/top-stories/mauis-daily-covid-case-count-
surpasses-oahu-for-the-first-time/>

2. COVID-19 CASE INVESTIGATION AND CONTACT TRACING
CASE INVESTIGATION and CONTACT TRACING are core public health tools used to
interrupt transmission of pathogens, including SARS-CoV-2, the virus that causes coronavirus
disease 2019 (COVID-19); timeliness is critical to effectiveness. Delays in interviewing
COVID-19 patients decrease the likelihood of quickly identifying and quarantining contacts.
Low ascertainment of contacts affects the nation's potential to interrupt the transmission of
SARS-CoV-2 through rapid notification, quarantining, and testing. Caseloads within
jurisdictions influence how quickly health departments can reach patients, which might
influence the completeness of data used to reach contacts. Increasing staffing capacity might
improve the timeliness of case interviews. Strengthening awareness regarding state and local
health department contact tracing efforts might improve community perception or willingness
to provide more complete lists of contacts.
Source: COVID-19 Case Investigation and Contact Tracing Efforts from Health Departments
United States, June 25–July 24, 2020 US Department of Health and Human Services, Centers
for Disease Control and Prevention. By Kimberly D. Spencer, MSPH; Christina L. Chung,
MPH; Alison Stargel, MPH; Alvin Shultz, MSPH; Phoebe G. Thorpe, MD; Marion W. Carter,
PhD; Melanie M. Taylor, MD; Mary McFarlane, PhD; Dale Rose, PhD; Margaret A. Honein,
PhD; Henry Walke, MD <https://www.cdc.gov/mmwr/volumes/70/wr/pdfs/mm7003a3-H.pdf>
___________________________________
COVID-19 SENTINEL SURVEILLANCE
Hawaii State Department of Health (HDOH) is partnering with CDC to conduct community sentinel
surveillance targeting outpatient healthcare settings to identify cases of COVID-19 among patients who
have mild to moderate febrile respiratory illness.This program is designed to detect and track community
spread of the disease and will be operated based on the framework of the existing influenza surveillance
program. Respiratory specimens (i.e., nasopharyngeal swabs) from a subset of patients who meet the
following criteria will be included in sentinel surveillance: no travel history outside of the state of Hawaii,
no severe respiratory disease (i.e., pneumonia), no hospitalization, demonstrates respiratory symptoms.
Additionally, patients will be selected to ensure geographic and age representation proportional to the
state's population.
The following reflects laboratory findings for week 41 of the 2020–21 influenza/respiratory disease
season. COVID sentinel surveillance data will be reported for one Morbidity and Mortality Weekly
Report (MMWR) week ahead of the influenza surveillance data to provide most current data.:
COVID-19 geographic spread: Regional. No activity: No laboratory-confirmed cases of COVID-19,
Sporadic: No laboratory-confirmed cases of COVID-19 detected through sentinel surveillance (i.e., only
travelassociated cases detected), Local: Laboratory-confirmed cases of COVID-19 detected through
sentinel surveillance in one county, Regional: Laboratory confirmed cases of COVID-19 detected through
sentinel surveillance in two to three counties, Widespread: Laboratory-confirmed cases of COVID-19
detected through sentinel surveillance in all counties. Geographic spread should be interpreted in the
context of influenza-like illness (ILI) activity level.
A total of 81 surveillance specimens have been tested statewide for COVID-19 (positive: 4 [4.9%]).
Season to date: A total of 3,570 surveillance specimens have been tested for COVID-19 (positive: 193
[5.4%])

3. 849 specimens have been tested at State Laboratories Division (SLD). Many specimens requested by
HDOH for COVID-19 testing are being tested at private laboratories. Specimens tested by private
laboratories that meet the COVID-19 surveillance criteria will be included in the surveillance summary
along with specimens tested by SLD. As Hawaii's private laboratories increase their testing capacity for
COVID-19, fewer specimens may be tested by SLD.
CUMULATIVE RESULTS
County Age
# Samples % Positive # Samples % Positive
Hawaii 368 1.1 0-17 537 3.5
Honolulu 2,303 7.7 18-64 2,086 6.3
Kauai 187 0.5 65+ 947 4.5
Maui 462 2.4
Unknown 250 0
Source:
Hawaii State Department of Health, Disease Outbreak Control Division
Influenza/Respiratory Disease Surveillance Report, Morbidity and Mortality Weekly Report (MMWR)
Week 41: October 4, 2020–October 10, 2020, Page 6
<https://health.hawaii.gov/docd/files/2020/10/Combined_2020-21.pdf>
___________________________________
Maui County
COVID-19 Clusters Under Investigation in Last 14 Days by Exposure Setting
February 18, 2021
<https://health.hawaii.gov/coronavirusdisease2019/files/2021/02/Hawaii_COVID-19_Weekly_Cluster_Report_18Feb21-1.pdf>
# ClustersTotal Cases # Cases Associated
With Primary Setting
Correctional
Facilities
1 22 22
Educational
Settings
0 0 0
Shelters 0 0 0
Food Service, Production, and Distribution
Bars &
Nightclubs
0 0 0
Food Suppliers 0 0 0
Restaurants 0 0 0

4. Occupational Settings
Construction &
Industrial
0 0 0
Other
Occupational
Settings
0 0 0
Travel, Lodging,
& Tourism
1 10
9
(1 Outside Primary
Setting)
Social and Recreational Activities
Social Gatherings 0 0 0
Places of Worship 0 0 0
Gyms 0 0 0