(BIVN) – There were 50 newly reported cases of COVID-19 in the State of Hawaiʻi on Thursday. Of that number, only one (1) case was identified on the Big Island.

The Hawaiʻi Department of Health says there have been 33 cases of COVID-19 reported on Hawaiʻi island in the past 14 days.

Hawaiʻi County has seen an average 0.4% test positivity rate over the last 14 days, with an average of only three new cases per day.

From the Hawaiʻi County Civil Defense:

The Hawaii Department of Health reports one (1) new case of Coronavirus with two (2) people hospitalized on Hawaii Island. There have been no deaths reported in the last eight weeks.

Thanks to your efforts, Hawaii County has maintained low case numbers for several weeks. According to data from the Department of Health, nearly 2/3 of the most vulnerable population, our Kupuna, has received at least one dose of the vaccine. As we await for the vaccine to be more readily available to everyone, we ask that you continue to follow the preventative policies of wearing face coverings, maintaining distance, and keeping our gatherings to no more than 10 persons.

The Department of Health continues to coordinate vaccination points of distribution around the island. Medical facilities and pharmacies on Hawaii Island are offering vaccine registration to individuals who are 75 and older. For a list of all the facilities providing vaccinations visit the Civil Defense website.

Civil Defense: hawaiicounty.gov

To date, the State of Hawaiʻi says 326,766 cumulative doses of COVID-19 vaccine have been administered; an increase of 8,224 from the previous day.

Best Practices on Managing Clusters

From the Hawai’i Department of Health on Wednesday:

The Centers for Disease Control and Prevention (CDC) provides guidance that has helped Hawai‘i to effectively respond to the COVID-19 pandemic. This week, Hawai‘i returns the favor to the CDC by providing lessons learned from last year’s cluster traced to three fitness centers highlighted in a scientific paper published today in the CDC’s Morbidity and Mortality Weekly Report (MMWR).

The investigation was performed by a team led by Dr. Sarah Kemble, acting state epidemiologist, who served as the principal investigator and lead researcher, for a paper titled, “Community Transmission of SARS-CoV-2 at Three Fitness Facilities — Hawai‘i, June–July 2020.”

“This publication is an acknowledgement of the caliber of work being done at the Hawai‘i Department of Health,” said Health Director Dr. Elizabeth Char. “As a result of the diligent work of Dr. Kemble and her staff on follow-up contact tracing and testing, we’ve been able to see patterns to gain more insight into transmission. This has helped us develop more effective guidance and requirements in our state, and it’s an honor to have the opportunity to contribute to the collective body of knowledge for other states to use.”

The paper chronicles how an asymptomatic fitness instructor initially transmitted the virus to participants in a high-intensity stationary cycle class in late June 2020. Another instructor who attended one of the classes, in turn, unknowingly transmitted the virus to participants during personal training sessions and kick-boxing lessons at another fitness center before the onset of symptoms. The second instructor tested positive and was later hospitalized and required intensive care. A third gym, where the first instructor taught a class more than 2 days prior to symptom onset, was also investigated, but no transmission was observed.

Altogether, more than 30 participants tested positive for COVID-19. However, the report notes the number may have been much higher as the number of participants infected with virus who were asymptomatic may not have been tested or participants might have underreported symptoms or refused testing.

At the time of the outbreak, face masks were not required in fitness centers. However, as a result of work done by the Department of Health, Honolulu City and County amended emergency orders on July 22, 2020, to require that all persons wear face coverings (i.e., nonmedical masks) in fitness facilities, including during exercise. Wearing a well-fitting mask is important whenever around people who do not live with you. For more information, see CDC’s guidance for wearing masks.

Dr. Kemble and her team shared other key findings in the paper:

• The rate of transmission was highest on the day of symptom onset for both instructors, which is consistent with findings from a previous study;
• Transmission was likely facilitated by extended close contact, poor room ventilation, and not wearing face masks. Transmission occurred despite spin cycles being spaced at least six feet apart; and
• Shouting throughout the one-hour cycle class might have contributed to transmission as aerosol emission during speech has been correlated with loudness and COVID-19 outbreaks related to intense physical activity and singing have been previously reported.

According to the DOH, the paper noted this COVID-19 cluster occurred when community transmission was low (daily average of two to three cases per 100,000). To reduce SARS-CoV-2 transmission in fitness facilities, the paper offered the following recommendations:

• It is important that everyone wear a mask even during high intensity activities;
• Facilities should combine engineering and administrative controls, including improving ventilation;
• Enforce consistent and correct mask use and physical distancing (maintaining at least six feet of distance between all persons, limiting physical contact, class size, and crowded spaces);
• Increase opportunities for hand hygiene;
• Remind patrons and staff members to stay home when ill; and
• Conducting exercise activities entirely outdoors or virtually could further reduce transmission risk.