Here is What Hawaii Can Study From Travel Quarantines In Different States

In March, as New York City became the epicenter of the nation’s emerging COVID-19 outbreak, many residents fled.

Some went to Rhode Island fearful the virus could follow.

Rhode Island State Police and National Guard forces put New York license plates on drivers to remind them to be in quarantine for 14 days.

Travelers arriving at Honolulu’s Daniel K. Inouye International Airport will sign the papers agreeing to the state’s mandatory 14-day quarantine order.

Claire Caulfield / Civil Beat

This misguided strategy quickly came under fire.

This is because, according to many legal experts, people are treated differently depending on where they live is unconstitutional.

The Rhode Island Police Error is one of many shaky beginnings and stumbling blocks by government officials struggling to design COVID-19 travel quarantine orders that are science-based, fair, and effective.

A total of 18 states and the District of Columbia require at least some arriving travelers to be quarantined for 14 days upon arrival. However, experts say that many of these guidelines have obvious design flaws.

“If a state wants to implement any kind of travel ban or quarantine, and it does so in a way that is effective, rather than doing it for shows – and we’ve had a lot of pandemic appearances – then it really has to be based on clear and transparent criteria said Wendy Parmet, a public health attorney based in Boston.

“Unfortunately, many measures across the country did not have such clear criteria and there have been many changes and exceptions that undermine them.”

However, many experts say Hawaii has a unique quarantine due to its geographic isolation, relatively small population, and the fact that most travelers cannot move between counties in the state without passing through a government-regulated checkpoint at a major airport can carry out port.

The problem with quarantine exceptions

In the absence of national quarantine rules, a patchwork of radically different state and regional policies has emerged.

There are No statewide travel restrictions in Illinois, However, a 14-day quarantine is required for many travelers coming to Chicago.

All travelers to New Jersey from states with a COVID-19 positivity rate of 10% or greater must be quarantined. However, this rule does not apply to people who spend less than 24 hours in the state.

Residents of New York, New Jersey, and Connecticut are exempt from each other’s quarantine rules because people who live in the tri-state of New York typically live and work in different states.

When a government exempts large populations from quarantine policies based on their place of residence, the effectiveness of that public health tool deteriorates, argues Parmet.

“The fact that metropolitan areas are integrated across national borders condemns their quarantines and travel bans to be more performative than real,” she said.

Brian Higgins, associate professor at John Jay College of Criminal Justice in New York, said exemptions make it difficult to enforce quarantine orders.

This is in part why the former New Jersey Police Chief advocates enforcement through education.

He supports Vermont’s method of relying on voluntary quarantine compliance. Instead of arrests or fines Vermont Police Quarantine Violations for Rule and Reasons why.

“Enforcement is good when someone is breaking quarantine,” Higgins said. “But this is really an opportunity for police-community relations. There are simply too many people on the move for anyone to conduct effective enforcement. “

Unlike most states, Hawaii’s quarantine could work

If a state could implement an effective quarantine policy, many experts say it is Hawaii.

“For a place like Hawaii, it’s much easier to actually screen people and control movement in and out of the state than it is for a place like California, which borders several states and has several large airports connected to several international ones Cities, ”said Christopher Kindell, a postdoctoral fellow at the University of Chicago who is writing a book on the history of infectious diseases in the Pacific.

“It’s also easier to track the movement of people and infectious disease transmission in Hawaii because travel between islands requires transportation, which is often state regulated,” he said.

Hundreds of passengers arrive and wait in line with Governor Ige in the foreground during the press conference.  Incoming passengers will be screened if testing is required prior to travel to avoid the 14-day quarantine for travelers.  Tests are only accepted from trusted test and travel partners.  October 15, 2020

Hundreds of arriving aircraft passengers wait in line for the public health screening at Daniel K. Inouye International Airport in Honolulu, where Governor David Ige held a press conference on the launch of the state pre-travel testing program on Oct.15.

Cory Lum / Civil Beat

New Zealand is an example of a government that has managed to turn its island status to its enormous advantage. However, the country’s success in containing the coronavirus is only partly due to its quarantine order, which requires travelers to book a government-monitored quarantine hotel room and isolate there for 14 days upon arrival.

An equally important component is New Zealand’s robust indoor testing strategy, which helps officials predict an outbreak before it explodes.

But even a well-designed quarantine can be dangerous, warns Parmet.

Here’s what health officials say when the virus first entered Lanai in October.

With the community appearing to have little or no risk of contracting the virus, some residents relaxed compliance with social distancing guidelines.

When the virus finally found its way, it ignited a dangerous group of more than 100 cases within a few days.

“I think this is actually the same problem that the United States as a whole faced with the travel ban to China,” Parmet said. “It was an illusion that it was protecting us – and it wasn’t. You didn’t realize that a terrible outbreak was forming on the east coast because you weren’t looking for it. And you didn’t look for it because you banned travel from China. “

Lessons from the quarantine island

Experts say it is difficult to generate a public buy-in for quarantine policies when the consequences of such a quarantine can be so severe: loss of income, family separation, extreme boredom.

“Every public health official today understands that quarantine and isolation are scary and people don’t like to be told to practice these things,” Kindell said. “And they know from generations of experience that the quarantine can go sideways very quickly.”

Hawaii has a colorful history as a disease checkpoint in the Pacific, dating back to the late 19th century, when quarantine rules and enforcement were far more draconian than they are today.

In 1868 the first trans-Pacific steamship between California and Hawaii arrived in Honolulu, ushering in a new era of travel and a new pipeline for infectious diseases: a case of smallpox was reported on board this first steamship.

Honolulu has a long history as a disease checkpoint in the Pacific. This 1880 map shows the quarantine island, now known as Sand Island, at the entrance to Honolulu Harbor. The man-made island was built in 1868 to quarantine ship passengers believed to be carrying contagious diseases.

Hawaii State Archives

This led to the creation of Quarantine Island, a small man-made island at the entrance to Honolulu Harbor.

This quarantine station, now known as Sand Island, is the place where public health officials confiscated people believed to be infected with a communicable disease until the early 20th century.

As a result, Oahu people commonly hid from government officials during an outbreak if they had symptoms of a disease that was classified as eligible for quarantine.

Infected Hawaiian residents were sometimes kept in isolation on the island for many months, according to Kindell. There have been a few cases where patients tried to swim back to Honolulu and were dejected, he said.

“We have seen over the past 200 years, especially in Hawaii, that it has been extraordinarily difficult to convince and encourage people to actually isolate and quarantine them when they are suspected of having a particular disease could, “said Kindell.

“While public health officials can come up with a good plan,” he said, “it only works if the public is willing to work together.”


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