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STATE OF HAWAII
COVID-19 SURVEILLANCE - OUTBREAK MANAGEMENT - CONTACT TRACING
BREACH OF THE PUBLIC TRUST
DECEPTION, DECEIT, DERELICTION OF DUTY
DEPRIVATION OF RIGHTS UNDER COLOR OF LAW
_____________________
PREFACE
Lieutenant Governor Josh Green stated to the Senate Special Committee on Covid-19 at an
Informational Meeting, “We can either Contact Trace or Lockdown”. Governor David Ige sided
with Dr. Sarah Park, State Epidemiologist and Dr. Bruce Anderson, Hawaii Department of
Health Director - Lockdown. The following chronology is shared for your review and
evaluation. Given the severity of the situation and pending Congressional Inquiry, information
from the Department of Justice is included.
_____________________
HOW HAWAII BOTCHED CONTACT TRACING AND WHAT IT WILL TAKE TO FIX IT
By Ashley Mizuo, Hawaii Public Radio, AUGUST 11, 2020
<https://www.hawaiipublicradio.org/post/how-hawaii-botched-contact-tracing-and-what-it-will-take-fix-it#stream/0>
CALLING FOR PARK'S RESIGNATION
The state's lack of robust contact tracing is one reason Lt. Gov. Josh Green, an emergency room
physician, called for Park to step down.
“Dr. Park has other priorities and a different philosophy. Her philosophy is very smart as far as
social distancing and decreasing large gatherings. She's very firm on the high risk behaviors in
state,” he said.
But while blaming public behavior for the surging cases and downplaying the importance of
contact tracing, Park at times appeared to be throwing in the towel when it comes to contact
tracing, noting that colleagues in other states have abandoned contact tracing.
“I know what we're capable of and what we're not capable of socially, as far as preventing spread,”
Green said. “She doesn't have that kind of commitment to a program that is necessary to trace and
test everyone.”
The senators and Green want the health department to set up a contact tracing hub at the Hawaii
Convention Center to house the contact tracers.
__________________
STATE DEBATES CONTACT TRACER WORKFORCE TO TRACK CORONAVIRUS
By West Hawaii Today, First Published by Associated Press, AUGUST 12, 2020
<https://www.westhawaiitoday.com/2020/08/12/hawaii-news/state-debates-contact-tracer-workforce-to-track-coronavirus/>
Hawaii is in the midst of a debate over the number of contact tracers needed to locate people who
have had close contact with people who tested positive for the coronavirus, while Democratic Lt.
Gov. Josh Green called for new oversight for the program. Green called for State Epidemiologist
Sarah Park to be removed from management of the state's contact tracing effort.
Green said he wants to employ 400 to 500 contact tracers, while estimating the state needs hundreds
more, The Honolulu Star-Advertiser reported Monday.
“WE CAN EITHER CONTACT TRACE OR LOCK DOWN” Green said last Friday
[Emphasis Supplied]
Park did not respond directly to Green's statement. A spokesperson said Park and state Health
Director Bruce Anderson would only answer questions during scheduled news briefings as a result
of their workload, Hawaii Public Radio reported Tuesday.
The State of Hawaii COVID-19 Joint Information Center responded to a request for comment from
the Associated Press with a statement by Democratic Gov. David Ige, which said in part, “I am in
ongoing discussions with DOH leadership on ways to improve our testing and contact tracing
systems and capacity. And we are confident that plans and resources are being put in place to meet
the needs of our community.”
__________________
HAWAII'S CONTACT TRACING EFFORT FALLS SHORT OF NATIONAL STANDARDS
By Stewart Yerton, The Honolulu Civil Beat, AUGUST 12, 2020
<https://www.civilbeat.org/2020/08/hawaiis-contact-tracing-effort-falls-short-of-national-standards/>
In the middle of April, roughly three weeks into stay-at-home orders that eventually would nearly
stop the spread of COVID-19 in Hawaii, public officials, economists and community leaders were
identifying contact tracing as a key element in the state's plan to contain the virus as the economy
reopened.
“This contact tracing is really where the action is,” Hawaii Department of Health Director Bruce
Anderson said at the time.
Now, nearly four months later, with the virus spreading out of control on Oahu, Anderson and State
Epidemiologist Dr. Sarah Park are being increasingly criticized for failing to provide enough
staffing to conduct the tracing necessary to quickly track down and isolate the people who had been
close to those infected with the virus.
Late Monday, the union that represents the public health investigators joined a growing number of
critics when it said it had filed a grievance on behalf of overwhelmed health department workers
who have said there aren’t enough of them to do the job.
That complaint came after a surprise visit to the health department on Friday by Hawaii senators
trying to fact check statements made the previous day by Park. During testimony before the Senate
Special Committee on COVID-19, Park downplayed the importance of contact tracing as a cause of
recent spreading and said the department has 105 active contact tracers and planning to bring on
about 20 more.
Park and Anderson blame the recent surge in cases on the public and the fact that people have
been attending large gatherings and engaging in other risky behavior.
But critics including lawmakers and health professionals are increasingly concerned that Park
and Anderson — as well as Gov. David Ige — are dismissing the importance of contact tracers
and haven't acted as quickly as they should have — and said they would — to get that leg of
the response effort solidly in place.
[Emphasis Supplied]
__________________
WE NEED AN ARMY
HIRING OF CORONAVIRUS TRACKERS SEEN AS KEY TO CURBING DISEASE SPREAD
By Maggie Fox, STAT (The Boston Globe), APRIL 13, 2020
<https://www.statnews.com/2020/04/13/coronavirus-health-agencies-need-army-of-contact-tracers/>
Combined with more widespread testing, contact tracing is seen as an essential part of the
strategy for keeping the coronavirus in check after the first wave recedes and the economy
reopens.
Hong Kong and South Korea “didn't do so much of physical distancing by shutting down
whole cities and whole regions. They did more in the way of using testing data and contact
tracing data to see who should be quarantining themselves or isolating themselves”
Dr. David R. Holtgrave, Dean of the School of Public Health, University at Albany
__________________
IGE URGED TO ORDER DOH TO ACCEPT MORE PANDEMIC HELP
Some think the Hawaii Department of Health is woefully short of people doing contact tracing,
but the department says it has enough staff to handle the short term
By Stewart Yerton and Eleni Avendaño, The Honolulu Civil Beat, MAY 4, 2020
<https://www.civilbeat.org/2020/05/ige-urged-to-order-doh-to-accept-more-pandemic-help/>
When it comes to reopening Hawaii's economy, there's little argument Hawaii's ability to
conduct contact tracing is key.
It's one of the four pillars – along with screening, testing and isolating – that officials have identified
as a prerequisite to lifting stay-at-home orders and eventually opening Hawaii’s economy.
But now there's a growing dispute over whether the state has enough people to do the tracing.
Maj. Gen. Kenneth Hara, who is leading the state's response to the COVID-19 outbreak, said he
would ask Gov. David Ige to order the Department of Health to accept help.
Bruce Anderson, the director of the Hawaii Department of Health, says the department currently has
about 50 staff and 30 volunteers conducting contact tracing — enough, he said, given the relatively
low number of active cases in Hawaii.
“I'm comfortable they can handle the volume of cases today,” Anderson said. “We are training and
have recruited volunteers to help with surge capacity. I'm comfortable with existing staff, at least in
the near term.”
The state official leading the recovery, meanwhile, said he's going to ask Gov. David Ige to
intervene and accept help that’s being offered to boost the department’s ranks.
During the weekly meeting of the House Select Committee on COVID-19 Economic and Financial
Preparedness, Maj. Gen. Kenneth Hara, the official in charge of the state's response, said he would
ask the governor to order the health department to accept help from the Hawaii Emergency
Management Agency, which Hara heads. Hara wasn't the only one pointing out that there are
hundreds if not thousands of people available to get training and help, including people with health
care experience.
Dr. Mark Mugiishi, the chief executive of Hawaii Medical Service Association who is on the House
Select Committee, said the head of the University of Hawaii's nursing school had offered several
hundred nursing students to help.
Carl Bonham, executive director of the University of Hawaii Economic Research Organization, said
there are thousands of out-of-work health care workers with at least some medical training who
could be hired to help.
“We just have to take it to the Department of Health to see if they’ll accept the help,” Mugiishi said.
In a news conference following the House meeting, Ige downplayed any tensions between
Hara's agency and the health department. He said health officials were not “pushing back.” “I
think it’s a misunderstanding. It's not pushing back as much as the acknowledgment that we
do have the personnel we need to handle the current case count,” Ige said. “General Hara has
been very active in planning for the worst case scenario.
__________
HEAD OF STATE EMERGENCY RESPONSE SAYS HEALTH DEPARTMENT
DRAGGING FEET ON EXPANDING CONTACT TRACING
By Ryan Finnerty, Hawaii Public Radio, May 5, 2020
<https://www.hawaiipublicradio.org/post/head-state-emergency-response-says-health-department-dragging-feet-expanding-contact-tracing#stream/0>
Contact tracing is universally regarded as critical in safely relaxing pandemic-induced lockdowns.
But Hawaii officials publicly disagree over how much tracing capacity is needed.
The process of contact tracking involves identifying and reaching anyone who may have come into
close proximity with a COVID-19 positive individual. The goal is to locate others who may have
become infected and either test or direct them to isolate.
Some senior officials in the Hawaii's recovery task force are now publicly agitating for the state
health department to significantly expand the number of tracers available. Major General Kenneth
Hara, Adjutant General of the Hawaii National Guard and head of the Hawaii Emergency
Manangement Agency, serves as the governor's emergency response lead. He says authorities need
to build that tracing capacity now, rather than waiting for a spike in cases.
“To be responsive, we need to anticipate needs. We need to organize, equip, and train the people, so
that when we need it, we're there,” Hara said.
Hara told a state House of Representative committee on Monday that he is frustrated by the health
department's lack of action to further expand the contact tracing program.
Hara offered to provide National Guard soldiers, many of whom are trained doctors, nurses, and
EMTs to help, but the health departmrnt has apparently not taken up on his offer. “We're all aligned.
It's just kind frustrating trying to convince DOH that its important,” Hara said to the committee.
Hara added that he had spoken with Gov. David Ige over the weekend and asked the governor to
personally intervene, possibly with an official order. But at a press conference later in the day, Ige
said the situation was a misunderstanding. When asked about Hara's comments, Ige stated that there
are adequate resources to handle the current outbreak.
“We do have the personnel we need for the current case count. General [Hara] has been very active
in planning for the worst case scenario, where we see hundreds of cases [per day], rather than the
one or two or 10 we're seeing now,” Ige said.
__________
COVID-19 CASE INVESTIGATION AND CONTACT TRACING
CONSIDERATIONS FOR USING DIGITAL TECHNOLOGIES
ASTHO and In-Q-Tel, Inc. (IQT), JULY 2020
<https://www.astho.org/ASTHOReports/COVID-19-Case-Investigation-and-Contact-Tracing-Considerations-for-Using-Digital-Technologies/07-16-20/>
As communities relax stay-at-home orders and ramp up testing, the public health system is seeing
increases in COVID-19 cases.
Until vaccines are broadly available, the primary ways of preventing transmission of COVID-19
include interventions such as case investigation, contact tracing, social distancing, and isolation and
quarantine.
Case investigation and contact tracing are well-established public health functions that have been
implemented for many diseases like Ebola, sexually transmitted infections (STIs), and tuberculosis.
However, the scale and speed needed for COVID-19 is unprecedented.
An extensive and swift expansion of the case investigation and contact tracing workforce—paired
with continuous evaluation to ensure effectiveness—is needed to adequately respond to rising
caseloads and rapid investigation cycles. To complement this time-tested, workforce-based solution,
technology companies have been engaging with various public health experts to develop new tools
that could aid in COVID-19 response efforts. Public health officials may choose to incorporate
solutions that can augment and support case investigation and contact tracing while also protecting
privacy.
There are a wide range of technology options that can be used to support discrete steps involved in
case investigation and contact tracing, including those that provide capabilities for exposure
notification, digital surveys, telemedicine, symptom tracking, testing and care coordination options,
and “customer” relationship management.
However, no single technology solution covers all functions required for case investigation and
contact tracing. Taking full advantage of technology options may require layering and linking
multiple technologies across the case investigation and contact tracing workflows.
State public health governance structures vary across the nation, with over half of states reporting
decentralized governance, meaning local government employees hold primary authority over local
health units. Close to 30 percent of states report a centralized structure in which state employees
primarily lead local health units, with the remainder of states reporting shared and mixed
governance structures.
The range of governance structures can influence or dictate how public health decisions are made
and services delivered—the impact of which is evident during the domestic response to COVID-19.
Traditional case investigation and contact tracing can take weeks to carry out. COVID-19 modeling
studies, however, have shown that faster contact tracing is needed to curb the spread of infection.
Transmission models suggest that contact tracing must be highly effective (i.e., more than 70% of
contacts traced) and leverage technology to facilitate instant contact notification in order to contain
the epidemic.
Data technologies, advanced analytics, and mobile devices can potentially be leveraged as force
multipliers for speed and scale in case investigation and contact tracing. As seen in South Korea,
Singapore, and China, technology tools can be deployed to facilitate contact tracing with varying
outcomes. Several other countries are exploring the use of a range of technologies with a strong
focus on proximity sensing and exposure notification capabilities.
There is a range of technology that can be used to support the steps involved in case investigation
and contact tracing. Notably, no single technology option spans across the full range of steps
involved in case investigation, contact tracing, care coordination, or team coordination. Rather,
taking full advantage of technology options may require layering multiple technologies across the
full range of work functions.
Though a wide array of technology options are being developed and piloted across jurisdictions,
models of technology enabled contact tracing are nascent, and decision-makers must consider issues
related to privacy and consent, stakeholder and community engagement, and operational issues.
Because no single technology option addresses the full arc of functionalities required for rapid and
scaled up case investigation and contact tracing, layering multiple technologies may be required to
take full advantage of digital options to support this work.
To improve effectiveness and outcomes, standards for evaluating data technologies should be
established and evolved based on lessons learned. Case investigation and contact tracing
technologies should be assessed to ensure they accomplish their intended function and protect data
appropriately.
The CDC has developed preliminary criteria for evaluating digital contact tracing tools,15 and
ongoing engagement from the public and private sector is required to develop and refine evaluation
standards.
* ASTHO is the national nonprofit organization representing the public health agencies of the
United States, the U.S. territories and freely associated states, and the District of Columbia, as well
as the more than 100,000 public health professionals these agencies employ. ASTHO members, the
chief health officials of these jurisdictions, are dedicated to formulating and influencing sound
public health policy and to ensuring excellence in public health practice.
* In-Q-Tel, Inc. (IQT) is the not-for-profit strategic investor that accelerates the development and
delivery of cutting-edge technologies to U.S. government agencies that keep our nation safe. IQT
was established in 1999 with a distinct mission: to identify and partner with startup companies
developing innovative technologies that protect and preserve our nation's security
__________
CONTACT TRACING FOR COVID-19
SUMMARY OF COVID-19 SPECIFIC PRACTICES
National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases
UPDATED JULY 22, 2020
<https://www.cdc.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-plan/contact-tracing.html>
 Contact tracing will be conducted for close contacts (any individual within 6 feet of an infected
person for at least 15 minutes) of laboratory-confirmed or probable COVID-19 patients.
 Remote communications for the purposes of case investigation and contact tracing should be
prioritized; in-person communication may be considered only after remote options have been
exhausted.
 Testing is recommended for all close contacts of confirmed or probable COVID-19 patients.
 Those contacts who test positive (symptomatic or asymptomatic) should be managed as a
confirmed COVID-19 case.
 Asymptomatic contacts testing negative should self-quarantine for 14 days from their last
exposure (i.e., close encounter with confirmed or probable COVID-19 case).
__________
HAWAII GOV. DAVID IGE CALLS OUT SENATORS
FOLLOWING DEPARTMENT OF HEALTH
CONTACT TRACING TOUR
By Dan Nakaso, The Honolulu Star Advertiser, AUGUST 16, 2020
<https://www.staradvertiser.com/2020/08/16/hawaii-news/ige-calls-out-senators-following-doh-contact-tracing-tour/>
Gov. David Ige has admonished Senate President Ron Kouchi after members of the Senate
Special Committee on COVID-19 toured the Health Department on Aug. 7 to review contact tracing
operations at the invitation of the state epidemiologist — but apparently without enough advance
notice. Ige wrote to Kouchi on Tuesday. “Committee members ignored the security protocols
and made their way into an area where contact tracing activities involving sensitive, protective
health information were ongoing.”
State Sen. Jarrett Keohokalole, a member of the Senate Special Committee on COVID-19,
called Ige's letter both inaccurate and “petty”. “People are dying and the governor's response
speaks for itself,” Keohokalole said Saturday. “This is a crisis and this is where his (Ige's)
focus is?”
In his response to Ige, Kouchi wrote: “Your demand that I 'ensure' that legislators 'should
never again' appear unannounced at another 'state department' in order to ‘protect and
support our public servants' rings hollow because your administration has previously
condoned unannounced department visits by legislators, i.e., when members of the House of
Representatives, including Speaker Scott Saiki, Representatives Sylvia Luke and news media, went
to the Department of Labor and Industrial Relations (DLIR) unannounced, toured DLIR and spoke
with employees and Director Scott Murakami about DLIR's inability to timely address and process
unemployment claims.”
In a phone interview with the Honolulu Star-Advertiser on Saturday, Kouchi said some of the
concerns expressed in Ige's letter “simply weren't true” based on multiple reports from members
of the Senate COVID-19 committee.
Ige gave the impression “they were wandering around unsupervised and interacting with employees,
which would have been inappropriate,” Kouchi said. “They were escorted by Dr. Park and they were
simply going where they were directed.”
Repeatedly pressed to describe the tenor of the exchange between himself and the governor, Kouchi
said: “I would refer to the last paragraph, which is the least interesting: I still stand committed to
work with the governor in the best interest of the people of Hawaii.”
[Emphasis Supplied]
__________
CALIFORNIA CONGRESSWOMAN WANTS ANSWERS ON HAWAII’S VIRUS RESPONSE
EFFORT - THE CHAIRWOMAN OF A CONGRESSIONAL SUBCOMMITTEE ON HEALTH
WANTS TO KNOW DETAILS ABOUT HOW THE STATE SPENT $50 MILLION IN CARES
ACT MONEY AIMED AT TESTING AND TRACING.
By Stewart Yerton, The Honolulu Civil Beat, AUGUST 19, 2020
<https://www.civilbeat.org/2020/08/california-congresswoman-wants-answers-on-hawaiis-virus-response-effort/>
U.S. Rep. Anna Eshoo, who chairs the House Health subcommittee of the Energy and Commerce
Committee, asked Ige for more information on the Hawaii Department of Health's testing and
contact tracing program, including things like how many contact tracing personnel the state has had
on staff each week since the outbreak began.
“As you know, less than two months ago, Hawaii had the lowest number of COVID-19 cases per
capita of any state in the nation,” wrote Eshoo, a California Democrat whose district includes
Silicon Valley. “However, this trend has reversed and now Hawaii has the highest infection rate in
the United States.”
Eshoo's criticisms and demands for transparency echoed those of U.S. Rep. Tulsi Gabbard, who last
week called for the resignations of Hawaii Department of Health Director Bruce Anderson and Dr.
Sarah Park, the state epidemiologist.
“The crisis we face today is a direct result of our state's failed leadership,” Gabbard said in a press
release that cited Eshoo’s letter. “Governor Ige and his team had months to hire, train and deploy a
robust contact tracing team to prevent the very situation we face today.
“Months ago we worked in Congress to deliver over $50 million in funding to the state so that they
had the resources to trace, test, and contain future COVID-19 cases. Yet, we have around a dozen
people doing contact tracing today, who are so overwhelmed that they can only reach a small
number of individuals who have contracted COVID-19.”
Gabbard blamed Ige and his staff for dropping the ball on contact tracing and testing and
suggested the state's inaction led to the outbreak Hawaii is currently experiencing.
“If Governor Ige and his team had done what they were supposed to do, we could have prevented
the major outbreak we are experiencing today that has taken more lives and resulted in so many of
our kupuna, families and keiki getting infected and sick,” she said in the statement. “This is a punch
in the gut to Hawaii residents who have sacrificed so much to try to prevent the spread of this virus,
only to see our state leaders failing the people.”
Last week, in a joint press conference with a DOH whistleblower, Gabbard accused Anderson and
Park of lying about the state's capacity to do contact tracing after Jennifer Smith, a Ph.D. virologist
and case investigator for the Department of Health, came forward to say the department's lack of
tracing capacity contributed to a recent surge in cases.
After Smith last week said the department recently had only nine people doing contact tracing on
Oahu, the department in a statement responded that it has about 100 for the state, and continues to
add more. The statement did not respond directly to Gabbard’s statement that Anderson and Park
lied.
Asked about Eshoo's letter at a news conference on Wednesday, Ige said he had not had time to
formulate a full response to the letter but said of the $50 million in CARES Act money, some $2.5
million was being used to train contact tracers from the University of Hawaii and $10 million to
increase testing and surveillance capacity, including systems for data management and lab testing
equipment.
Although public health officials have shifted the blame onto the public for participating in
gatherings that let the virus spread, it appears a lack of contact tracing contributed to
Hawaii's recent surge in cases. For much of May, it appeared the state had all but eliminated the
virus, as the weekly average of new cases hovered at less than two.
The plan was to use extensive testing and tracing to keep the virus in clusters as the economy
opened. As the state prepared to open the local economy in early June, Anderson rebuffed attempts
to provide extra contact tracers and vowed the department would be able to “surge from within” to
ramp up tracing capacity to trace and contain the expected surge in cases.
But that didn't happen. And as Eshoo noted, “From early June through the end of July, your state’s
cases more than tripled to 2,111 confirmed infections, and from July 31 through August 14, the
state’s cases doubled and now stand at 5,042 positive cases.”
Eshoo, whose committee has oversight over public health and quarantine among other health-related
issues, wants detailed information from the Ige administration about the contact tracing program that
has been in place since the COVID-19 outbreak was declared an emergency more than five months
ago.
She also wants to know how the state has used federal money aimed at the coronavirus response,
including how much the state has received for testing and contact tracing and how much remains
unspent.
Eshoo also wants the state to provide a plan and timeline for bringing Hawaii's testing and tracing
effort up to national standards.
“Due to the numerous instances of conflicting and false information being released to the
public by your Department of Health regarding the number of contact tracers employed and their
capabilities, what specific actions will you take to restore the integrity of the Department of
Health?” Eshoo asked.
__________
CONGRESS SEEKS ANSWERS ABOUT HAWAII'S CONTACT TRACING, USE OF
FEDERAL FUNDS - HAWAII'S SURGE IN COVID-19 CASES THIS MONTH IS RAISING
QUESTIONS AT THE CONGRESS OF THE UNITED STATES.
THE CHAIRWOMAN OF THE SUBCOMMITTEE OF HEALTH, U.S.
REPRESENTATIVE ANNA ESHOO, WANTS ANSWERS
KITV NEWS, AUGUST 19, 2020
<https://www.kitv.com/story/42518350/congress-seeks-answers-about-hawaiis-contact-tracing-use-of-federal-funds>
Hawaii's surge in COVID-19 cases this month is raising questions at the Congress of the United
States.
The chairwoman of the Subcommittee of Health, U.S. Representative Anna Eshoo, wants answers.
In a letter addressed to Governor David Ige, she says she is concerned over the coronavirus outbreak
and the way Hawaii is handling contact tracing and testing.
She includes questions to “bring greater clarity regarding these issues.” Eshoo questions the
amount of contact tracers and exactly how much of the federal funds was used since receiving the
grant in March.
Hawaii received over $50 million from the CDC solely for the purpose of contact tracing,
purchasing of COVID-19 tests, administration costs and other operations needed to stop the
spread of the virus. Eshoo also wants a response to the Department of Health's whistle
blower's allegations of reporting false information about active contact tracers.
Eshoo requests the governor's complete response by August 28, along with “specific actions” to
“restore the integrity of the Department of Health”.
__________
U.S. HOUSE SUBCOMMITTEE CHAIR QUESTIONS GOVERNOR IGE
ON CONTACT TRACING
By Big Island Video News, AUGUST 19, 2020
<https://www.bigislandvideonews.com/2020/08/19/house-subcommittee-chair-questions-governor-ige-on-contact-tracing/>
U.S. Congresswoman Tulsi Gabbard (D-Hawaii) says another Democratic member of the U.S.
House – California Representative Anna Eshoo, who chairs the House Energy and Commerce
Committee’' Subcomittee on Health – is “demanding answers and transparency from Governor
David Ige about how federal funds designated for contact tracing and testing have been used in
Hawaii.”
Gabbard held a news conference last Friday, in which she criticized the Hawaii Department of
Health for its response to the COVID-19 pandemic, and introduced a DOH employee whistleblower
who revealed what is really going on with the State’s contact tracing effort.
__________
MAYOR AGAIN WARNS OF COUNTY RESTRAINTS
HOSPITAL COVID-19 CASES CLIMB TO 45
By Kehaulani Cerizo, The Maui News, AUGUST 20, 2020
<https://www.mauinews.com/news/local-news/2020/08/mayor-again-warns-of-county-restraints/>
As Maui hit a single-day record for COVID-19 cases, Maui County Mayor Michael Victorino again
warned that he will reinstate emergency restrictions if numbers don't improve — this time by
Monday.
“I'm going to say that unless this changes quite drastically quite quickly, rollback will start,”
Victorino said during a news conference Wednesday afternoon. “And we're looking probably at
announcing something no later than Monday.”
Maui recorded a record 20 new cases Wednesday, according to state Department of Health officials.
The state also recorded two more Oahu deaths related to COVID-19. All the while, cases at Maui's
main hospital continued to creep up, with Maui Memorial Medical Center reporting 45 COVID-19
cases — 24 patients and 21 health care workers — on Wednesday, up from 36 on Tuesday.
The hospital surge triggered mass testing of all patients, employees and providers. Tracy Dallarda,
hospital spokeswoman, said Wednesday that the HOSPITAL SO FAR HAS PERFORMED 637
TESTS ON EMPLOYEES, with 602 negative results, 21 positive and 14 pending.
“The purpose of this testing is to understand the prevalence of the virus in our hospital,” Dallarda
said in a statement. “Because our patients, employees and providers are a direct reflection of our
community, it will also provide a valuable estimate of viral incidence on Maui and help identify
symptomatic and asymptomatic individuals and allow us to further isolate, quarantine and limit
further transmission.”
Dallarda has said the surge at the hospital is a reflection of spikes around the state and that
many MMMC cases are community spread.
Dr. Lorrin Pang, state Department of Health Maui District health officer, said at the news
conference, that because the virus is prevalent throughout the community, it's difficult to tell
whether MMMC health care workers contracted COVID-19 outside or inside of the hospital.
When clusters have popped up on Maui, such as at a hot yoga class, a bachelor party or out-of-state
travel for a funeral, officials make pleas to the public to change behavior, Pang added. “We say stop
it, change things, don't travel so much,” he said. “But sometimes you can’t quite shut it down. You
can't say shut down the hospital, you can't do that.” He discussed the importance of individual
responsibility and prevention measures, such as physical distancing, wearing face masks and
sanitizing.
The Health Department reported that as of late Tuesday afternoon there were 16 people hospitalized
at Maui Memorial with COVID-19. The hospitalization counts on other islands were 163 on Oahu,
six on Hawaii island and two on Kauai. In light of triple-digit surges sweeping over Oahu for weeks,
Gov. David Ige signed the City and County of Honolulu's “Act Now Honolulu” order Wednesday,
which will restrict social indoor and outdoor gatherings to no larger than five people effective at
12:01 a.m. today.
“We can only be successful when we each take personal responsibility . . . stay home, wash hands,
wear masks,” Ige said during a state news conference. “We're focused on unstructured social
gatherings, and the surge we’re seeing is because people let their guard down.” He said that the
Neighbor Islands will remain in the “Act with Care” phase of reopening due to lower case counts.
However, Victorino has cautioned for weeks that rollbacks may be coming if cases average double-
digits over a consistent period of time. He upgraded his warning Wednesday, saying that he will
decide over the next few days whether restrictions are coming.
Asked by The Maui News what rollbacks he's considering, Victorino declined to lay out specifics
but added that he is eyeing uncontrolled social gatherings, such as sporting activities with large
families not wearing masks or social distancing. “I will say if you are in modem of gatherings where
you have large groups of people that are coming together . . . these are the kind of things that make
it really difficult to monitor,” he said. “These are areas I'm looking at first because these seem to be
where many of the outbreaks have begun, in activities where people gather . . . they congregate, they
are not wearing masks, and they're not physical distancing,” Victorino added.
“Beaches? Beach parks? Who knows? “Those are areas that are rising to the top as far as priorities
to be shut down.”
MAUI HOSPITAL CONFIRMS TWO MORE COVID-19 CASES
By Wendy Osher, Maui Now, AUGUST 21, 2020
<https://mauinow.com/2020/08/21/maui-hospital-confirms-two-more-covid-19-cases/>
Maui Health identified two additional positive COVID-19 patients on Thursday, bringing the total
number of infections at the facility since last week Thursday, Aug. 13, to 47. Total infections over
the past eight days include 26 patients and 21 health care workers.
Tracy Dallarda, Communications for Maui Health / Maui Memorial Medical Center said one-
time testing of all patients, employees and providers continues.
“As a reminder the purpose of this testing is to understand the prevalence of the virus in our
hospital. Because our patients, employees, and providers are a direct reflection of our community, it
will also provide a valuable estimate of viral incidence on Maui and help identify symptomatic and
asymptomatic individuals and allow us to further isolate, quarantine, and limit further transmission,”
said Dallarda. Hospital administrators have said the suspected source of infection are index cases of
an employee and a patient, with both appearing to have come from the community.
The newly reported cases since Aug. 13, 2020 are separate from an initial cluster reported earlier
this year.
During the first wave of infection, the cluster of individuals linked to the initial Maui Health
outbreak totaled 52 including 38 health care workers and 14 patients who had tested positive,
according to previous reports. That cluster was declared “closed” on May 19, 2020.
The state has reported 236 new COVID-19 cases on Thursday including 230 on Oahu, one on Maui
and five on Hawaii Island. More than 96% of the active cases statewide are on the island of Oahu.
The death of a Lanai man was also reported yesterday by the state Department of Health. He was
40-59 years old with underlying health conditions, and had been hospitalized on Maui. So far there
have been seven COVID-19 related deaths on Maui and 45 in the state over the course of the
pandemic.
Of the 263 cases in Maui County, at least 166 have been released from isolation, and 31 have
required hospitalization. Based on Thursday's numbers, there are 90 active cases in Maui County.
__________
20 AT ROSELANI PLACE TEST POSITIVE HOSPITAL OUTBREAK
GROWS TO 31 PATIENTS, 35 STAFF
By Colleen Uechi, Assistant City Editor, The Maui News, AUGUST 25, 2020
<https://www.mauinews.com/news/local-news/2020/08/20-at-roselani-place-test-positive/>
Eight residents and 12 staff have tested positive for COVID-19 at a senior independent and assisted
living community that’s largely escaped the pandemic until now.
The outbreak at Roselani Place in Kahului that began with a resident in the memory support area
and three staffers had grown to 20 on Monday after a round of testing over the weekend.
Karl Drucks of Paradigm Senior Living, the management company for Roselani Place, said that the
first resident confirmed with the virus had been discharged from Maui Memorial Medical Center
earlier this month. However, because of possible exposure from a family member, it was unclear
where the resident had actually contracted the virus.
Drucks explained that the resident had been admitted to Maui Memorial on JULY 28 for other
medical issues. The patient tested negative upon admission to the hospital and was tested again
on AUG. 12 and AUG. 14, both with negative results.
On AUG. 15, the patient was discharged to Roselani Place. On AUG. 17, a nurse at Roselani
Place was notified of possible exposure from the resident's son; the nurse and the general
manager immediately contacted the state epidemiologist. After the resident's primary physician and
family members were informed, the resident was immediately isolated in a private apartment at
Roselani, with limited staff entry and recommendations to retest the resident every five to six days.
On Wednesday, Maui Memorial informed Roselani's general manager that the resident may
have been exposed as of AUG. 12. Contact tracing and testing found that three of the staff who
had interacted with the resident had caught the virus. Roselani arranged for testing of
remaining staff Sunday.
Maui Health spokeswoman Tracy Dallarda said Monday that the patient who left Maui Memorial
for Roselani did not have COVID while in the hospital and tested negative twice upon discharge, a
requirement for placement at another care facility.
The hospital outbreak had grown from 26 patients and 21 workers on Thursday to 31 patients and 35
workers on Monday; the 66 cases have now outpaced the first cluster in April that reached 57 at one
point. Dallarda said that no new cases were reported Monday and that Maui Memorial was currently
caring for 25 positive patients.
Nearly 1,500 COVID-19 TESTS HAVE BEEN CONDUCTED ON MAUI HEALTH
WORKERS since mass testing began AUG. 12.
“Maui Health continues to conduct mass testing and our team of physicians, nurses and other leaders
are committed to doing all we can to prevent viral spread for the health and safety of our patients,
employees, providers and our community,” Dallarda said in a statement.
__________
UNITED STATES DEPARTMENT OF JUSTICE
DEPRIVATION OF RIGHTS UNDER COLOR OF LAW
<https://www.justice.gov/crt/deprivation-rights-under-color-law>
[Emphasis Supplied]
SUMMARY:
Section 242 of Title 18 makes it a crime for a person acting under color of any law to willfully
deprive a person of a right or privilege protected by the Constitution or laws of the United
States.
For the purpose of Section 242, acts under “color of law” include acts not only done by federal,
state, or local officials within their lawful authority, but also acts done beyond the bounds of
that official's lawful authority, if the acts are done while the official is purporting to or
pretending to act in the performance of his/her official duties.
Persons acting under color of law within the meaning of this statute include police officers, prisons
guards and other law enforcement officials, as well as judges, care providers in public health
facilities, and others who are acting as public officials. It is not necessary that the crime be
motivated by animus toward the race, color, religion, sex, handicap, familial status or national origin
of the victim.
The offense is punishable by a range of imprisonment up to a life term, or the death penalty,
depending upon the circumstances of the crime, and the resulting injury, if any.

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State of Hawaii - COVID-19 Response - Beneath the Tip of the Iceberg - Accountabilty and Responsibility

  • 1. STATE OF HAWAII COVID-19 SURVEILLANCE - OUTBREAK MANAGEMENT - CONTACT TRACING BREACH OF THE PUBLIC TRUST DECEPTION, DECEIT, DERELICTION OF DUTY DEPRIVATION OF RIGHTS UNDER COLOR OF LAW _____________________ PREFACE Lieutenant Governor Josh Green stated to the Senate Special Committee on Covid-19 at an Informational Meeting, “We can either Contact Trace or Lockdown”. Governor David Ige sided with Dr. Sarah Park, State Epidemiologist and Dr. Bruce Anderson, Hawaii Department of Health Director - Lockdown. The following chronology is shared for your review and evaluation. Given the severity of the situation and pending Congressional Inquiry, information from the Department of Justice is included. _____________________ HOW HAWAII BOTCHED CONTACT TRACING AND WHAT IT WILL TAKE TO FIX IT By Ashley Mizuo, Hawaii Public Radio, AUGUST 11, 2020 <https://www.hawaiipublicradio.org/post/how-hawaii-botched-contact-tracing-and-what-it-will-take-fix-it#stream/0> CALLING FOR PARK'S RESIGNATION The state's lack of robust contact tracing is one reason Lt. Gov. Josh Green, an emergency room physician, called for Park to step down. “Dr. Park has other priorities and a different philosophy. Her philosophy is very smart as far as social distancing and decreasing large gatherings. She's very firm on the high risk behaviors in state,” he said. But while blaming public behavior for the surging cases and downplaying the importance of contact tracing, Park at times appeared to be throwing in the towel when it comes to contact tracing, noting that colleagues in other states have abandoned contact tracing. “I know what we're capable of and what we're not capable of socially, as far as preventing spread,” Green said. “She doesn't have that kind of commitment to a program that is necessary to trace and test everyone.” The senators and Green want the health department to set up a contact tracing hub at the Hawaii Convention Center to house the contact tracers. __________________ STATE DEBATES CONTACT TRACER WORKFORCE TO TRACK CORONAVIRUS By West Hawaii Today, First Published by Associated Press, AUGUST 12, 2020 <https://www.westhawaiitoday.com/2020/08/12/hawaii-news/state-debates-contact-tracer-workforce-to-track-coronavirus/> Hawaii is in the midst of a debate over the number of contact tracers needed to locate people who have had close contact with people who tested positive for the coronavirus, while Democratic Lt. Gov. Josh Green called for new oversight for the program. Green called for State Epidemiologist Sarah Park to be removed from management of the state's contact tracing effort.
  • 2. Green said he wants to employ 400 to 500 contact tracers, while estimating the state needs hundreds more, The Honolulu Star-Advertiser reported Monday. “WE CAN EITHER CONTACT TRACE OR LOCK DOWN” Green said last Friday [Emphasis Supplied] Park did not respond directly to Green's statement. A spokesperson said Park and state Health Director Bruce Anderson would only answer questions during scheduled news briefings as a result of their workload, Hawaii Public Radio reported Tuesday. The State of Hawaii COVID-19 Joint Information Center responded to a request for comment from the Associated Press with a statement by Democratic Gov. David Ige, which said in part, “I am in ongoing discussions with DOH leadership on ways to improve our testing and contact tracing systems and capacity. And we are confident that plans and resources are being put in place to meet the needs of our community.” __________________ HAWAII'S CONTACT TRACING EFFORT FALLS SHORT OF NATIONAL STANDARDS By Stewart Yerton, The Honolulu Civil Beat, AUGUST 12, 2020 <https://www.civilbeat.org/2020/08/hawaiis-contact-tracing-effort-falls-short-of-national-standards/> In the middle of April, roughly three weeks into stay-at-home orders that eventually would nearly stop the spread of COVID-19 in Hawaii, public officials, economists and community leaders were identifying contact tracing as a key element in the state's plan to contain the virus as the economy reopened. “This contact tracing is really where the action is,” Hawaii Department of Health Director Bruce Anderson said at the time. Now, nearly four months later, with the virus spreading out of control on Oahu, Anderson and State Epidemiologist Dr. Sarah Park are being increasingly criticized for failing to provide enough staffing to conduct the tracing necessary to quickly track down and isolate the people who had been close to those infected with the virus. Late Monday, the union that represents the public health investigators joined a growing number of critics when it said it had filed a grievance on behalf of overwhelmed health department workers who have said there aren’t enough of them to do the job. That complaint came after a surprise visit to the health department on Friday by Hawaii senators trying to fact check statements made the previous day by Park. During testimony before the Senate Special Committee on COVID-19, Park downplayed the importance of contact tracing as a cause of recent spreading and said the department has 105 active contact tracers and planning to bring on about 20 more. Park and Anderson blame the recent surge in cases on the public and the fact that people have been attending large gatherings and engaging in other risky behavior.
  • 3. But critics including lawmakers and health professionals are increasingly concerned that Park and Anderson — as well as Gov. David Ige — are dismissing the importance of contact tracers and haven't acted as quickly as they should have — and said they would — to get that leg of the response effort solidly in place. [Emphasis Supplied] __________________ WE NEED AN ARMY HIRING OF CORONAVIRUS TRACKERS SEEN AS KEY TO CURBING DISEASE SPREAD By Maggie Fox, STAT (The Boston Globe), APRIL 13, 2020 <https://www.statnews.com/2020/04/13/coronavirus-health-agencies-need-army-of-contact-tracers/> Combined with more widespread testing, contact tracing is seen as an essential part of the strategy for keeping the coronavirus in check after the first wave recedes and the economy reopens. Hong Kong and South Korea “didn't do so much of physical distancing by shutting down whole cities and whole regions. They did more in the way of using testing data and contact tracing data to see who should be quarantining themselves or isolating themselves” Dr. David R. Holtgrave, Dean of the School of Public Health, University at Albany __________________ IGE URGED TO ORDER DOH TO ACCEPT MORE PANDEMIC HELP Some think the Hawaii Department of Health is woefully short of people doing contact tracing, but the department says it has enough staff to handle the short term By Stewart Yerton and Eleni Avendaño, The Honolulu Civil Beat, MAY 4, 2020 <https://www.civilbeat.org/2020/05/ige-urged-to-order-doh-to-accept-more-pandemic-help/> When it comes to reopening Hawaii's economy, there's little argument Hawaii's ability to conduct contact tracing is key. It's one of the four pillars – along with screening, testing and isolating – that officials have identified as a prerequisite to lifting stay-at-home orders and eventually opening Hawaii’s economy. But now there's a growing dispute over whether the state has enough people to do the tracing. Maj. Gen. Kenneth Hara, who is leading the state's response to the COVID-19 outbreak, said he would ask Gov. David Ige to order the Department of Health to accept help. Bruce Anderson, the director of the Hawaii Department of Health, says the department currently has about 50 staff and 30 volunteers conducting contact tracing — enough, he said, given the relatively low number of active cases in Hawaii. “I'm comfortable they can handle the volume of cases today,” Anderson said. “We are training and have recruited volunteers to help with surge capacity. I'm comfortable with existing staff, at least in the near term.” The state official leading the recovery, meanwhile, said he's going to ask Gov. David Ige to intervene and accept help that’s being offered to boost the department’s ranks.
  • 4. During the weekly meeting of the House Select Committee on COVID-19 Economic and Financial Preparedness, Maj. Gen. Kenneth Hara, the official in charge of the state's response, said he would ask the governor to order the health department to accept help from the Hawaii Emergency Management Agency, which Hara heads. Hara wasn't the only one pointing out that there are hundreds if not thousands of people available to get training and help, including people with health care experience. Dr. Mark Mugiishi, the chief executive of Hawaii Medical Service Association who is on the House Select Committee, said the head of the University of Hawaii's nursing school had offered several hundred nursing students to help. Carl Bonham, executive director of the University of Hawaii Economic Research Organization, said there are thousands of out-of-work health care workers with at least some medical training who could be hired to help. “We just have to take it to the Department of Health to see if they’ll accept the help,” Mugiishi said. In a news conference following the House meeting, Ige downplayed any tensions between Hara's agency and the health department. He said health officials were not “pushing back.” “I think it’s a misunderstanding. It's not pushing back as much as the acknowledgment that we do have the personnel we need to handle the current case count,” Ige said. “General Hara has been very active in planning for the worst case scenario. __________ HEAD OF STATE EMERGENCY RESPONSE SAYS HEALTH DEPARTMENT DRAGGING FEET ON EXPANDING CONTACT TRACING By Ryan Finnerty, Hawaii Public Radio, May 5, 2020 <https://www.hawaiipublicradio.org/post/head-state-emergency-response-says-health-department-dragging-feet-expanding-contact-tracing#stream/0> Contact tracing is universally regarded as critical in safely relaxing pandemic-induced lockdowns. But Hawaii officials publicly disagree over how much tracing capacity is needed. The process of contact tracking involves identifying and reaching anyone who may have come into close proximity with a COVID-19 positive individual. The goal is to locate others who may have become infected and either test or direct them to isolate. Some senior officials in the Hawaii's recovery task force are now publicly agitating for the state health department to significantly expand the number of tracers available. Major General Kenneth Hara, Adjutant General of the Hawaii National Guard and head of the Hawaii Emergency Manangement Agency, serves as the governor's emergency response lead. He says authorities need to build that tracing capacity now, rather than waiting for a spike in cases. “To be responsive, we need to anticipate needs. We need to organize, equip, and train the people, so that when we need it, we're there,” Hara said. Hara told a state House of Representative committee on Monday that he is frustrated by the health department's lack of action to further expand the contact tracing program.
  • 5. Hara offered to provide National Guard soldiers, many of whom are trained doctors, nurses, and EMTs to help, but the health departmrnt has apparently not taken up on his offer. “We're all aligned. It's just kind frustrating trying to convince DOH that its important,” Hara said to the committee. Hara added that he had spoken with Gov. David Ige over the weekend and asked the governor to personally intervene, possibly with an official order. But at a press conference later in the day, Ige said the situation was a misunderstanding. When asked about Hara's comments, Ige stated that there are adequate resources to handle the current outbreak. “We do have the personnel we need for the current case count. General [Hara] has been very active in planning for the worst case scenario, where we see hundreds of cases [per day], rather than the one or two or 10 we're seeing now,” Ige said. __________ COVID-19 CASE INVESTIGATION AND CONTACT TRACING CONSIDERATIONS FOR USING DIGITAL TECHNOLOGIES ASTHO and In-Q-Tel, Inc. (IQT), JULY 2020 <https://www.astho.org/ASTHOReports/COVID-19-Case-Investigation-and-Contact-Tracing-Considerations-for-Using-Digital-Technologies/07-16-20/> As communities relax stay-at-home orders and ramp up testing, the public health system is seeing increases in COVID-19 cases. Until vaccines are broadly available, the primary ways of preventing transmission of COVID-19 include interventions such as case investigation, contact tracing, social distancing, and isolation and quarantine. Case investigation and contact tracing are well-established public health functions that have been implemented for many diseases like Ebola, sexually transmitted infections (STIs), and tuberculosis. However, the scale and speed needed for COVID-19 is unprecedented. An extensive and swift expansion of the case investigation and contact tracing workforce—paired with continuous evaluation to ensure effectiveness—is needed to adequately respond to rising caseloads and rapid investigation cycles. To complement this time-tested, workforce-based solution, technology companies have been engaging with various public health experts to develop new tools that could aid in COVID-19 response efforts. Public health officials may choose to incorporate solutions that can augment and support case investigation and contact tracing while also protecting privacy. There are a wide range of technology options that can be used to support discrete steps involved in case investigation and contact tracing, including those that provide capabilities for exposure notification, digital surveys, telemedicine, symptom tracking, testing and care coordination options, and “customer” relationship management. However, no single technology solution covers all functions required for case investigation and contact tracing. Taking full advantage of technology options may require layering and linking multiple technologies across the case investigation and contact tracing workflows.
  • 6. State public health governance structures vary across the nation, with over half of states reporting decentralized governance, meaning local government employees hold primary authority over local health units. Close to 30 percent of states report a centralized structure in which state employees primarily lead local health units, with the remainder of states reporting shared and mixed governance structures. The range of governance structures can influence or dictate how public health decisions are made and services delivered—the impact of which is evident during the domestic response to COVID-19. Traditional case investigation and contact tracing can take weeks to carry out. COVID-19 modeling studies, however, have shown that faster contact tracing is needed to curb the spread of infection. Transmission models suggest that contact tracing must be highly effective (i.e., more than 70% of contacts traced) and leverage technology to facilitate instant contact notification in order to contain the epidemic. Data technologies, advanced analytics, and mobile devices can potentially be leveraged as force multipliers for speed and scale in case investigation and contact tracing. As seen in South Korea, Singapore, and China, technology tools can be deployed to facilitate contact tracing with varying outcomes. Several other countries are exploring the use of a range of technologies with a strong focus on proximity sensing and exposure notification capabilities. There is a range of technology that can be used to support the steps involved in case investigation and contact tracing. Notably, no single technology option spans across the full range of steps involved in case investigation, contact tracing, care coordination, or team coordination. Rather, taking full advantage of technology options may require layering multiple technologies across the full range of work functions. Though a wide array of technology options are being developed and piloted across jurisdictions, models of technology enabled contact tracing are nascent, and decision-makers must consider issues related to privacy and consent, stakeholder and community engagement, and operational issues. Because no single technology option addresses the full arc of functionalities required for rapid and scaled up case investigation and contact tracing, layering multiple technologies may be required to take full advantage of digital options to support this work. To improve effectiveness and outcomes, standards for evaluating data technologies should be established and evolved based on lessons learned. Case investigation and contact tracing technologies should be assessed to ensure they accomplish their intended function and protect data appropriately. The CDC has developed preliminary criteria for evaluating digital contact tracing tools,15 and ongoing engagement from the public and private sector is required to develop and refine evaluation standards. * ASTHO is the national nonprofit organization representing the public health agencies of the United States, the U.S. territories and freely associated states, and the District of Columbia, as well as the more than 100,000 public health professionals these agencies employ. ASTHO members, the chief health officials of these jurisdictions, are dedicated to formulating and influencing sound public health policy and to ensuring excellence in public health practice.
  • 7. * In-Q-Tel, Inc. (IQT) is the not-for-profit strategic investor that accelerates the development and delivery of cutting-edge technologies to U.S. government agencies that keep our nation safe. IQT was established in 1999 with a distinct mission: to identify and partner with startup companies developing innovative technologies that protect and preserve our nation's security __________ CONTACT TRACING FOR COVID-19 SUMMARY OF COVID-19 SPECIFIC PRACTICES National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases UPDATED JULY 22, 2020 <https://www.cdc.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-plan/contact-tracing.html>  Contact tracing will be conducted for close contacts (any individual within 6 feet of an infected person for at least 15 minutes) of laboratory-confirmed or probable COVID-19 patients.  Remote communications for the purposes of case investigation and contact tracing should be prioritized; in-person communication may be considered only after remote options have been exhausted.  Testing is recommended for all close contacts of confirmed or probable COVID-19 patients.  Those contacts who test positive (symptomatic or asymptomatic) should be managed as a confirmed COVID-19 case.  Asymptomatic contacts testing negative should self-quarantine for 14 days from their last exposure (i.e., close encounter with confirmed or probable COVID-19 case). __________ HAWAII GOV. DAVID IGE CALLS OUT SENATORS FOLLOWING DEPARTMENT OF HEALTH CONTACT TRACING TOUR By Dan Nakaso, The Honolulu Star Advertiser, AUGUST 16, 2020 <https://www.staradvertiser.com/2020/08/16/hawaii-news/ige-calls-out-senators-following-doh-contact-tracing-tour/> Gov. David Ige has admonished Senate President Ron Kouchi after members of the Senate Special Committee on COVID-19 toured the Health Department on Aug. 7 to review contact tracing operations at the invitation of the state epidemiologist — but apparently without enough advance notice. Ige wrote to Kouchi on Tuesday. “Committee members ignored the security protocols and made their way into an area where contact tracing activities involving sensitive, protective health information were ongoing.” State Sen. Jarrett Keohokalole, a member of the Senate Special Committee on COVID-19, called Ige's letter both inaccurate and “petty”. “People are dying and the governor's response speaks for itself,” Keohokalole said Saturday. “This is a crisis and this is where his (Ige's) focus is?”
  • 8. In his response to Ige, Kouchi wrote: “Your demand that I 'ensure' that legislators 'should never again' appear unannounced at another 'state department' in order to ‘protect and support our public servants' rings hollow because your administration has previously condoned unannounced department visits by legislators, i.e., when members of the House of Representatives, including Speaker Scott Saiki, Representatives Sylvia Luke and news media, went to the Department of Labor and Industrial Relations (DLIR) unannounced, toured DLIR and spoke with employees and Director Scott Murakami about DLIR's inability to timely address and process unemployment claims.” In a phone interview with the Honolulu Star-Advertiser on Saturday, Kouchi said some of the concerns expressed in Ige's letter “simply weren't true” based on multiple reports from members of the Senate COVID-19 committee. Ige gave the impression “they were wandering around unsupervised and interacting with employees, which would have been inappropriate,” Kouchi said. “They were escorted by Dr. Park and they were simply going where they were directed.” Repeatedly pressed to describe the tenor of the exchange between himself and the governor, Kouchi said: “I would refer to the last paragraph, which is the least interesting: I still stand committed to work with the governor in the best interest of the people of Hawaii.” [Emphasis Supplied] __________ CALIFORNIA CONGRESSWOMAN WANTS ANSWERS ON HAWAII’S VIRUS RESPONSE EFFORT - THE CHAIRWOMAN OF A CONGRESSIONAL SUBCOMMITTEE ON HEALTH WANTS TO KNOW DETAILS ABOUT HOW THE STATE SPENT $50 MILLION IN CARES ACT MONEY AIMED AT TESTING AND TRACING. By Stewart Yerton, The Honolulu Civil Beat, AUGUST 19, 2020 <https://www.civilbeat.org/2020/08/california-congresswoman-wants-answers-on-hawaiis-virus-response-effort/> U.S. Rep. Anna Eshoo, who chairs the House Health subcommittee of the Energy and Commerce Committee, asked Ige for more information on the Hawaii Department of Health's testing and contact tracing program, including things like how many contact tracing personnel the state has had on staff each week since the outbreak began. “As you know, less than two months ago, Hawaii had the lowest number of COVID-19 cases per capita of any state in the nation,” wrote Eshoo, a California Democrat whose district includes Silicon Valley. “However, this trend has reversed and now Hawaii has the highest infection rate in the United States.” Eshoo's criticisms and demands for transparency echoed those of U.S. Rep. Tulsi Gabbard, who last week called for the resignations of Hawaii Department of Health Director Bruce Anderson and Dr. Sarah Park, the state epidemiologist. “The crisis we face today is a direct result of our state's failed leadership,” Gabbard said in a press release that cited Eshoo’s letter. “Governor Ige and his team had months to hire, train and deploy a robust contact tracing team to prevent the very situation we face today.
  • 9. “Months ago we worked in Congress to deliver over $50 million in funding to the state so that they had the resources to trace, test, and contain future COVID-19 cases. Yet, we have around a dozen people doing contact tracing today, who are so overwhelmed that they can only reach a small number of individuals who have contracted COVID-19.” Gabbard blamed Ige and his staff for dropping the ball on contact tracing and testing and suggested the state's inaction led to the outbreak Hawaii is currently experiencing. “If Governor Ige and his team had done what they were supposed to do, we could have prevented the major outbreak we are experiencing today that has taken more lives and resulted in so many of our kupuna, families and keiki getting infected and sick,” she said in the statement. “This is a punch in the gut to Hawaii residents who have sacrificed so much to try to prevent the spread of this virus, only to see our state leaders failing the people.” Last week, in a joint press conference with a DOH whistleblower, Gabbard accused Anderson and Park of lying about the state's capacity to do contact tracing after Jennifer Smith, a Ph.D. virologist and case investigator for the Department of Health, came forward to say the department's lack of tracing capacity contributed to a recent surge in cases. After Smith last week said the department recently had only nine people doing contact tracing on Oahu, the department in a statement responded that it has about 100 for the state, and continues to add more. The statement did not respond directly to Gabbard’s statement that Anderson and Park lied. Asked about Eshoo's letter at a news conference on Wednesday, Ige said he had not had time to formulate a full response to the letter but said of the $50 million in CARES Act money, some $2.5 million was being used to train contact tracers from the University of Hawaii and $10 million to increase testing and surveillance capacity, including systems for data management and lab testing equipment. Although public health officials have shifted the blame onto the public for participating in gatherings that let the virus spread, it appears a lack of contact tracing contributed to Hawaii's recent surge in cases. For much of May, it appeared the state had all but eliminated the virus, as the weekly average of new cases hovered at less than two. The plan was to use extensive testing and tracing to keep the virus in clusters as the economy opened. As the state prepared to open the local economy in early June, Anderson rebuffed attempts to provide extra contact tracers and vowed the department would be able to “surge from within” to ramp up tracing capacity to trace and contain the expected surge in cases. But that didn't happen. And as Eshoo noted, “From early June through the end of July, your state’s cases more than tripled to 2,111 confirmed infections, and from July 31 through August 14, the state’s cases doubled and now stand at 5,042 positive cases.” Eshoo, whose committee has oversight over public health and quarantine among other health-related issues, wants detailed information from the Ige administration about the contact tracing program that has been in place since the COVID-19 outbreak was declared an emergency more than five months ago.
  • 10. She also wants to know how the state has used federal money aimed at the coronavirus response, including how much the state has received for testing and contact tracing and how much remains unspent. Eshoo also wants the state to provide a plan and timeline for bringing Hawaii's testing and tracing effort up to national standards. “Due to the numerous instances of conflicting and false information being released to the public by your Department of Health regarding the number of contact tracers employed and their capabilities, what specific actions will you take to restore the integrity of the Department of Health?” Eshoo asked. __________ CONGRESS SEEKS ANSWERS ABOUT HAWAII'S CONTACT TRACING, USE OF FEDERAL FUNDS - HAWAII'S SURGE IN COVID-19 CASES THIS MONTH IS RAISING QUESTIONS AT THE CONGRESS OF THE UNITED STATES. THE CHAIRWOMAN OF THE SUBCOMMITTEE OF HEALTH, U.S. REPRESENTATIVE ANNA ESHOO, WANTS ANSWERS KITV NEWS, AUGUST 19, 2020 <https://www.kitv.com/story/42518350/congress-seeks-answers-about-hawaiis-contact-tracing-use-of-federal-funds> Hawaii's surge in COVID-19 cases this month is raising questions at the Congress of the United States. The chairwoman of the Subcommittee of Health, U.S. Representative Anna Eshoo, wants answers. In a letter addressed to Governor David Ige, she says she is concerned over the coronavirus outbreak and the way Hawaii is handling contact tracing and testing. She includes questions to “bring greater clarity regarding these issues.” Eshoo questions the amount of contact tracers and exactly how much of the federal funds was used since receiving the grant in March. Hawaii received over $50 million from the CDC solely for the purpose of contact tracing, purchasing of COVID-19 tests, administration costs and other operations needed to stop the spread of the virus. Eshoo also wants a response to the Department of Health's whistle blower's allegations of reporting false information about active contact tracers. Eshoo requests the governor's complete response by August 28, along with “specific actions” to “restore the integrity of the Department of Health”. __________ U.S. HOUSE SUBCOMMITTEE CHAIR QUESTIONS GOVERNOR IGE ON CONTACT TRACING By Big Island Video News, AUGUST 19, 2020 <https://www.bigislandvideonews.com/2020/08/19/house-subcommittee-chair-questions-governor-ige-on-contact-tracing/> U.S. Congresswoman Tulsi Gabbard (D-Hawaii) says another Democratic member of the U.S. House – California Representative Anna Eshoo, who chairs the House Energy and Commerce Committee’' Subcomittee on Health – is “demanding answers and transparency from Governor David Ige about how federal funds designated for contact tracing and testing have been used in Hawaii.”
  • 11. Gabbard held a news conference last Friday, in which she criticized the Hawaii Department of Health for its response to the COVID-19 pandemic, and introduced a DOH employee whistleblower who revealed what is really going on with the State’s contact tracing effort. __________ MAYOR AGAIN WARNS OF COUNTY RESTRAINTS HOSPITAL COVID-19 CASES CLIMB TO 45 By Kehaulani Cerizo, The Maui News, AUGUST 20, 2020 <https://www.mauinews.com/news/local-news/2020/08/mayor-again-warns-of-county-restraints/> As Maui hit a single-day record for COVID-19 cases, Maui County Mayor Michael Victorino again warned that he will reinstate emergency restrictions if numbers don't improve — this time by Monday. “I'm going to say that unless this changes quite drastically quite quickly, rollback will start,” Victorino said during a news conference Wednesday afternoon. “And we're looking probably at announcing something no later than Monday.” Maui recorded a record 20 new cases Wednesday, according to state Department of Health officials. The state also recorded two more Oahu deaths related to COVID-19. All the while, cases at Maui's main hospital continued to creep up, with Maui Memorial Medical Center reporting 45 COVID-19 cases — 24 patients and 21 health care workers — on Wednesday, up from 36 on Tuesday. The hospital surge triggered mass testing of all patients, employees and providers. Tracy Dallarda, hospital spokeswoman, said Wednesday that the HOSPITAL SO FAR HAS PERFORMED 637 TESTS ON EMPLOYEES, with 602 negative results, 21 positive and 14 pending. “The purpose of this testing is to understand the prevalence of the virus in our hospital,” Dallarda said in a statement. “Because our patients, employees and providers are a direct reflection of our community, it will also provide a valuable estimate of viral incidence on Maui and help identify symptomatic and asymptomatic individuals and allow us to further isolate, quarantine and limit further transmission.” Dallarda has said the surge at the hospital is a reflection of spikes around the state and that many MMMC cases are community spread. Dr. Lorrin Pang, state Department of Health Maui District health officer, said at the news conference, that because the virus is prevalent throughout the community, it's difficult to tell whether MMMC health care workers contracted COVID-19 outside or inside of the hospital. When clusters have popped up on Maui, such as at a hot yoga class, a bachelor party or out-of-state travel for a funeral, officials make pleas to the public to change behavior, Pang added. “We say stop it, change things, don't travel so much,” he said. “But sometimes you can’t quite shut it down. You can't say shut down the hospital, you can't do that.” He discussed the importance of individual responsibility and prevention measures, such as physical distancing, wearing face masks and sanitizing.
  • 12. The Health Department reported that as of late Tuesday afternoon there were 16 people hospitalized at Maui Memorial with COVID-19. The hospitalization counts on other islands were 163 on Oahu, six on Hawaii island and two on Kauai. In light of triple-digit surges sweeping over Oahu for weeks, Gov. David Ige signed the City and County of Honolulu's “Act Now Honolulu” order Wednesday, which will restrict social indoor and outdoor gatherings to no larger than five people effective at 12:01 a.m. today. “We can only be successful when we each take personal responsibility . . . stay home, wash hands, wear masks,” Ige said during a state news conference. “We're focused on unstructured social gatherings, and the surge we’re seeing is because people let their guard down.” He said that the Neighbor Islands will remain in the “Act with Care” phase of reopening due to lower case counts. However, Victorino has cautioned for weeks that rollbacks may be coming if cases average double- digits over a consistent period of time. He upgraded his warning Wednesday, saying that he will decide over the next few days whether restrictions are coming. Asked by The Maui News what rollbacks he's considering, Victorino declined to lay out specifics but added that he is eyeing uncontrolled social gatherings, such as sporting activities with large families not wearing masks or social distancing. “I will say if you are in modem of gatherings where you have large groups of people that are coming together . . . these are the kind of things that make it really difficult to monitor,” he said. “These are areas I'm looking at first because these seem to be where many of the outbreaks have begun, in activities where people gather . . . they congregate, they are not wearing masks, and they're not physical distancing,” Victorino added. “Beaches? Beach parks? Who knows? “Those are areas that are rising to the top as far as priorities to be shut down.” MAUI HOSPITAL CONFIRMS TWO MORE COVID-19 CASES By Wendy Osher, Maui Now, AUGUST 21, 2020 <https://mauinow.com/2020/08/21/maui-hospital-confirms-two-more-covid-19-cases/> Maui Health identified two additional positive COVID-19 patients on Thursday, bringing the total number of infections at the facility since last week Thursday, Aug. 13, to 47. Total infections over the past eight days include 26 patients and 21 health care workers. Tracy Dallarda, Communications for Maui Health / Maui Memorial Medical Center said one- time testing of all patients, employees and providers continues. “As a reminder the purpose of this testing is to understand the prevalence of the virus in our hospital. Because our patients, employees, and providers are a direct reflection of our community, it will also provide a valuable estimate of viral incidence on Maui and help identify symptomatic and asymptomatic individuals and allow us to further isolate, quarantine, and limit further transmission,” said Dallarda. Hospital administrators have said the suspected source of infection are index cases of an employee and a patient, with both appearing to have come from the community. The newly reported cases since Aug. 13, 2020 are separate from an initial cluster reported earlier this year.
  • 13. During the first wave of infection, the cluster of individuals linked to the initial Maui Health outbreak totaled 52 including 38 health care workers and 14 patients who had tested positive, according to previous reports. That cluster was declared “closed” on May 19, 2020. The state has reported 236 new COVID-19 cases on Thursday including 230 on Oahu, one on Maui and five on Hawaii Island. More than 96% of the active cases statewide are on the island of Oahu. The death of a Lanai man was also reported yesterday by the state Department of Health. He was 40-59 years old with underlying health conditions, and had been hospitalized on Maui. So far there have been seven COVID-19 related deaths on Maui and 45 in the state over the course of the pandemic. Of the 263 cases in Maui County, at least 166 have been released from isolation, and 31 have required hospitalization. Based on Thursday's numbers, there are 90 active cases in Maui County. __________ 20 AT ROSELANI PLACE TEST POSITIVE HOSPITAL OUTBREAK GROWS TO 31 PATIENTS, 35 STAFF By Colleen Uechi, Assistant City Editor, The Maui News, AUGUST 25, 2020 <https://www.mauinews.com/news/local-news/2020/08/20-at-roselani-place-test-positive/> Eight residents and 12 staff have tested positive for COVID-19 at a senior independent and assisted living community that’s largely escaped the pandemic until now. The outbreak at Roselani Place in Kahului that began with a resident in the memory support area and three staffers had grown to 20 on Monday after a round of testing over the weekend. Karl Drucks of Paradigm Senior Living, the management company for Roselani Place, said that the first resident confirmed with the virus had been discharged from Maui Memorial Medical Center earlier this month. However, because of possible exposure from a family member, it was unclear where the resident had actually contracted the virus. Drucks explained that the resident had been admitted to Maui Memorial on JULY 28 for other medical issues. The patient tested negative upon admission to the hospital and was tested again on AUG. 12 and AUG. 14, both with negative results. On AUG. 15, the patient was discharged to Roselani Place. On AUG. 17, a nurse at Roselani Place was notified of possible exposure from the resident's son; the nurse and the general manager immediately contacted the state epidemiologist. After the resident's primary physician and family members were informed, the resident was immediately isolated in a private apartment at Roselani, with limited staff entry and recommendations to retest the resident every five to six days. On Wednesday, Maui Memorial informed Roselani's general manager that the resident may have been exposed as of AUG. 12. Contact tracing and testing found that three of the staff who had interacted with the resident had caught the virus. Roselani arranged for testing of remaining staff Sunday.
  • 14. Maui Health spokeswoman Tracy Dallarda said Monday that the patient who left Maui Memorial for Roselani did not have COVID while in the hospital and tested negative twice upon discharge, a requirement for placement at another care facility. The hospital outbreak had grown from 26 patients and 21 workers on Thursday to 31 patients and 35 workers on Monday; the 66 cases have now outpaced the first cluster in April that reached 57 at one point. Dallarda said that no new cases were reported Monday and that Maui Memorial was currently caring for 25 positive patients. Nearly 1,500 COVID-19 TESTS HAVE BEEN CONDUCTED ON MAUI HEALTH WORKERS since mass testing began AUG. 12. “Maui Health continues to conduct mass testing and our team of physicians, nurses and other leaders are committed to doing all we can to prevent viral spread for the health and safety of our patients, employees, providers and our community,” Dallarda said in a statement. __________ UNITED STATES DEPARTMENT OF JUSTICE DEPRIVATION OF RIGHTS UNDER COLOR OF LAW <https://www.justice.gov/crt/deprivation-rights-under-color-law> [Emphasis Supplied] SUMMARY: Section 242 of Title 18 makes it a crime for a person acting under color of any law to willfully deprive a person of a right or privilege protected by the Constitution or laws of the United States. For the purpose of Section 242, acts under “color of law” include acts not only done by federal, state, or local officials within their lawful authority, but also acts done beyond the bounds of that official's lawful authority, if the acts are done while the official is purporting to or pretending to act in the performance of his/her official duties. Persons acting under color of law within the meaning of this statute include police officers, prisons guards and other law enforcement officials, as well as judges, care providers in public health facilities, and others who are acting as public officials. It is not necessary that the crime be motivated by animus toward the race, color, religion, sex, handicap, familial status or national origin of the victim. The offense is punishable by a range of imprisonment up to a life term, or the death penalty, depending upon the circumstances of the crime, and the resulting injury, if any.