Task force doctor defends COVID-19 screening of senators

  • MISCOVICH

Dr. Scott Miscovich, a private physician on Oahu who is a senior adviser on Lt. Gov. Josh Green’s COVID-19 Task Force, said Tuesday he conducted the testing of several asymptomatic senators at the state capitol on Thursday after Sen. Clarence Nishihara tested positive.

“Bottom line is, the lieutenant governor alerted me that there was a positive, and there was a lot of concern, and he asked me, since I have the mobilization team, if I could mobilize. And I mobilized,” said Miscovich. “He didn’t order me to do it or anything like that.”

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Miscovich said the tests weren’t done on the basis of the senators’ influence and privilege. Rather, the decision to test was made based on their level of exposure to Nishihara, who tested positive after exhibiting symptoms of illness subsequent to a late February trip to Las Vegas, Miscovich said.

Those tested include Sen. Lorraine Inouye of Hilo, the Senate Transportation Chairwoman, who tested negative, Senate President Ronald Kouchi of Kauai, and members of the Senate Ways and Means Committee, on which Inouye sits.

Kouchi told Hawaii News Now Tuesday morning he was still awaiting test results.

Both the U.S. Centers for Disease Control and Prevention and the state Department of Health have issued guidelines for testing that call for asymptomatic individuals to not be tested, even if they have been in contact with an individual known to have tested positive for the COVID-19 coronavirus.

The CDC’s website does have a disclaimer, however, about testing: “CDC has guidance for who should be tested, but decisions about testing are at the discretion of state and local health departments and/or individual clinicians.”

In addition to his work with Green’s task force, Miscovich has been instrumental in establishing drive-through screening operations statewide, including a mass screening Monday in Kona that resulted in approximately 1,600 individuals screened and about 300 tests being done.

He referred the Tribune-Herald to a document titled “Hawaii Clinical Screening Criteria 3/24/2020; LG COVID TASK FORCE” — which Miscovich described as “guidelines we update daily.”

The document said: “At this stage we are not doing asymptomatic screening.” It also had what it called a “final important note” in all capital red letters: “The final criteria is the clinician’s judgment. As a physician with a relationship with the patients and the people of Hawaii, you have the ability to request screening.”

“I can tell you that there are exceptions to the guidelines, including what we call very close, serious-level exposure,” Miscovich said.

He cited an exception listed in the task force document used to justify the screening: “A person who was in a closed environment — classroom, meeting room, hospital waiting room — with a COVID case for more than 15 minutes.”

“Sen. Kouchi said he and five or six others were in a closed room (with Nishihara) a few days before the positive came out. And they were in there for 2 1/2 hours,” Miscovich said. “The same exception to the guideline was held for the lady (who tested positive) at Kualoa Ranch who lived in a Native Hawaiian household, as it was for the people in that meeting. I did make an exception, also for the Ways and Means Committee. … They were in that window of exposure where they were dropped to a lower level of screening for testing.

“This was identical to (screening and testing) at Kualoa Ranch, and I can tell you it will be identical to if we have a school that has it. I am willing to stand up and do it. We have worked the process out, and this is, in fact, what should be done. This is what’s happening around the world, and this is how it should be done.

“Given the same set of circumstances, I would take the same actions with a homeless individual or a bank president.”

The news website Honolulu Civil Beat — hours after the Tribune-Herald’s interview with Miscovich — reported Gov. David Ige ordered cabinet officials and others to not consult Green, a physician, on the administration’s coronavirus response. The article cited only anonymous sources, saying the officials who commented were in fear of jeopardizing their positions. Green, who has been critical of the administration’s response to the crisis, has been conspicuously absent from news conferences on COVID-19 with Ige and Department of Health officials, and Civil Beat reported Green had been banned from the conferences.

The governor’s office issued a statement late Tuesday afternoon denying Civil Beat’s claims, saying Green isn’t banned from news conferences and meetings.

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“In this new COVID-19 reality, we are reinventing the way state government conducts business while implementing appropriate social distancing in meetings, news conferences and other activities. These gatherings are now limited to no more than 10 people. Therefore, we are bringing in those who are most directly involved with specific topics that are being discussed at our meetings and news conferences,” Ige’s statement, which was posted to his Facebook page, said.

Replies to Ige’s Facebook post were overwhelmingly critical of the governor’s response to the crisis, with many suggesting Green would be a more credible and reassuring public face on the COVID-19 pandemic than the governor has been.

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