Pandemic travel: What can we learn from Hawaii's COVID-19 testing protocols?

While it had remained closed to visitors throughout much of 2020, Hawaii reopened to tourists in October. Given that tourism is the top moneymaking industry in the 50th state, reopening quickly—but safely—is crucial for businesses of all sizes on every island.

Over the past few months, Hawaii’s state government has imposed entry and quarantine rules that are strict compared with those of other U.S. states; its geographical advantage as an archipelago hasn’t proved to be an especially effective barrier against the virus, with resurgences more akin to those seen in Ireland or Iceland versus near-perfect textbook examples of controlling the virus as seen in New Zealand, Singapore, and South Korea.

Nevertheless, Hawaii set up a detailed program this fall that has some travel industry experts suggesting it could serve as a blueprint for reopening international travel, even as approved vaccines start to roll out in the coming months.

“Given the size of our country and rapidly growing infection rate, other countries are very concerned about Americans traveling abroad. Several countries have implemented programs similar to Hawaii’s, requiring a valid PCR test prior to arrival,” says Jason Feldman, cofounder and CEO of Vault Health, which provides mail-in, saliva-based tests (versus a nasal swab) for at-home use with videoconference supervision to ensure the test is taken properly. “Most airlines have done remarkable work to make travel safer, especially with more flights available over the holidays [when] more people will be traveling. Testing before, and after, arrival is smart to keep yourself and others safe.”

Lanai, the secluded 90,000-acre Hawaiian paradise, has become a popular destination for travelers seeking luxury experiences during the holidays.

And so far, travel industry experts don’t see the stricter requirements as deterrents, but rather just the opposite.

“These rules are very specific, and knowing the state is being so cautious with entry makes travelers feel more comfortable. We know the requirements can also be challenging for travelers,” says Misty Belles, a managing director at luxury travel firm Virtuoso. “For example, having to time their COVID test right before their departure; travelers are taking advantage of airlines that are offering preflight testing. Hawaii is so dependent on tourism—they know if they get this wrong and COVID spreads through the islands, it will take years for it to come back.”

The hope, and the intent, is that Hawaii serves as a blueprint for other parts of the world, Belles says. “We heard about the possibility of travel bubbles and travel corridors early on, but nothing has materialized at this point. If Hawaii gets it right, international destinations could replicate this model, opening up both corporate and leisure travel that is so important to driving economies.”

The key, she continues, is ensuring rigorous standards are maintained at both the entry and exit points. “We can’t have one set of protocols at one destination, with another set of protocols at another destination. Success is dependent upon the cooperation between both countries for this to work.”

Vault Health is working with Infinity BiologiX and Spectrum Solutions to offer at-home saliva testing for the coronavirus.

All international and domestic transpacific travelers to Hawaii are required to submit a negative COVID-19 test taken within the previous 72 hours to avoid a mandatory 14-day quarantine. (The notable exception is for travelers visiting the island of Kauai, which, as of Dec. 2, is requiring a 14-day quarantine for all visitors—with or without a COVID test.)

However, visitors cannot take just any COVID-19 test. Rather, Hawaii requires a nucleic acid amplification test (NAAT) from a certified CLIA (Clinical Laboratory Improvement Amendments) lab that’s provided by one of the state’s designated testing partners. For Americans planning on domestic travel right now, some accepted testing partners include CVS Health, Costco, and Walgreens. But even these major retailers don’t offer COVID-19 testing at every location, making it difficult for some would-be visitors to Hawaii to get tested easily before departure.

Vault’s COVID-19 test is performed under supervision via Zoom video call, eliminating the risk of person-to-person exposure to the virus.

Hawaii has approved less than a handful of health providers that offer at-home COVID-19 tests, with Vault Health among them. “We are working with several state governments who want to unlock testing for their residents and travelers. Hawaii is a unique case as they rely on tourism for their economy,” Vault CEO Feldman says.

Vault Health is also the exclusive mail-in option accepted by the state. Vault’s consultants monitor the saliva collection via Zoom to ensure the sample is properly secured and sealed for accurate results, which is preferred by state governments and airlines. Available for patients of all ages, tests are sent out via FedEx and arrive on doorsteps within 48 hours of ordering. Sent back via Fedex as well, results can be made available within 24 hours. Individual tests cost $119. Vault provides a detailed receipt highlighting the cost of the test that can be submitted to insurance for reimbursement through the CARES Act, and the company also accepts HSA and FSA funds.

Upon their arrival in Hawaii, visitors will find that hotels and resorts have stepped up their requirements and sanitization protocols considerably to curb the spread.

Under new COVID-19 protocols, each Four Seasons property is appointing a hygiene officer focused on implementing enhancements to already stringent procedures.

The Four Seasons in Lanai, for example, has experienced a remarkable turnaround in the last quarter. While untouched by the pandemic for months, Lanai sustained a serious outbreak in October. Most of the hotel properties on the island are owned by Oracle cofounder Larry Ellison, whose funding has reportedly been critical not only in curbing the virus through investment in testing supplies but also in keeping employees on the payroll as any further pandemic aid flounders in Congress. Lanai has since kept down consistently its daily new-cases average to zero, as of Dec. 15.

Lanai hosts two Four Seasons locations, open at 50% occupancy: the Four Seasons Resort Lanai, a more traditional island resort with a lush pool oasis and four-star restaurants such as Nobu; and Sensei Lanai, a Four Seasons Resort, which is touted as an ultra-wellness getaway with a guided experience curated to each individual guest based on his or her wellness needs and set mostly outdoors. Aside from the Four Seasons, the 140-square-mile island has a few other tourist-friendly activity sites, such as a horseback riding range and a ferry terminal for local sailing and connections to Maui, as well as a hydroponic farming startup that sells its organic produce across greater Hawaii.

Any outbreaks risk longer-term economic pain for Lanai’s workers and inhabitants, which has inspired the Four Seasons to develop a rigorous health and safety program, Lead With Care. Developed in partnership with Johns Hopkins Medicine International, the program includes extra employee training, new food handling protocols, and enhancements to ventilation systems and other back-of-the-house operations.

Rooms are disinfected daily with EPA-approved products and will undergo black-light inspection by room attendants. Public areas are cleaned hourly with extra attention to frequented areas, such as front desk counters and public restrooms. Restaurants and bars may operate with reduced capacity and socially distanced seating, and nearly all restaurants must provide à la carte service with digital menus wherever possible. In-room dining means contactless delivery outside guest rooms along with sustainable, single-use packaging. And special kits are placed in each guest room upon arrival, providing masks, hand sanitizer, and sanitization wipes, with additional masks supplied on request from guest services.

The Four Seasons Resort Lanai features 213 guest rooms in a series of low-rise buildings spread along the Pacific coastline, providing a private residential experience.

Even though many resorts like the Four Seasons are also promoting special offers to attract visitors (airfare from Honolulu to Lanai is included in all bookings through March 31), most hotels aren’t offering big discounts compared with the bargain basement airfares currently available from major U.S. carriers. That’s because there is still healthy tourist traffic to Hawaii this winter, and Virtuoso’s Belles says that there is more demand than supply.

“People want to naturally go there. They have been reopening their doors methodically, in a very structured way, to ensure safety,” Belles says. “Beyond standard tourism, Hawaii is being creative by attracting people to come and stay for longer durations, ensuring more money moves through their economy for longer periods of time.”