HONOLULU – On the rural island of Kauai, Hawaii, where expansive white sand beaches and dramatic oceanfront mountains draw visitors from around the world, local residents have spent the first seven months of the pandemic in Shelter from the viral storm. Early and aggressive local measures coupled with a strictly enforced statewide travel quarantine kept Kauai’s 72,000 residents healthy – the island had only 61 known cases of the March coronavirus to September. But on October 15, the state launched a pre-trip testing program to jumpstart Hawaii’s decimated tourism economy: Kauai went from being infected with at least 84 new cases in seven weeks. The rise in power has sowed transmission in the community and led to the island’s first death – and so far only – from COVID-19: Ron Clark, who has worked for decades as a tour driver. Despite Hawaii’s cautious reopening efforts that allowed travelers who tested negative for COVID-19 before they flew to the state to bypass quarantine rules, the peak of Kauai illustrates the difficulty to preserve public health – even on an isolated island – when economic recovery relies on travel. Kauai officials have decided that the cost of a vacation in paradise, at the moment, is too high. Clark had COVID-19 in November and died about 10 days later. At 84, he worked until he contracted the disease and more recently he shuttled between airline pilots and airport crews. Airline crews are exempt from state testing and quarantine rules. The day after Clark died, officials in Kauai said they would withdraw from the state’s testing program and demand that visitors to be quarantined again for two weeks, whether or not they tested negative for COVID-19 before Kauai officials say the single testing system was not enough to protect the people who live there. With just nine intensive care beds and 14 ventilators, the island’s health system could quickly be overwhelmed by a major epidemic, Kauai Mayor Derek Kawakami said. Seeking to avoid such a scenario, Kawakami proposed a mandatory second test for all passengers after arrival. His plan reportedly included a short quarantine while people waited for their second result. “We believe that a negative test is a good prerequisite for getting on a plane,” Kawakami said. But “once you land in Kauai … (travelers) should be able to sit and cool off for three days.” But the proposal was rejected by state officials, with Democratic Gov. David Ige saying the plan should be local.After the Kauai outbreak, the State Department of Health traced most cases from October and November on the island to residents and returning tourists who introduced the virus despite pre-flight testing program JoAnn Yukimura, former mayor and Kauai friend of Ron Clark for more than three decades, said his death shook the community and that she constantly thinks “of him being alone in the hospital.” … How lonely it must have been to die. “Ron’s death may seem like such a small matter to strangers,” Yukimura said. But it “hit us hard because we in Kauai haven’t gotten used to death and disease – and we never want to come to this.” Before the pandemic, Hawaii was home to about 30,000 tourists daily who spent nearly $ 18 billion last year. In March, when the two-week quarantine rule was imposed by the state, tourist arrivals and incomes plummeted. The number of visitors has since increased with the screening program, but only to reach about a third of pre-pandemic levels. In Kauai, 57-year-old Edwin Pascua has been unemployed from his job as a hotel bellboy since March and worried about having contact with infected travelers – but prefers to work. “If there are safeguards in place, that would undermine everything,” he said. also be afraid. Pascua and his wife, who works at the same hotel, have made do with unemployment benefits, but he knows people who “haven’t even received a check, an unemployment check yet. Despite the new outbreak of infection and record-breaking deaths in the Americas, senior Hawaii officials believe the pre-trip testing program is working. “The proof is in the pudding,” Hawaii Lt. Gov. Josh Green said. “Hawaii has the lowest rate of COVID in the country as a result of this program right now.” Hawaii enjoys relatively low hospitalization and death rates, but health experts have said that because of the way COVID-19 builds up in the body over time, second tests for travelers would rule out no more infection. Kapono Chong-Hanssen, an indigenous Hawaiian doctor who runs a community health center in Kauai, said the single testing requirement “goes against medical evidence.” “We’re starting to see these big gaps in the plan and I think it’s a matter of. There have been over 380 travel-related infections in Hawaii since the screening program started, according to the Department of Health. ‘State. The actual number of infections in the general population is believed to be much higher than what has been reported. Many asymptomatic people, who can still spread the disease, do not get tested. Ashish Jha, dean of the school of public health at Brown University, said travel restrictions for most places at this stage of the pandemic are “either counterproductive or relatively unnecessary” and can give a false sense of security. International travel bans are helpful in slowing things down, ”Jha said. But “unless you completely seal your country and do it early on, it’s pretty hard to use it as a strategy. Kauai, isolated by the ocean and largely protected by the early When the original quarantine rule was in effect, Kauai residents went to restaurants, schools were open, and locals spent their money in the community. This could happen again with Kauai’s reinstatement of the quarantine rule as locals hoped the community will remain healthy. The trip “introduces a continuous stream of new infections,” said Dr Janet Berreman, head of the Kauai health department. “This tsunami, if you will, of disease,” she said, “crossed the continent from east to west. We are just a little further west across a body of water. But everyone wants to come here for the holidays. ——— Associated Press writer David Koenig in Dallas contributed to this report. .