Issues & Advisories

Learn more and protect yourself

Coronavirus Disease 2019 (COVID-19)

Current Situation
Impact in Hawaii
What can I do?
Resources
Information for Clinicians

Last Updated on March 22, 2020

Current Situation

Novel Coronavirus in Hawaii COVID-19 Positive* Cases Cumulative totals as of 12:00 noon on March 22, 2020
Total (new)	56 (8)
County
Hawaii	3 (0)
Honolulu	41 (6)
Kauai	3 (0)
Maui	9 (2)

Required Hospitalization	3 (0)
Deaths	0 (0)
*includes presumptive and confirmed cases, and Hawaii and non-Hawaii residents; note that CDC provides case counts according to states of residence.

An outbreak of a new coronavirus disease in 2019 (COVID-19) that began in Wuhan, China has been developing since December 2019. This outbreak now includes hundreds of thousands of cases globally and has become widespread in a number of countries.

Update: As COVID-19 spreads globally and nationally, we are detecting cases introduced into our state by both visitors and residents alike, although >80% of our cases are among returning residents from mainland as well as international locations. At least one of the newly identified cases has no known travel or contact with travelers. This is the first indication of community spread of COVID-19 in Hawaii and highlights the importance of social distancing (i.e., maintaining at least 6 ft distance or 2 arm’s length, whichever is longer, from others). Social distancing can reduce the spread of disease and protect those who are most vulnerable in our community. If you get sick, please stay home—get rest, drink plenty of fluids, and get better. If you are older or have an underlying medical condition and become ill, call your doctor.

For an interactive tool with guidance on who should seek medical care, visit: CDC’s COVID-19 Self-Checker

Who should be tested?

Only certain people who are experiencing symptoms of COVID-19 need to be tested. Symptoms include:
- Fever
- Cough or Shortness of breath
Most people who are sick do NOT need to be tested, even if they may have been exposed to COVID-19
- There is no specific medicine to treat COVID-19
- The management of illness is the same whether you test negative or positive
Individuals who have symptoms of COVID-19 AND who are at higher risk for severe disease (older people, those with chronic medical conditions and immunosuppression) should call their usual healthcare provider who will help them determine whether they should be tested for COVID-19 and/or other respiratory infections, such as influenza. If you do not have a provider, call an urgent care or community clinic in your area.
Anyone having difficulty breathing should seek medical care immediately. If possible, call ahead to let your provider know about your symptoms.
People with mild illness who are young and healthy can help protect our most vulnerable community members and conserve precious medical resources by managing their illness at home, isolating from others, and calling a healthcare provider if their symptoms worsen or persist.
For an interactive tool with guidance on who should seek medical care, visit: CDC’s COVID-19 Self-Checker
For those who may be tested at a screening site, please contact the healthcare provider who ordered your test regarding your results as they are responsible for notifying you of your result and providing you guidance regarding your health. Please do not call the Department of Health as your information is not provided to us unless your results are positive.

The virus is primarily spread by prolonged close contact when respiratory droplets from an infected person pass to an uninfected person.

The symptoms of the disease can include fever, cough or shortness of breath.

There is no vaccine for the disease and no specific treatment besides supportive care.

The best way to prevent the disease from spreading is to practice good hygiene (e.g., washing your hands and covering your cough) and social distancing (i.e., reducing the potential for close contact between people who are sick and people who are healthy).

If you become ill with a fever AND cough or shortness of breath:

Stay home and avoid contact with others
If you think you may need medical care, try to call ahead to the doctor’s office or an emergency room and let them know about your symptoms
If you need immediate medical care, call 911
COVID-19 Home Care Guide (HDOH)

COVID-19 Frequently Asked Questions (FAQ)

If you prefer to speak to someone about COVID-19 you can call Aloha United Way at 2-1-1.

Trained operators are available from 7am – 10pm to answer all COVID-19 questions.

Cases in the US:

As of 9:00 AM, March 20, 2020 there have been 15,219 total cases detected in the U.S. This represents an increase of 4,777 cases from the previous day. There have been 201 deaths (increase of 51 in the past day).

Worldwide Cases:

The World Health Organization (WHO) has confirmed widespread community transmission of COVID-19 in a number of other countries and the situation is changing rapidly.

The Hawaii Department of Health (HDOH) is urging all residents to avoid travel to areas with a high burden of the disease especially if you are elderly or have underlying medical conditions.

If you are considering international travel, check CDC’s Travelers’ Health website for country-specific health information and alerts and the U.S. State Department Travel website for travel restrictions that may affect your itinerary.

Impact in Hawaii

Cases in Hawaii:

There have been 56 cases of COVID-19 identified in Hawaii. Of those 56 cases, 6% have been hospitalized, and over 80% were residents returning from other areas. There have been no deaths.

The Hawaii Department of Health (HDOH) is urging all residents to act now to prevent the spread of COVID-19 in our communities (see ‘What Can I Do?’, below).

HDOH is expanding existing statewide influenza surveillance to include testing for COVID-19 to identify cases of community spread of the new coronavirus. For more information see: COVID-19 Sentinel Surveillance.

Screening is being conducted at Daniel K. Inouye International Airport (HNL) by federal authorities to identify travelers from countries with restrictions that require quarantine or public health supervision.

Anyone arriving in Hawaii after having having traveled to areas with widespread sustained community transmission is being asked to stay home and monitor their health for 14 days from the time they left the affected area.

What can I do?

Protect yourself and your family from COVID-19 and other respiratory diseases.
Prepare for what to do if COVID-19 becomes widespread in our communities.

Protect – Following everyday preventive actions can prevent or slow down the spread of respiratory illness in the community:

Stay home if you start to feel ill
Wash your hands often

- Use soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
- If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.

Avoid touching your eyes, nose, and mouth
Avoid close contact with people who are sick
Cover your coughs and sneezes

- Use a tissue, then throw the tissue in the trash
- If you don’t have a tissue, use your elbow

Clean and disinfect

- Clean frequently touched objects and surfaces using a regular household
  cleaning spray or wipe.
Get the flu shot
- People with seasonal influenza will exhibit similar signs and symptoms as COVID-19 (fever and cough). If more people are protected against influenza, this will reduce confusion and the burden on our healthcare system.

Prepare – You can prepare now for the potential spread of COVID-19 in Hawaii:

Stock up on all prescription medications and other basic household items like food and cleaning products so you can care for yourself and your family at home if someone becomes ill. Supplies of these items may be affected in the event of a pandemic. Anyone who becomes ill and who is a household contact of someone who is ill should stay home and avoid social contact as much as possible.
Plan for the possibility of continued school closures, cancelled events and activities.
Consider talking to your employer about your organization’s strategies for preventing the spread of illness in the workplace (e.g., alternative scheduling, telecommuting, online meetings).
Practice social distancing measures like limiting your time spent around groups and avoiding unnecessary close contact with people (e.g., handshakes, aloha kiss).

If you are planning on traveling, you should stay informed of the latest travel alerts and information related to COVID-19 for the area you are traveling to.

CDC recommends that all persons should defer any travel on cruise ships worldwide because of the increased risk of COVID-19 transmission onboard ships.

Travelers from areas where there is confirmed widespread community transmission should:

Self-monitor their health for 14 days after they left that location
- Watch your health, and if you have a thermometer, take your temperature 2 times a day
Remain at home and practice social distancing
- Avoid large gatherings
- Maintain a distance of approximately 6 feet from others as much as possible

If you become ill with a fever (100.4°F/38°C or higher) or cough, and have recently left an area having widespread community transmission of COVID-19 or have had prolonged close contact with a person confirmed to have COVID-19:

Stay home and avoid contact with others except for seeking medical care.
If you need medical care, call ahead to your doctor’s office or an emergency room and let them know about your travel history. If you need emergent medical care, call 911.
If you have difficulty accessing medical care or have questions about how to care for yourself at home

What HDOH is doing

Vigilance and Monitoring

We are actively working to detect potential cases of COVID-19 as early as possible by monitoring our disease surveillance systems to identify persons that require investigation and testing and are reviewing internal protocols to ensure proper management of cases.
We are working with our federal airport partners (U.S. Customs and Border Protections and CDC’s Division of Global Migration and Quarantine) who are performing enhanced screening to identify travelers returning from China. Our disease investigation staff are actively monitoring these individuals with daily phone calls to record their temperature and confirm that they are avoiding contact with the public.
We are in constant communication with the CDC, public health partners in other jurisdictions, and our local legislators and state officials to ensure Hawaii is aware of new developments in the COVID-19 outbreak.
Over the past 15 years we have been developing and refining our respiratory disease surveillance systems following CDC guidelines. This system includes sentinel influenza-like illness surveillance sites, virologic surveillance, pneumonia and influenza associated mortality, and cluster/outbreak investigations. We are monitoring these systems on a daily basis looking for changes that might indicate the presence of COVID-19 in Hawaii.

Preparation and Prevention

We are working with the medical community to issue Medical Advisories and Alerts and to ensure that hospitals and providers are following infection control recommendations and are prepared to detect and treat any patient with symptoms and travel history consistent with COVID-19.
We are communicating regularly with our local partners in the travel industry and schools to address their concerns and ensure the latest and most accurate guidance and information are being shared with their staff (see Workplace Guidance and Guidance for Schools and Universities below).