State leaders in Hawaii, reluctant to implement a two-test COVID-19 policy on visitors, are facing pressure to increase testing of visitors to the islands.
The news comes as Hawaii deals with a record surge of new infections, hospitalization and deaths due to the virus, as well as federal guidelines change to require negative virus tests from both vaccinated and unvaccinated people coming to the U.S.
Dr. Darragh O'Carroll, an emergency and disaster physician in Honolulu, told USA Today that using just one test to prevent spread among tens of thousands of daily visitors is akin to using a chain link fence to keep out mosquitos.
"There are a lot of holes," O'Carroll said. "The science has been fairly conclusive since probably June of 2020 that a single-test system was no more effective than 30 to 40 percent in catching a population of infected people."
Just two weeks ago, Hawaii introduced a new digital health pass for vaccinations.
Even with a single pre-flight test for unvaccinated travelers, experts say infected passengers can easily slip through the cracks.
New federal rules announced Monday require all foreign travelers flying to the U.S. to demonstrate proof of vaccination before boarding, as well as proof of a negative COVID-19 test. Unvaccinated American citizens will need to be tested within a day before returning to the U.S., as well as after they arrive home.
As USA Today noted, Hawaii lifted its quarantine and testing requirements for vaccinated travelers in July. A month later, the state was in the throes of a record surge of delta variant cases that were filling hospitals and leaving more people dead than at any other time in the pandemic.
Before July, Hawaii reported a seven-day average of 46 daily cases. In the first week of September, that number was up to nearly 900. Case rates have slowly begun to decline since, but experts say it's unclear if that will hold.
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