Should you travel to Hawaii during its COVID surge? Here’s what an ethicist says – SF Gate

September traditionally marks the start of Hawaii’s “shoulder” season, when the number of visitors dips as mainland and local families send their children back to school. It’s a time of warm weather, low airfares and tourist-enticing events such as the Aloha Festivals, set to begin its 75th anniversary with a Royal Court investiture in Waikiki on Sept. 18. 

But with coronavirus cases and hospitalizations surging to record levels across the state, many in the islands are questioning the ethics of traveling there now. While Gov. David Ige has simply asked visitors and residents to postpone nonessential travel, others point to the decisive action of a real-life royal, Queen Liliuokalani.
  
This Labor Day weekend would normally have seen hundreds of domestic and international competitors, and thousands of supporters and spectators in Kailua-Kona for the world’s largest outrigger canoe competition, the Queen Liliuokalani Canoe Race, founded in 1972. But in the spirit of the race’s namesake, whose birthday is Sept. 2, the organizers first limited the event to paddlers from Hawaii Island, and then recently canceled it altogether.

“Queen Liliuokalani witnessed many illnesses and several pandemics in her time and always put her people first, ensuring their resiliency and survival,” according to the Aug. 11. statement from Kai Opua Canoe Club, which specifically recalled the steps the monarch took to limit the spread of smallpox while she was serving as regent in 1881. 

As regent, Liliuokalani “summoned her cabinet and made the decision to shut down Oahu, stopping inter-island travel, prohibiting vessels from taking on any passengers, and quarantining the sick. These regulations were so strictly enforced that when they were raised, no cases outside of the area where the sickness first appeared were reported,” the statement noted.

Barbara Koenig, a medical anthropologist and registered nurse who recently retired as a professor and director of the UCSF Bioethics Program, notes that the ethics of travel depend on “who is making the decision and about what.”

For example, the government has to balance the health benefits of a total lockdown with the impact on a tourism-dependent economy. “If no one can eat and no one can work, then it doesn’t matter if you close down the economy,” she noted. 

“The other groups of decision makers are all those people who are making individual choices to fly to particular areas,” Koenig said. “They should definitely not go to an area with no hospital or ICU beds, because if they get sick, they’re going to burden the system further.”

Koenig said she had considered traveling to Hawaii this summer, because “I’d been in the San Francisco fog all summer, and it’s been hard not seeing the sun or having warmth. … But when everyone pointed out to me Hawaii is a place you shouldn’t go right now, I took it off my list.”

On the other hand, some travel may be justified despite the risk to the health system, Koenig said, such as that of a friend who lives in Northern California but flies one week a month to take care of her nearly 100-year-old mother. “That’s someone who has a justifiable reason to go and take the additional burden of risk,” Koenig said. “She’s not just going to surf and lie on the beach.”

While Hawaii currently allows visitors to avoid a mandatory 10-day quarantine by showing proof of full vaccination or a negative COVID test from specific providers within 72 hours of arrival, unvaccinated travelers should not come to Hawaii for ethical and medical reasons, according to Koenig.

 “I certainly don’t think you should fly to Hawaii if you’re unvaccinated,” Koenig said. “If you’re going to make the island safe, you’re going to need to do that. That’s not an ethical analysis, it’s just the facts on the ground. … For the benefit of going to Hawaii, you have the obligation of getting vaccinated. If you don’t want to, you can go other places.”

Besides the ethical and health incentive, residents and visitors to Oahu will have another reason to be vaccinated starting Sept. 13, when the city and county of Honolulu’s Safe Access Oahu program begins. Employees and patrons of restaurants, bars, museums and movie theaters who are 12 and older will be required to show proof of vaccination or a negative COVID test taken within 48 hours. 

The Kahala Hotel & Resort announced Thursday that it will go one step further, requiring all employees — not just those in its food and beverage outlets — to be vaccinated by Sept. 30, or undergo weekly testing if approved for medical or religious exemption. 

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