It started with a little tickle at the back of her throat.
When she lost her sense of smell, this Hawaii Island woman had no doubt. She had COVID-19.
She wasn’t surprised, really. She’d been identified as a close contact in a workplace cluster.
She knew she had it, but convincing the state Department of Health was another matter entirely.
The first obstacle was the length of time between when she took her test on a Tuesday and when the results came back the following Sunday. She was in touch with DOH from the onset of her symptoms, but the department contact tracer wouldn’t verify her contacts because she didn’t have test results, the woman said.
“His response was you haven’t tested positive yet,” she said. “I ended up talking to everybody I could remember I had contact with just as a precaution.”
Then when she did get her positive results, the contact tracer took the names only of those in her household. The department had her workplace contacts because of the cluster it was investigating, but her contact tracer never took down the names of the other people she’d been in close contact with, she said.
“They’re not having that conversation,” she said. “They’re not doing contact tracing.”
A Hawaii Island man, unrelated and miles away, had a similar experience. His results came in two days after his test, but he also found the Health Department less than responsive.
“I called DOH a few times and nobody got back to me,” he said. “I was a little bit disgruntled with the guy.”
West Hawaii Today tried to reach the state for a response. Representatives from the Health Department and the state COVID-19 Joint Information Center didn’t return phone calls and emails on Wednesday, Thursday or Friday.
But county Mayor Harry Kim said a newly created central command post should help enhance communication and make sure people don’t fall through the cracks.
The command center, located at Aunty Sally Kaleohano’s Luau Hale in Hilo, will hold staff from state and county agencies to coordinate public education, enforcement, contact tracing, monitoring of incoming passengers, quarantine/isolation facilities, hospitalization and care facilities.
The county has added 15 travel quarantine trackers on contract to keep tabs on what’s expected to become an increase in travelers as Hawaii’s economy begins to reopen. That group was the first getting settled into the new command post Thursday.
Those trackers are different from the ones hired by the state Department of Health to trace the close contacts of people who test positive for COVID-19. The Health Department told a legislative committee in early August there were 18 tracers on Hawaii Island, but a department whistleblower told the media at an Aug. 14 news conference there were fewer than 10 across all the neighbor islands.
It’s not known if the numbers have changed since then. Kim said the county assigned two members of the police department to the state’s contact tracing team when it seemed the department needed the help.
“They were told point blank from Day 1, ‘Yours is such an important task; you’ll have what you need,’” Kim said Thursday. “They’re given the responsibility for the whole island. They’re just trying to do their jobs and this facility will help them do their job, help all of us do our jobs.”
Fear and uncertainty
Both COVID-19 survivors had just finished their quarantine period when West Hawaii Today spoke with them by phone Wednesday. They’d also been interviewed the prior Friday. Their coronavirus cases were mild, both said.
Their symptoms seemed to progress through phases, they said. But their loss of taste and smell seemed to stick with them longest. Other symptoms were headaches, fatigue, mental fogginess, body aches and difficulty breathing.
Some, but not all, family members in their households also tested positive, they said.
The fear and uncertainty was the hardest part, they said. Most people who contract COVID-19 experience mild flu symptoms that clear up in two or three weeks, but others, especially older people with preexisting conditions, contract pneumonia and can die.
Scientists still haven’t pinpointed what people should expect based on their own preexisting conditions.
Nationally, about 5.5% of coronavirus tests came back positive during the last week of August, according to the Centers for Disease Control and Prevention. Hawaii’s seven-day positive case rate is currently 3.3%, the Health Department said in a press release Thursday.
About 3% of those contracting COVID-19 in the United States die, according to data analyzed by the Johns Hopkins University Coronavirus Resource Center.
“I kept waiting for the worst day and then it doesn’t happen,” the woman said. “For the most part, it wasn’t terrible. But recovery is much longer than you think. You don’t want to get it.”
Families in limbo
The two survivors expressed concern with how the isolation and quarantine periods were factored and what it meant for others in their homes. Once the woman tested positive, her 10-day isolation was counted back to when she first experienced symptoms, as was the man’s.
But members of their households who tested negative couldn’t end their own quarantine period until 14 days after the last positive member of the household had completed their 10-day quarantine. That left the woman’s husband out of work for more than a month, she said.
“You could potentially have an entire family in quarantine for months,” she said. “You almost wish for a positive test.”
Advice from caseworkers about distancing in the households by using separate bathrooms and sleeping apart arn’t always feasible, they said.
Subsidized hotel rooms to help separate the families may not have been available at the time, Kim said. He said the county has since contracted with hotels or houses on both sides of the island to help separate families.
“We’ve really grown with the Department of Health,” Kim said. “We grew as we learned.”
Both survivors were less angry during the second interviews after the intervening days, but both remained concerned.
The stigma of COVID
West Hawaii Today is keeping the names of the two individuals confidential. Both are people known to the newspaper and the communities they serve.
The woman said she would share her name publicly but she didn’t want to expose her co-workers unnecessarily.
“You isolate in your room. There’s so much guilt, so much shame, so much stigma around it,” she said, recounting a conversation she had with a co-worker who said, ‘I don’t want to go back to work with this big ‘C’ on my back.’”
The uncertainty, the stigma, the cost of the test and the possibility of losing work may make people less likely to be tested, the two residents said. They said the government hasn’t really communicated a clear message and, lacking information, people are driven by fear.
“It’s cooties times a thousand,” the man said, describing how friends and acquaintances reacted to him once he came out of quarantine.
The two had plenty of advice for the public and government agencies, based on their own experiences.
“Government needs to start communicating about resources — here’s a mental health hot-line, here’s some breathing exercises, here’s how you get groceries,” the woman said. “What they’re doing, they’re promoting fear.”
Free testing is definitely a step in the right direction, both said. But even better, said the man, would be a rapid-response test that people could self-administer. A half-hour turnaround time, even if the test isn’t as accurate, is better than the four to five days it took his wife to get her test results, he said.
“The whole thing definitely needs some refining. People could be administering their own test and get ahead of the curve,” he said. “I think basically people want to do the right thing.”