Coronavirus Disease 2019 (COVID-19)

Last Updated on February 22, 2020

Current Situation

Image Credit: CDC

An outbreak of a new coronavirus disease in 2019 (COVID-19) in Wuhan City, Hubei Province, China has been developing since December 2019. This outbreak now includes thousands of infections in China with confirmed cases also in a number of other countries, including the United States (15 cases total in Arizona, California, Illinois, Massachusetts, Texas, Washington and Wisconsin). Twelve of the cases identified in the United States had recently traveled to Wuhan, China, one had recently traveled to China and had contact with a COVID-19 case while there, and two became ill after prolonged close contact with a known case in the same household.

On February 14th, HDOH was informed by CDC that a traveler from Japan was hospitalized and tested positive for COVID-19 after visiting Hawaii. The traveler’s wife also became symptomatic after returning to Japan and tested positive for COVID-19. The travelers visited Maui from January 28 to February 3, and Oahu from February 3 to February 6, 2020. After extensive investigation by HDOH, no one has been identified as having had close contact with the travelers and subsequently becoming ill. HDOH continues to monitor closely for any potential concerns related to this situation.

On February 22, 2020 the Centers for Disease Control and Prevention (CDC) issued a Level 2 (Alert) Travel Notice for Japan and South Korea due to sustained community transmission of COVID-19. Because they may be at higher risk for severe illness, the alert recommends older adults and individuals with chronic medical conditions consider postponing nonessential travel to these locations. A Level 1 (Watch) Travel Notice for Hong Kong was issued on February 19, 2020,  indicating that people should “practice usual precautions” when traveling to Hong Kong and emphasizing the importance of these precautions to prevent illness while traveling. These include avoiding contact with sick people, avoiding touching your eyes, nose and mouth with unwashed hands, and cleaning your hands often by washing them with soap and water for at least 20 seconds. Anyone with plans to travel internationally should stay apprised of the latest Traveler’s Health Recommendations for their specific destination, as this is an evolving situation.

Additionally, the U.S. Department of State has recommended that U.S. citizens reconsider travel by cruise ship to or within East Asia and the Asia-Pacific Region.  This is a dynamic situation and people traveling by ship may be impacted by travel restrictions affecting their itineraries or ability to disembark, or may be subject to quarantine procedures implemented by the local authorities.  All U.S. citizens should evaluate the risks associated with choosing to remain in an area that may be subject to quarantine and take the appropriate proactive measures (U.S Department of State China Travel Advisory).

After February 2, 2020, foreign nationals who have been in China in the past 14 days are barred from entering the United States. U.S. citizens, residents, and their immediate family with travel to China in the past 14 days are permitted to enter, but must undergo special screening and may be subject to quarantine for up to 14 days (White House proclamation). Also on February 2, 2020, the U.S. Department of State issued a level 4 travel advisory for all of China, recommending against any travel to China because of the COVID-19 outbreak (U.S Department of State China Travel Advisory).

Note: On February 11, 2020 the World Health Organization announced COVID-19 as the official name for the disease that is causing the novel coronavirus outbreak. We are updating our website and other materials to reflect the official name.

Impact in Hawaii

There have been no reported cases in Hawaii, and the Hawaii Department of Health (HDOH) continues to monitor the situation closely.

All flights from China to the United States are being funneled through 11 airports, including the Daniel K. Inouye International Airport (HNL). However, as of February 2, 2020, there are no longer any flights to Hawaii from China scheduled. Screening is being conducted at HNL by federal authorities, and any passengers identified as having travel history to Hubei Province, China in the past 14 days will be placed in mandatory quarantine until 14 days since they left the province. Travelers that have been to other areas of China in the past 14 days will be allowed to travel to their home or final destination and will be asked to monitor their health at home with public health supervision.

Additionally, the U.S. Coast Guard will deny entry to the U.S any passenger vessels carrying passengers that have been to mainland China (which excludes Hong Kong, Taiwan, and Macau) within the past 14 days. Non-passenger commercial vessels that have been to, or have crew that have been to, mainland China, with no sick crew members will be allowed entry to the U.S., but crew must remain aboard the vessel (U.S. Coast Guard bulletin).

What HDOH is doing

  • At this time, there are no persons requiring investigation for potential COVID-19 infection in Hawaii; we are monitoring existing disease surveillance systems and reviewing response protocols with relevant in-state partners.
  • We are collaborating and frequently communicating with CDC and state public health partners to closely monitor the situation and ensure Hawaii is prepared should a person potentially exposed or infected with COVID-19 be identified in Hawaii.
  • We are working with healthcare facilities to ensure hospitals and healthcare providers are up to date on infection control recommendations in the event they encounter a person potentially infected with COVID-19.
  • We are communicating regularly with travel partners, public and private, to ensure the latest CDC guidance and information is being shared with all relevant personnel.
  • We have been conducting illness surveillance of international travelers at the Daniel K. Inouye International Airport since October 2005 and continue to work with our airport partners on ongoing, regular surveillance.

What can I do?

The best way to prevent transmission of any respiratory illness (including flu) is to follow everyday preventive actions:

  • Get your flu shot. With current seasonal influenza activity, it is likely there will be confusion as persons with influenza will exhibit similar signs and symptoms such as fever and cough. We strongly recommend residents 6 months and older protect themselves against flu by receiving the seasonal influenza vaccination.
  • Wash your hands often with 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 with unwashed hands.
  • Avoid close contact with people who are sick.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces using a regular household
    cleaning spray or wipe.

Travelers from China entering Hawaii on or after February 3, 2020, including children, students, and workers, should stay home from school, work, and public gatherings and monitor their health for 14 days after leaving China:

  • During this time, you should stay home and avoid group settings, including work and school.
  • Have another family member/friend, who didn’t travel from China, run necessary errands for you, such as picking up food or medicine.
  • Avoid using public transportation, taxis, or ride-shares.
  • Watch your health, and if you have a thermometer, take your temperature 2 times a day.

If you left China less than 14 days ago (regardless of the date you entered Hawaii) and feel sick with fever (100.4°F/38°C or higher)  or cough, you should:

  • Stay home and avoid contact with others except for seeking medical care.
  • Call HDOH (at (808) 586-4586) for advice before seeking care. If you can’t reach HDOH, call ahead before going to a doctor’s office or emergency room. Tell them your symptoms and that you were in China.
  • If you have trouble breathing or need emergent medical care, seek medical care immediately or call 911. If possible, call ahead to tell your healthcare provider about your symptoms and that you were in China.

HDOH is monitoring the situation carefully and and is continually updating this guidance to communicate any changes as they develop.

 

If you have general questions about COVID-19, you can call Aloha United Way at 211 (dial 2-1-1)

Resources

(Note: If the “updated date” on a loaded PDF does not match the date on the links below, try refreshing the PDF  [by pressing Ctrl+F5, or clicking the refresh button while holding the Ctrl key] )

 

For more information, and for the most up-to-date information, visit CDC’s website.

For general questions about COVID-19, you can call Aloha United Way at 211 (dial 2-1-1)

Information for Clinicians

If you have a patient with symptoms and travel history consistent with this outbreak, contact the Hawaii Department of Health, Disease Outbreak Control Division at (808) 586-4586.

For more information, see our updates for clinicians page.