Senator Dela Cruz asks Governor to consider pooled testing for arriving travelers

Hawai‘i State Senator Donovan Dela Cruz, Chair of the Ways and Means Committee and Special Committee on COVID-19, sent a letter to Governor David Ige encouraging the state to consider pooled testing of incoming travelers to Hawai‘i to mitigate the spread of COVID-19.

Pooled testing would allow the state to test more travelers using fewer tests, and allow for testing of presymtomatic and asymptomatic patients who do not have a fever at their time of arrival.

“I am hoping that as we keep the screening and quarantine in place, that the state would also develop alternatives to the quarantine in ensuring the health and safety of our community,” Chair Dela Cruz wrote. “Alternatives may include government authorized travel bubbles, taking tests upon arrival, and others that still need to be identified and researched. ‘Pool testing’ may be a consideration.”

Pooled testing is recommended by Dr. Darragh O’Carroll, an experienced emergency medicine physician at Kuakini Medical Center. Chair Dela Cruz included a letter from Dr. O’Carroll explaining pooled testing.

“Samples from up to thirty individuals are pooled and tested together in a single tube using sensitive molecular biological detection methods,” wrote Dr. O’Carroll. “Only if the pool result is positive do the samples need to be tested individually. When the infection rate is low and only a few people are infected, pool testing can significantly expand the testing capacity of existing laboratory infrastructure.”

“This new testing approach would further ensure that we can increase our capacity to test all travelers in a cost-effective way,” Chair Dela Cruz wrote. He recommended that the Hawai‘i Department of Health purchase an additional 3,000 to 5,000 tests to be administered daily to visitors.

Dr. Carroll explained the need to test visitors who do not have symptoms:

“New understanding from studies conducted by the CDC shows 40 percent of disease transmission occurs prior to symptom onset, in which infected individuals are unknowingly contagious prior to developing typical symptoms such as fever, sore throat, cough or pneumonia, collectively known as presymptomatic. This research also shows that the coronavirus can be spread three days prior to an individual becoming sick, with viral loads even peaking before symptoms begin. Furthermore, up to one third of individuals will never develop any symptoms, but remain contagious for some time, collectively known as asymptomatic. It is crucial that these presymptomatic and asymptomatic patients are identified, as this allows for the early prevention of infection hotspots, and will lead to isolation of infected individuals.

“An article in Scientific American also details how the pooled testing approach effectively identifies presymptomatic and asymptomatic carriers, and can accomplish it in large numbers in order to meet the high demand for screening. Sans a vaccine, the pooled testing approach ‘is trying to do more with the same number of tests.’”


Letter from Chair Dela Cruz

Letter from Dr. Darrah Cormac O’Carroll MD