On guard?


POSTED: Wednesday, May 20, 2009

We're in a war with a nasty virus, the swine flu, but look out for other viruses that may be popping their head up in the near future. As in all wars, every theater or front requires a different strategy.

Hawaii, an island state, is completely different from the mainland with its large land mass that includes over 6,000 miles of border with Canada and Mexico. Therefore, we require a different strategy than what the Centers for Disease Control is recommending. What we should be doing is learning from and emulating what other island states/nations are doing—like Australia, Japan and Hong Kong, who are taking aggressive, proactive screening measures at their points of entry.

Unfortunately, Hawaii is not following the successful example of these island nations. Instead, our leaders have chosen to follow a “;passive”; surveillance program at our domestic and international points of entry. What this means is that if airline personnel see obvious flu-like symptoms, they report it to the state health authorities at the airport.

The flaws in this passive surveillance protocol are clear.

What we should be doing is exactly what other island states are successfully doing by stepping up our vigilance at our entry points. This would include: 1) Prior to landing, flight attendants would announce that if anyone has symptoms, to notify them or someone at the terminal. Additionally, information sheets and health declaration questionnaires would be distributed at the same time as customs/agriculture forms. 2) After landing, quick, non-invasive temperature readings would be taken. It's quick and efficient and takes less than a few seconds per passenger.

The price tag for implementing these procedures would be minimal compared to what a pandemic in Hawaii would cost—and that's not even taking into account the cost in human suffering. Visitors will greatly appreciate these precautions because it will give them confidence that Hawaii is doing everything it possibly can to protect the health of their families. Residents will also feel more confident in our leadership.

Comparing our tourist industry, the lifeblood of Hawaii's economy, with other island states/countries tells an interesting story. Our visitors numbered 7.4 million in 2007, while Japan had 8.35 million. In 2006, Hong Kong had 25.25 million and Australia had 5.5 million visitors. If these island states are able to efficiently and effectively process the millions of visitors they have every year, then Hawaii is certainly capable of doing the same.

If the state plans to follow a policy of containment for swine flu victims and their families to prevent them from spreading the virus to the wider community, then this policy will be complemented by the aggressive screening at the ports that I am advocating. If, however, the state plans to have a containment policy for people already in the state, but continue to leave the ports of entry relatively wide open, then it will be impossible for the state's containment strategy to succeed. After all, there will be little value in trying to contain local outbreaks of swine flu or any other virus if an endless number of new cases are allowed to enter. The only way that the state's present policy at the airports and seaports can be considered logical or consistent would be if the state does not plan to contain potential local outbreaks. In other words, if the state plans to treat the swine flu or other potential deadly pandemics in the same way that they treat the seasonal flu, then their passive strategy at the ports makes sense.

So our leadership needs to make clear to the public which strategy they are following. Are they following a special strategy of containment in connection with the swine flu or other potentially pandemic viruses, or are they going to take the laissez-faire strategy that we follow with the common cold and seasonal flus?

Our governor and her administration should open up an honest discussion about this issue. Let's consider the reasonableness of the strategies—namely should we be following the example of island states in a similar situation to our own, or should we be blindly following the CDC strategy for the mainland even though we are in completely different circumstances?

Currently, there are 30 confirmed cases of the virus on Oahu. Now that Hawaii has officially joined the growing number of states with swine flu, we need to apply every known strategy to prevent further introduction and spread. Like on any battlefield, we can do our best fighting to ward off the enemy when we are using all available defenses and when we have strong leadership, willing to take aggressive action to win the war.

SARS and the swine flu are just the first of many health crises that our people will be facing in the near future. We should always hope for the best and prepare for the worst. Whether the public health threat of swine flu continues to grow or if it declines and ultimately fades away, we should have an ironclad process in place that is tailored to the uniqueness of Hawaii as an island state so we are ready to go to war when the next enemy virus heads our way.

Sen. Mike Gabbard (D, Waikele-Makakilo-Kapolei) is chairman of the Senate Energy and Environment Committee.