Good morning welcome to this new edition of Community Connection on Facebook Live I'm Governor David Egan and we're here in my conference room. I know that there has been many many changes that have come to our community and our life as we know it as a result of this covered 19 pandemic and we know that there are many questions in our community and we really wanted to focus. Today's Community Connection program on on coded 19. I'm joined by someone that is probably very familiar with with most of you Doctor Sarah Park is the Department of Health. she's the state epidemiologist and she has been working with our health care community understanding the data that we see we have been focused on being data driven in a lot of different. Trying to take the prudent actions that we know will help us fight this virus throughout the discussion we certainly would welcome the questions that you have we know that there are many things that that have been going through the community and we've we've received many questions at the governor's office. I know that Sarah has has. Some had many questions so I just wanted to start maybe by the current update on the the cases and activities to this point. Yeah. I would say I don't have the exact numbers on me right now, but I would say to the public and to everyone out there you can always look at our website. we update the numbers and we if you look right now. as of this past week provided some new sort of visualize sort of visualizations of our data in the form of a map. something we call an epidemic curve and you know, stay tuned. We'll be providing some more visual. Of the data to help people understand and partners understand what's going on and that that data is updated every day by noon. so you know, check it out but as of now I think it's fair to say that we do see increases in numbers of cases continue to see those increases majority of the cases. The vast majority are still travel Associated. I think it'll still be a little time before we see that drop off as a result of your 14 day quarantine or. Yeah, 14 Day quarantine orders but you know we also do still see some evidence now of localized community transmission. So I think it's really important to that. everyone does their part in our community and practice good social distancing measures as well as the usual hygiene measures that we've always recommended you know and I have been telling people everyone that I talk with or meet with that. Certainly we can only be successful if every. Takes their responsibility you know we the whole notion of social distancing is really stopping the spread of the virus and we do believe that the primary way that the virus is transmitted is person to person through the air correct so definitely that something that we continue to encourage everyone. you know I've gotten to the point of saying that everybody should assume that their code positive and really keep their distance they. Wanna infect anyone, especially people that they care about right? you know and I think that especially for the through the end of April, which with the mandatory 14 day, quarantine and other actions, the stay-at-home orders statewide as well as different things that the counties are implementing certainly I believe will help us get through this pandemic. I wanted to get to a couple of questions from our view. those in Facebook Jessica has asked when do you think the state will peak in the number of cases and I know that I get asked that question all the time. Yeah, you know it's it's not unlike the question I always get asked during flu season, you know regular times. I'm always asked by me and others you know when do I think I'll see we'll see flu season peaks or of activity peak and I'm always saying, let me look at my crystal ball. You know, I know that they're. I'm sure if you look on the Internet, various areas a lot of different experts. if you will and universities organizations are trying to predict with their modeling and and I would just say they're huge cobia read their methods for how they use their how they develop their models. because of the fact that you know it those those parameters they use for their models really directs you know what you actually see in terms of curve, so some are a little bit more skewed. You know, obvious, dramatic drastic effects and others or certain rescue towards maybe a little less dramatic and you know some of them are predicated on the model is based on China's conditions, which are not the US or European conditions. Others are predicated other things. so in short, basically models are useful for planning purposes for leadership and such, but you always have to take those models with a grain of salt and in the end, it really is down to the community. All of us, you know the governor, our leaders enact certain orders for us to to hopefully help encourage the social distancing. But in the end, it's our community that really needs to practice that and how well we all each individually practice that social distancing will really determine not just in Hawaii, but everywhere will really determine where we see that peak actually happen and how high that peak will really be. so I know it's not a specific answer, but but it is it is the. Answer Really, If you think about it I and I just wanted to make one comment and I know that it certainly seems like the last few days. The number of cases have really jumped and I just wanted to let the public and keep them informed you know at the beginning only the state lab could do the test in House in the Commercial Labs award taking the samples, but they were being sent to the mainland so they definitely was a lag in the state receiving. The results all of the private labs now are able to do the testing locally. so we do so I do think the last few days with the The huge jumps were ketchup because there were a lot of samples taken that were sent to the lab. so we got in the course of three or four days, probably two weeks worth of samples. many that went to the lab. so I think on a going forward basis that the next few days would be what the normal Case comes partly true, Yeah and I should just let you know that in all of you know that the clinical commercial Labs is the governor said, are able to test locally right now, but they do have us a limit to their capacity right so some tests are still going out of state. so we'll continue to see that lag for some results and so we will so you know a lot of people are looking at the jump as oh my God. they're new cases right now, but really, the reality is that there's there's reports. Legs So some of those cases are more recent in the last day but some of those cases really their illness on sets where weak even 10 days ago or even further back and that's when they were actually tested and so there is that leg and and it really underscores that you know when you get tested understand that the reason why your physician decide you got you should get tested is because you're sick and you know you need to stay home and that that really helps all of us in the community and that why. Waiting for your test result, please stay at home. Please keep your germs to yourself help to you know hopefully I see help us through the end of all of this. if we can make sure that there is no illness infection being transmitted that that really is the name of the game at this point. Yeah. Thanks thanks Derek for joining us. how are you tracking those in self cointelpro? South South Korea used an app? I can think I think I can take. Question you know when we had instituted the 14 -day mandatory cointelpro, we started from nothing so we are in the process. the the quarantine registration was a manual process. We had formed. We have people to to fill them out. we verify that the information their ID as they came off and then we entered it into a database that allowed us to follow up with them. we are getting very close. To launching a new website that will ask those who are travelling to fill in that form on the on the in the cloud and we will be generating an automating a lot of the follow up with those in quarantine to make sure that that they are in quarantine and then that they are following the rules and then we do anticipate developing an app that we would be implementing. Kind of a follow on to the website so we definitely know that we want to be able to follow up and ensure that those visitors as well as residents who are travelling into island that they are following the mandatory self-quarantine in their residence for in a place of lodging. then we're working with all of the County police departments to ensure enforcement and I just want to note. is is it from the department of health that case investigation and currently in relation to win lost on people is really true related to identifying and always and not still is the and has to be done in person so we can we make contact we documented interview with people we do have A very personal sort of monitoring system and that we are making personal contact with those as you can imagine that is very labor intensive. We are exploring right now the use of potentially other apps in such to support that. However, it doesn't negate the need to have that. so your personal contact with individuals that are in quarantine or isolate and especially isolation for the reason of actually being infected or potentially definitely confirmed as. Having exposed to have been exposed to the disease, so that's very different process than the process around the trailers right and I just saw Thanks Darrell for joining us he he wanted to ask you about. you know how the Department defines close contact and then how do you determine if you have a code positive who needs to be tested who's screened maybe who you would ask to be isolated. So in terms of how we do, I think you're asking really about how do we identify contacts for contact tracing and things like this. So the first thing is when we. Identify a confirmed case. We're talking with them about all their activities. We're asking them first of course, Can you list all your contacts all the persons you've interacted with and say the last week or so right before your illness started okay but in addition to that, we're asking them what their activities are because some people may not remember all their interactions and so each one of those things that they tell us about. we're tracking back and when we identify someone through that list or through activities as potentially being contac. Of a confirmed case, we're asking them okay. What was the nature of your interaction where you face to face talking to each other? Was it more than 30 minutes? Do you remember the person coughing or sneezing on you? Those are really pertinent questions because based on the answers that then drives how we categorize that interaction are you a high-risk individual? Are you a medium risk? individual? Are you a lower no risk individual high risk to give you an example, as usually gonna be some with one with intimate contact household contact. or health care worker who had who is examining the person without any protective gear, which hopefully is not happening in this, you know in this current stage. those are high-risk medium would more be like someone who did have sort of could be still household, but maybe it's a roommate. so you're not really talking to you know, maybe you're not really close and you're just passing and in passing with each other, you have separate rooms and things like that or you're sitting on the plane next to the person that could be a medium risk contract. low risk is. You may have had a 10 -minute interaction. There was no coughing or sneezing, and but there was a 10 -minute interaction the medium and the high risk or the individuals that we generally definitely the highest need to be in quarantine and and we monitor them along with them and then the medium wrist are really we say self monitoring in at home and and then the low and no risk is really just you know be aware of your symptoms and such in especially no risk. It's just no worries. Basically, you know it could have been In passing you hear an announcement that someone was in some area and you think oh my gosh I I was in that area. That's probably a no risk if you don't even remember if we don't contact you and we know you don't remember an interaction with someone who's ill. So so the question of is about I've heard that someone in my workplace is called positive. So you know what kinds of interactions in that setting would be something that would be an obviously. I know that you guys are going in and contact tracing but right you know. I work at the Bank and it was announced at the Bank had a positive thought who would in that environment need to be concerned so again, usually obviously we would have identified and working with the Bank manager in terms of identifying what the occupation what the responsibilities of the person would have been in the Bank and you know who they might have interacted with and especially talking with that individual to know who did you actually have face to face conversations with with with regard to your. Your work colleagues who do you interact with on a daily regular basis on a constant basis, you know day in day out those individuals we might categorize as medium risk and you know I doubt honestly in a work situation. you're gonna be in a high-risk situation. unless you someone tells us know this person definitely cough right in my face, you know that that would be a different situation than so again. you can see that that you know, it's really crucial to have that interview with each people each person that. A person identifies the manager identifies for us to really categorize and determine how we need to follow that person what we need to do with that person for everyone else who's working in the Bank is just being aware so you probably would be categorized as you would be categorized in that low risk setting because you didn't likely have that close interaction, but you were in that same space on a daily basis and so it's just monitoring yourself and being aware and letting your you know physician know that. If you do get sick that someone in your workplace had been diagnosed with Covid- 19 and then therefore your physician knows and says okay, based on your symptoms, your hair history. Maybe you need to be tested or based on your symptoms know this is something else or you know various things, but really remembering to to let your physician know about your exposures. That's really helpful for for them. Yeah. thank you so if someone if I know that someone at my workplace was And I haven't been contacted by the Department of Health. You're probably low risk. Yeah like I said We work with the Bank manager or the manager for a workplace and we would advise them and then they could advise the rest of the employees. Okay. Thank you. Megan Thanks for joining us. the question is when will we have access to the 40 - five -minute tests and I will let you know what I know I mean we were on a call with the President and vice President when they announced that Abbott Laboratories Had had. Develop this test a point of care test where they could get a a result in 20 minutes or so they had informed us that every state would be receiving some of these Abbi machines that would allow us to to do a very quick test but we continue to work with the federal government to find out exactly when the the equipment. Will be provided understand what the requirements that staffing requirements training requirements might be and you know and then we'll be thinking about how we would deploy those units. No yeah. I'm glad to to feel that question about the testing. I think it's really important for the public to understand for all of us understand there are many many organizations businesses out there internationally that are peddling from frankly, a lot of different tests and I would. To make sure everyone understands there's there are distinctions right now and I'm just gonna start with the blood test. They're out there just to put that off to the side and just address that quickly. There are numerous blood tests that are being offered and they're generally speaking a what we call an antibody test. These antibody tests are not recommended not useful for what we call in the acute diagnosis period is your antibodies. If you think about for any disease it takes a while. Before you develop antibodies detectable antibodies, your body is starting to make them when you get infected, but to have detectable antibodies, it could be anywhere from like 10 even 20 days before there's detectable antibodies. So right there, I'm sure you can all realize to do a blood test and that interval that early time, which when you're most likely to see your doctor or or have symptoms, I mean, if you're gonna have a negative test, that's not very helpful on top of that. you have antibodies that will stick around for could be months could be years We don't. Even know how long so you get the test and it's positive and then you're left with the weight is this from past infection or exposure or what is this so not very useful right now, plus a lot all these tests. None of them have been validated by the US food and Drug Administration. there are no standards that have been set so bottom line is if you hear about a blood test do not get sold on. you know if someone trying to say that hey, I've got a quick 10 -minute tub. For you or whatever, yeah, those are not the same so great. Thank you for joining us they they he had asked whether we could use a blood test so that people could get back to work. Yeah not not for general use at this time. They are definitely the CDC and others reputable institutions are working on developing reliable and what we call Serologist assets and a body asset tests, but that's coming. It's not here yet and it's unfortunately I I would hope it's a simple blood print in blood. Of a finger pet fricke, but it's probably gonna be a blood draw. so it's not as easy as that so but stay tuned and wait until you hear from us that there's something on that front and even then it's probably not gonna be useful as a clearance for work. Plus you're talking about a health care worker but it's probably gonna be more useful in terms of trying to take care of the burden of disease in any community after the fact, but back to the Abbott test that test is still requires. I hate to inform people people like thinking it's a finger prick or whatever. Still, that swab that goes to the back of your nose potentially it could be a swab in the front of your nose, but again it has to be performed by someone who is trained. it the that test kit. It's a machine. Yay. big my understanding it you know it sounds like it could be in a doctor's office, but that's technical specs require for it to sit in a what what are our lab directors said a medium or a high complexity lab so basically one of our clinic. Commercial labs or state lab and such and so that's the other thing. These tests are not for high-proof put that means you cannot just you know, I can't do a whole bunch of tests all at once. It's one at a time. So where we're looking on using these test deploying these tests right now is really for you know high purity like a health care worker. we have a suspicion they might have it and we need an answer right now because it could affect the health care worker staff and the patients in the whole unit and maybe in a long-term care facility. So we need to answer very quickly to be able to address you know what do we do next could be with a first responder or it could be someone who's really sick and we just need an answer so that the physicians taking care of the person need it need to know what you know we have that sort of knowledge that then they can make the next determination about care. so those are just examples how this test could be very useful to us. Yeah well, thank you for explaining that because I do get a lot of questions around in and around the same thing so Thanks for asking Megan and Greg Roman Thank you for joining us. he's seen other countries and cities having crews clean and disinfect streets and building spring crews and trucks going through and disinfecting the general areas and do you envision that occurring here or I guess what would the conditions that would recommend? That happen, I don't know that we would necessarily recommend that you know the environment itself. UV light our son is I think everyone here in Hawaii. We all know how powerful our son is just an end of itself. I mean things to create and break apart just by sitting in the Sun. So imagine a pathogen out there and that you've exposed to our son or UV light here in Hawaii, you know that ended itself is a great cleanse or if you will it's when things are in the dark that might you know not. So great, I might be sanitized so to speak, but in terms of you know environmental sanitation, I think for all of us really, it's to keep in mind that in our local environment, whether it's a workplace or home or whatever it's more important to consider cleaning frequently you know high touch what we call a high-touch frequency areas so the tables you know like you know, I'm putting my hands on the table, you know or your keyboard a phone you know. A door door knobs, Those are things you know, think about making sure those things are cleaned on a regular basis. I think a lot of us tend to not think about cleaning those things and then sort of get to that. when we do spring cleaning and stuff and it really, I think it's more a matter of our all of us in our community. thinking about you know making sure that in our own environment that things are kept clean on a regular basis and then washing your hands, you know even if we're to deploy these crews. There which I honestly think, is not a good use. right now of our of our resources we we still have responsibly wash our hands. You know because crew can come right through and then someone sick comes right after them coughs on something you come in touch the traffic lights stop liver and then and then you you've Justin forgot infected If you just follow behind someone else and you know it's the cleaning crew could have been there half an hour ago so it to my point wash your hands. Mindful of what when you touch your hands, make sure your hands are clean when you touch your. I mean touch your face I mean and yeah, I think that's the most important thing. Yeah. Miss Smith, who are thank you for joining us on National News just said it might take months to get stimulus checks. What what are people with no income supposed to do you know we are working very hard for those of you who have been employed. you know we're working to get unemployment insurance benefit checks out as as quickly as. Can would like to encourage you if you're worried about rent payments or mortgage payments? the landlords that I've talked with all recognized that this is a once in a lifetime disruption of our entire way that we live and so I certainly would encourage you to talk with your landlord and ask for help also would like to remind people if if they need help to call. 11, You know we are staffing. I know that seven days a week now that if you call 211, they are in connect, they are connected to many nonprofits and others social groups that can provide assistance and I know that the federal government is working as quickly as they can to make those payments to the individuals who will receive them as quickly as you can. So certainly, but I want to encourage you if if you need assistance to call 211, I'm Melissa Thank you for joining us this morning her question a panel just presented info to the White House that the virus may be spreading through just breathing and stays in the air for up to three hours. how does this work with the the six -foot social distancing that you have been suggesting Yeah. I'm not familiar yet with the panel presentation I'm just a little bit skeptical about that. it is a respiratory pathogen. We know that it's a respiratory droplets. Whether you know how does it behave more like measles which is a true airborne pathogen that you know can be in a fine particulate particles that can stay floating in the air so to speak. that's still you know again day more data is required for that. if that were the case honestly, I would have expected, we would see a lot. Transmission even here in Hawaii among our community or in terms of the known cases again, remember back from the early part of our conversation, talking about our contact tracing. we're monitoring individuals, especially those individuals and households and you know we've actually not really seen a lot of transmission even among the households, except for intimate very intimate contacts. so really speaks to that that I am very skeptical of that sort of presentation, maybe in a pretty. condition where someone somehow air stylized the virus for certain period of time, maybe we know that innovation and a health care worker setting could put some put health care workers ups such risk. But in terms of regular everyday, we're not seeing evidence at least in in the investigations that we're doing so again a little skeptical about that. I think it is important, maintaining that six feet the six feet by the way of people do not know where that. From is various studies in the past looking at how much lung power we generate to expels or respiratory droplets when we cough or sneeze, it's not you know when you talk, you're not generally gonna be expelling respiratory droplets that far. But if someone were to cough or sneeze, we have enough lung power from previous data to actually expell little droplets as far as six feet away. So that's where that six feet is actually coming from. So if someone's not coughing or sneezing, you're probably really. Good being six feet away when someone's coughing or sneezing definitely wanna keep that six feet distance or make sure they're wearing a mask. you know the mask another Frank Thank you for joining us. He. he just said the question would you consider a mandatory use of mask in public? Yeah. I know that the article about the aerosol talks about masks. so maybe so you might wanna master an interesting question. There's. I I will say there's a lot of conversation among my colleagues with CDC experts around the Mass because you know we're noting the cultural differences and wearing Mass or not wearing mask, but they're today. there are no data to show that for an individual not in a health care worker setting. But in an individual out in the public setting to wear a mask for individual protection, it's not been shown to actually provide that protection. If anything we look at Mass as source control which. Means that if you're sick and and I was just saying to some of the staff here before we start my natural instinct when I see someone wearing a mask is to shy away from that person because I look at his own, you're sick. Yeah, I I gotta keep my distance from you. So if I see someone wearing a mask to me, I'm thinking they're infected. I don't wanna be near them. You know that's my natural instinct. you know for the other thing around wearing mask is that if you're not used to wearing a mask You know it is a very natural inclination for all of us to start touching our face and so a real concern on our part that someone starts wearing a mask that you start to just eat without thinking about you. start adjusting that mess you, you tend to touch your face a lot more and that's more than likely to encourage you to get contaminated in such so in terms of mandatory, I would really hesitate on that. if it were mandatory, it would be more of a supplement as I've commented supplemented. to social distancing in the regard that well, then maybe it will help people who are not keeping their germs to themselves to help. you help the rest of us from keeping being exposed to their germs. That's how I look at that sure and and Frank, I just would want you to know that we still are having trouble with a personal protective equipment in general right and so clearly kind of a mandate that would require everyone in White to our mask would really. The shortage so and you know just from my perspective that certainly the other half of that you know to have a mandatory requirement and when we know that we are having trouble getting personal protective equipment, especially for our health care workers would really I I would have a big concern about India. Thank you for joining us University of Washington Health Metrics States for the worst-case scenario for Hawaii hospital. Impacts will begin May third have you seen this or are we ready? I think again it all goes back to considering different models and and their inputs. What are they using as input into their models? What are the parameters that particular model? my understanding is that they are predicating that we have a effect so to speak that that the types of the severity of cases the the speed of progression, the deaths that occurred in that they're basically. Applying it to us, we're not so that's my number one number two is there are a lot of measures that our governor and the mayors have all put into effect that weren't existing in so that changes the game. so we have to take it with a grain of salt. so we don't know is that really May third is it really gonna be early? Is it never gonna really get to that level because we are we're acting you know right now again. It also depends on the community in terms of effects in the hospitals, Yes, there are effects in that the hospitals. Our you know zealously guarding their PPE is governor just talked about there is a lot of concern about the shortage of PPE and so we really that is a definite effect. in terms of I think people think about ventilators and such you know it's not just about. do we have enough ventilators or rooms for people. It's also about do we have enough health care workers staff so I would say that our health care partners out there and and the the Health Care Association of Hawaii there. our hospital coalition are really really working on the. hard on this issue along with the lieutenant governor to really try and address very very much, you know what you know how we can prevent that effect of that that concern that is being brought up by the models. Yeah and certainly India I have looked personally at that model and one big factor that they don't acknowledge is that we've put in place extreme travel limitation, no other state in the country and countries have you know they've shutdown trap. In and out of China, for example, but no other state has put in lace a mandatory self corn teen 14 days and I do believe that that would dramatically impact the curve and so you know I just wanted to let you know and and we actually are working with University of Washington to see if they can reflect the the. Distancing actions that we put in place, they recognize some stay-at-home order. they recognize a closing of a bars and restaurants and those big gatherings. so the model does include some of those things, but it doesn't include the most important one. I think from our perspective that would change the curve so you know I think we're at the end of our time just really wanted to thank all of you who have sent messages the next Community Connection on Facebook Live is scheduled for Thursday April ninth at 9:30 AM wanted to thank Doctor Sarah Park just really wanted to remind all of you. If you need assistance, please call 211. they have a whole directory of those who can provide assistance for a variety of needs. we continue to receive contributions from those in our community who want to help just a reminder that you can send us an Email at Coco. Sorry, Coldwell Cocoa at Hawaii dot Gov. If you have on things that you would like to share with our community or if you want to volunteer please send us an Email really wanna thank all of you for joining us and just remind everyone that we can only be successful. If we work together all of us need to take a responsibility I've gotten into act. As if I am positive and keeping distance so that I don't have the possibility of infecting anyone. I would certainly encourage each of you to do the same. you know you should limit your social activities. you should can go to work if if you're able to tell a working from home is even better but certainly practice social distancing and everything you do. I I know and we have always as a community come together under crisis and I am inspired. To see so many heating the warnings staying at home and most importantly coming together as a community to help our neighbors in need and others. If you are able so thank you so much for everything that you do. we can be covered 19. if we work together, Aloha Aloha.