Update on COVID-19 case investigations

Risk Factors

• Yesterday, there were 158 adult cases and 16 children. Today, there are 129 adult cases and 5 children. Child cases are household contacts of adult cases, indicating the virus is spreading within households.
• Based on the information available today for today’s new cases, 105 cases were exposed by community spread, 23 are unknown sources, and 7 cases have a travel-related exposure, which means they likely obtained the disease while outside of the state or their county of residence.
• Of all cases since March, 93% are Hawaii residents and 2% are non-residents from other states or countries, information is pending for 5%.
• Investigations/contact tracing are continuing to identify cases connected to gatherings or “hanging out with close friends” or co-workers. There are also cases of residents who traveled recently or hosted out of state visitors. One of the three cases on Hawai‘i Island has a history of travel to O‘ahu.

On Maui, there are small clusters arising from activity at a construction site. In another cluster, five Maui residents held a party on O‘ahu; one case from the party attended another gathering while ill/symptomatic and nine cases were later associated with this party (5 primary, 4 secondary). In another cluster, a healthcare facility has 13 positive staff and 11 positive patients.

In Honolulu, many cases are new and unassociated with other known positive cases.

• 27 pending residence location
• 0 nonresidents
• 53 in Honolulu and at least 10 in Ewa Beach with smaller numbers scattered in other areas of the island.

Honolulu Clusters

In Honolulu over the past month:

• Circuit gym cluster—4 cases; report of inconsistent masking; investigation ongoing
• Preschool cluster in one bubble—teacher (index case; associated with previously confirmed cases in the teacher’s household) and 3 students.
• Health plan offices—at least 31 cases; investigation ongoing
• Homeless shelter—20 cases; quarantine implemented facility-wide; investigation ongoing
• 5 distinct restaurant clusters, each involving multiple employees at a single location; no transmission to customers identified.
• City & County office—11 cases; located on 2 floors, potluck gatherings mentioned by employees being investigated as potential transmission source
• Strip club worker with potential exposures to coworkers and clientele; clarification of place of work pending.
• Oahu Community Correctional Center—287 cases; facility areas in lockdown; additional facility-wide testing continues, conditions challenging.
• Automotive cleaning and detailing service location—16 cases; investigation ongoing
• 3 fire stations—10 confirmed cases in firefighters; investigation ongoing.
• Large funeral cluster—75 confirmed cases linked to a series of funeral events.
• Bar clusters involving at least 5 people and 2 bars, Brix & Bones and Arena 808 (period of concern, July 16–26); possibly up to 7 cases downstream of this cluster
• Construction company—10 cases; investigation ongoing

High-Risk Situations

Based on information gathered from disease investigations and contact tracing, the following circumstances are increasing the likelihood of community spread because of inconsistent mask use and inconsistent physical distancing protocols:

Multiple household and other clusters associated with social interactions—e.g., house parties, beach parties/gatherings, birthday parties, Father’s day and Fourth of July gatherings, religious functions, mahjong, spectating a boxing fight (several instances of gathering at a person’s home to watch), co-workers sitting in prolonged (~2hr) meeting and removing masks to drink water, co-workers eating lunch together without distancing, retail establishments, warehouse and delivery personnel, funeral events (multiple gatherings, visitations, etc. without adhering to safe practices), meeting for drinks/socializing at bars (still), and retirement celebrations. These events occurred with inconsistent mask use and inconsistent physical distancing.

COVID-19 Cases in Long Term Care Facilities and Community Care Homes in Hawa‘i

(March 1 – present)

Facility Type	No. facilities w/cases reported	Total Cases	Patients	Healthcare Personnel	Other (visitors, noncaregiver household members)	Hospitalized	Died
Skilled Nursing Facility*	14	58	27	31	0	17	1
Community Care Foster Family Home	7	20	7	6	7	7	2
Adult Residential Care Home	4	11	6	4	1	2	3
Developmental Disability Residential Setting	2	3	0	3	0	1	0
Assisted Living Facility	1	2	1	1	0	0	0
TOTAL	28	94	41	45	8	27	6

*Includes combined skilled nursing and assisted living facility.

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PDF: Update on COVID-19 Case Investigations