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HomeMy WebLinkAboutMIN PSC 2020/09/01 2018-2020Committee on Public Safety 13th Session Hawaii County Building 25 Aupuni Street Hilo, Hawai i September 1, 2020 CALL TO The regular meeting of the Committee on Public Safety was called to order ORDER: at 2:13 p.m., in the Council Chambers, Hilo, by Ms. Rebecca Villegas, Chair. ROLL CALL: Present: Ms. Rebecca Villegas, Chair (via videoconference from Kona) Mr. Aaron S. Y. Chung, Member Ms. Maile Medeiros David, Member (via videoconference from Kona) Mr. Matt Kaneali`i-Kleinfelder, Member Ms. Ashley L. Kierkiewicz, Member Ms. Susan L. K. Lee Loy, Member Ms. Valerie T. Poindexter, Member Mr. Herbert M. "Tim" Richards, III, Member Absent & Excused: Ms. Karen Eoff, Vice Chair STATEMENTS The Chair directed the Committee to proceed to the next order of business, FROM THE Statements from the Public on Agenda Items. PUBLIC ON AGENDA ITEMS: (There were none.) COMMUNI- The Chair directed the Committee to proceed to the next order of business, CATIONS: Communications. (There were none.) CHR. VILLEGAS: Mr. Clerk, if you could read in the Order of Resolutions. ORDER OF The Chair directed the Committee to proceed to the next order of business, RESOLUTIONS: Order of Resolutions. PSC -13 September 1, 2020 Res. 716-20: URGES THE MAYOR'S OFFICE TO AUTHORIZE GOOGLE AND/OR APPLE TO RELEASE SUSTAIN HAWAII'S "SAFE TRAVELS CONTACT TRACING APPLICATION" FOR VOLUNTARY USE BY COUNTY CONSTITUENTS TO AUGMENT EXISTING SAFETY PROTOCOLS CURRENTLY IN PLACE IN THE STATE OF HAWAII IN RESPONSE TO THE COVID-19 PANDEMIC Seeks to increase access to contact tracing and testing in response to Hawai`i's recent COVID-19 spike. Reference: Comm. 1050 Intr. by: Mr. Kaneali`i-Kleinfelder Motion to Approve: Mr. Kaneali`i-Kleinfelder moved to recommend adoption of Res. 716-20. Seconded by Ms. Poindexter. CHR. VILLEGAS: Mr. Kaneali`i-Kleinfelder. MR. KANEALII-KLEINFELDER: Aloha, my name is Matt Kaneali`i- Kleinfelder, Council Member for Puna. Before we get too far into this, I just wanted to say that one of the people joining us today is currently on the phone with DOH, Department of Health, and he'll be joining us at 2:30. I will say a few words, and we also have Stephanie Yan zooming in today or via WebEx with us as well. Stephanie can you hear us? (Note: At this time, General Trauma and Critical Care Surgeon Stephanie Yan, M.D. came forward via WebEx to address the members of the Committee.) DR. YAN: Yes, I can hear you. Thank you for having us today. MR. KANEALII-KLEINFELDER: Thank you very much for being here, appreciate it. So I was just going to say a few things, and again, he can't join us till 2:30. And I want to make sure that we have him, because he's one of the developers of the app. So I requested a hearing for Resolution 716 because of the recent surge we've had in COVID cases here on the island of Hawaii and across our state. I would like to take just a few moments to just bow our heads for the three kupuna that we lost over this weekend and yesterday at the Veterans Home. These are our first three deaths in Hawaii County, so I just wanted to take a few moments, if you will, to recognize the loss and for the ohana. So maybe give it a little time. Page 2 PSC -13 September 1, 2020 Moment of Silence: At this time, Mr. Kaneali`i-Kleinfelder requested a moment of silence in honor of the three kupuna that recently passed away at the Veterans Home. Mahalo, thank you. I think it's important to recognize the families have lost. And it's our job as leaders to be responsible in a way to help guide everyone. So this is our kuleana. I do find that, you know, this is unacceptable and it is our responsibility to find solutions. That's why this is important. That's why we brought this up. The COVID response from the state right now is in question. The Director of the Department of Health retired Monday, yesterday in the middle of a global pandemic. We are five months in and our cases are growing, not declining. Experts agree that for every ten cases that are positive and have been confirmed, there's usually a hundred more behind that in the community, that are quiet, or undiagnosed cases. So I will no longer stand by and watch our businesses, our families, our loved ones, and our way of life suffer. I reviewed dozens of techniques used in countries across the world that have been used to, you know, combat COVID. Many with much denser populations than we have in Hawaii Island, and even in Oahu. And I have visited many websites. I've had lengthy discussions with different app developers, some being Nobel Laureates; statistical analysis; and then went over white papers for privacy security; before bringing this up today because these are some of the major points and the people involved in this kind of technology to help us be safer. I informed the Mayor's Office of the resolution this week, and we've been going over the details, and they're always invited to our meetings as well. Since a notice of a public hearing being scheduled, I have been bombarded with phone calls and emails. And to make it clear to the public, you know, that what it comes down to is the Mayor of each County needs to endorse or authorize the use or the release of the app to the public. Otherwise, we can't use it. The goal for today is to discuss the available technology and begin to move forward with a coordinated plan for reopening our County, which is what we, I think, at many different levels are lacking. And without this we'll continue to see the same thing that we've seen. Open -close, open -close; limit gatherings, open gatherings. Businesses open -close, you know, positive employees basically shutting down a school or a restaurant for cleaning. It's going to be very difficult. This is not a silver bullet to kill COVID. This will not solve everyone's problems, but this along with the sweep of other measures begins to make the difference in how we address it in our community and how we can move forward Page 3 PSC -13 September 1, 2020 from here. And I think that's the most important thing for everyone to understand. Finally, I do need to say that this app is voluntary for use by the people of Hawaii County if it is authorized by the Mayor's Office. It's not a requirement, it's voluntary. And that's important because many people's first issue is the privacy aspect. So you'd have to download this app and then install it, and then use it first. There's no requirement that you do so. So with that said, and you know, we're at about 2:20. We've got to give Kevin about ten more minutes. And Stephanie, if you could maybe enlighten the Council as to who you are, you know, who the group is, Sustain Hawaii, that developed the app, and just give us some of the basic details before we have Kevin come on and help us with that as well. DR. YAN: Yes, I can do that. Thank you so much for the invitation today and for giving us the time to present this app, which has been ready for two months. So let me tell you a little bit about my background. I'm a General Trauma and Critical Care Surgeon here in Maui, and I got involved with a HI-COVID Healthcare Provider Taskforce to help during the COVID-19 pandemic. And it's a taskforce made out of healthcare providers from different physicians, nurses all around Hawaii. What we did is, we met starting from March, April, and May. We met every day to connect our community with resources to connect people to talk about strategies to obtain PPE (Personal Protective Equipment), to start, you know, moving things on the ground. So our taskforce has been involved with getting PPE for community health workers, home health nurses, private doctors, and private dentists who weren't involved with the original plan to get the PPE for the hospital system. So everybody on the outside whose business wasn't carrying and their healthcare didn't have PPE at that time. So the taskforce got together and starting procuring and getting PPE's from all over the United States and the world actually. And then a doctor in that group sent me an article about digital contact tracing and how it would really help in this kind of infectious dynamic, because it's slightly different from the SARS (Severe Acute Respiratory Syndrome) that came before. A lot different actually from the regular flu. So, to kind of explain that, I just want to also tell you, that I'm a mom; I'm a physician, and I also have asthma. So it was kind of a protective mechanism to find out about the disease early on and to kind of accumulate the knowledge needed so that I wouldn't get asthma and I wouldn't be sick with COVID. So that's just a little bit of my background. Page 4 PSC -13 September 1, 2020 But to tell you a little bit about this disease and why I thought the digital contact tracing is an important part of the contact tracing effort is that the way that it's spread, everybody has heard of the R -naught (basic reproduction number Ro) value, which is the transmissibility of the virus. So for one person that gets infected, COVID-19 infects about two to three other people. So it's R -naught is two to three. Now, when you look at SARS, which was the first type of coronavirus that had an epidemic in the world, the R -naught was similar there. Two to three as well. But what makes this virus different is that the capa to the R -naught has little variability. So if you take a group of 100 people, one person may be able to spread it to 300 people; and 99 other people doesn't spread it to anybody. The R -naught in that group of 100 people will still be between two to three, because that's the average. The R -naught is an average number. Now for COVID, if you have a group of 100 people and each one can spread to about two to three, there's no variability between people. Each person can spread it to about two to three. So if you have a person in the first group that goes to somewhere without COVID, you have 99 out of a 100 chance of not spreading the disease. However, in COVID because the capa value is little variability, each person that goes to a non-COVID area can spread it about the same chances. So in the mathematical modeling that science mag put out about the dynamics of this disease, they predicted that manual contact tracing will get overwhelmed quickly with this type of disease because it's less of the cluster. One person doing the cluster spread. And it's more like everybody can have the same amount of spread. And so for each point of contact; for each point of person with a positive test, you have to trace all these contacts, so the estimate right now is about 20 contacts per positive. So if you have 100, 500 manual contact tracers, they easily could get overwhelmed with this kind of spread. And the other thing too is that COVID-19, they did analysis, the mathematically modeling that if you delay from the time you find out someone's COVID-19 positive—if you delay notifying the contact to isolate or to test, more than 24 hours, the percent success of your intervention is very minimal. So you have to be able to contact trace within one to two days; best if it's less than 24 hours, to be able to have any effect in this kind of a disease with the R -naught that's two to three with a capa that's has very limited variability. MR. KANEALI`I-KLEINFELDER: Can I stop you for a second? So you are speaking in doctor talk right now. So for everyone else, I think you're speaking to the transmission rate of the virus. Is that correct? DR. YAN: Yes. Page 5 PSC -13 September 1, 2020 MR. KANEALI`I-KLEINFELDER: We have a very high transmission rate. DR. YAN: Very high, but not only is it very high. Each person can spread it. Whereas in cases like HIV or cases like SARS, you can pinpoint a couple of people that can spread it to many different people. And this is where manual contact tracers glow. They are good when it comes to a super -spreading event. They can identify that person and stop transmission. With COVID, each person infected can have the same amount of transmission to the community. So it's very important to have technology help us with this type of spread, because as you can see and as you hear from the news, manual contact tracers are getting overwhelmed. But that was already predicted, because people have done mathematical modeling to show it doesn't matter if you have 200 to 400 to 500 manual contact tracers. It does if it's early on in the disease, but if it's later on in the disease and there's a surge in your community, you need digital contact tracing help because at this point your systems will be overwhelmed. So armed with that knowledge I actually went and read all the different types of digital contact tracing apps that were coming out all over the world; South Korea, anywhere they had digital tracing, I looked at them. And I looked at the different things that would be kosher in the United States. Would it be surveillance or privacy protection, anonymity? Those are all important. And then in April, I was able to connect with a Harvard MIT (Massachusetts Institute of Technology) group. And the Harvard MIT group put together tech developers here in Hawaii, and we formed together the Aloha Trace Coalition to come up with one app for Hawaii so that people wouldn't get confused. And we've been trying to reach out since April. Reach out to DOH (State Department of Health) to see if they would look at our apps and our solutions. And for a couple months, they kept saying "no," and finally, somebody had an in with Dr. (Sarah) Park, and we were able to show her our initial stages of the app. And then she was willing to take the diary portion. So in the app you can get a COVID positive individual's 14- to 30 -days worth of location, where they've been. And then you can take that, redact all the private locations, redact their private information and put that in a server on a map where you can see where they've been for 14 days to 30 days, depending on the parameters you put. And then people on the outside who have downloaded that map can check, can cross-reference where they've been for the last 14 days. And if they were within nine to 12 feet of those people, they can be notified to see their PCP (primary care physician) or get tested, because they've had contact with a COVID-positive person, in an anonymous and secure way. Page 6 PSC -13 September 1, 2020 MR. KANEALI`I-KLEINFELDER: So for those who don't quite understand, because there are some minor difference in the words, but between a contact tracer and contact tracing app, what's the difference? DR. YAN: So a contact tracer is somebody who calls—so the DOH or the County will get a positive person's result; they call the positive person and ask, "Hey, where have you been the last 14 days?" And this is very difficult for many people, including myself, to trace where I've been the last 14 days. And then they'll ask that person. And all that information they gather from that person is voluntary. I heard many times that people actually say, "Hey, this is the DOH calling," and then they just hang up because they don't want to volunteer any information. And then when they ask where they've been, they also ask, "Can you remember which people were at these places?" And so they list down the people's names, and then they list down the phone numbers, and then they call those people individually for manual contact tracing. MR. KANEALI`I-KLEINFELDER: So that's contact tracer, yes? DR. YAN: That's investigative contact tracers. MR. KANEALI`I-KLEINFELDER: Okay. What we have developed is—not we, but you guys have developed, that's Sustain Hawaii, is a contact tracing app, which would be something that does the tracing for you using GPS (Global Positioning System) and then holds the data so it's present, so there's no human error involved in where you've been; who you've come into contact with. Okay, that's good because sometimes it has to be, you know, we really need to break this down, because they're so similar, the names. You know, so I appreciate you doing that. And I see, it looks like Kevin has joined us. Kevin are you there? Can you hear me? Do you want to introduce yourself, Sir, so we can get to know you a little bit and understand your role in this? I think you may be muted on your end, Sir, because we're good on our end. And thank you for bearing with us because this is the COVID era of communication. Chair, do you mind if we take a recess? We're going to try and work out the communication with Kevin. CHR. VILLEGAS: Sure, happy to do so. MR. KANEALI`I-KLEINFELDER: Thank you. Page 7 PSC -13 September 1, 2020 Recess: At 2:34 p.m., the Chair called for a recess. Reconvene: The meeting reconvened at 2:39 p.m. CHR. VILLEGAS: Calling this meeting out of recess. We're back in session. MR. KANEALI`I-KLEINFELDER: Wonderful. Thank you everyone for that brief moment. Okay, so Kevin I think you can see us and hear us now. We can see you and hear you. Thank you for joining us today and thank you for making time for us. I know you had a meeting with DOH, but can you please introduce yourself, let everyone know who you are so we can get a feel for your role in the app and Sustain Hawaii. (Note: At this time, Sustain Hawaii Executive Director and Tech Lead Kevin Vaccarello came forward via WebEx to address the members of the Committee.) MR. VACCARELLO: Yeah, aloha and thank you so much for allowing us to participate in this hearing and for considering this opportunity. My name is Kevin Vaccarello. I'm the Executive Director of Sustain Hawaii. We're a Native Hawaiian nonprofit organization that's been around since 2003. Eighty percent of our board is Native Hawaiian and we've been focusing on health and wellness issues for the Native Hawaiian and Pacific Islander population base for the duration, focused primarily on sustainability but health as a very specific definer of that. And we've been moving forward on this suite of tools to help safely reopen. As a technology firm that's been around for 20 years combined with our—we call it high-tech, high -touch integration of efforts so that we can ground truth things with data driven decision making. MR. KANEALI`I-KLEINFELDER: Thank you. So Stephanie touched on a little bit of Sustain Hawaii and some basics of the app. I think we really focus on explaining this in a very simplified way so we can really get a grasp of what the app offers and what it can do; and how it helps us overcome the challenges presented by COVID. MR. VACCARELLO: Sure. MR. KANEALI`I-KLEINFELDER: So I think the biggest concern we hear is the privacy issue. And I really think the goal of this is to again, get an authorization for a lease. So, let's start with that actually. With the outcome of this resolution being heard by the County Council, what is your need, you know, as Sustain Hawaii to get your app available to the public? Because like you said, this has been available for almost three months now, if I remember correctly. Page 8 PSC -13 September 1, 2020 MR. VACCARELLO: That's correct. MR. KANEALI`I-KLEINFELDER: I think if we implemented this three months ago, we might be in a different situation than we are now. So with that in mind, you know, what is needed on your end to have this available to the public? MR. VACCARELLO: So on our end, we need one of four different types of entities in the community to be able to submit an endorsement supporting us and allowing the app to be optionally accessible to the community at large. So Apple and Google have constraints for COVID related apps. It requires government, some authority to have signing power within the government whether it's County or State, to provide a letterhead that's signed that says that they would like to endorse Sustain Hawaii and the COVID app to give that accessibility to the public. They can also be insurers, hospitals and clinics, and educational institutions. Those are the four that are allowed. MR. KANEALI`I-KLEINFELDER: Okay, so anyone in the County and within the State, it could be the Mayor himself or just a single entity could use this app within their locale or whatever that may be. MR. VACCARELLO: Yes, whoever has signing authority for that entity. MR. KANEALI`I-KLEINFELDER: Okay. That is incredibly important because that guides how we look at this resolution in front of us. Next, the issue of privacy and security. From what I remember, this app, you chose to go the route of GPS versus Bluetooth. And there are subtle differences and I think for many people this would be almost too techie of a conversation, but I think it's important to understand. So if you could, in layman's terms, kind of layout the difference between GPS and Bluetooth. And also how that overlays with the information stored on a phone and how that's handed and delivered to different people, you know, what's public what's not? So we understand the privacy and security issues. MR. VACCARELLO: Okay. So first, GPS is for the actual location information to be captured. Bluetooth does not capture location information, it just lets people know how close they are to each other. So that's probably the biggest difference by a significant amount. The other difference is that Bluetooth allows for proximity to be maybe down to a foot if you're lucky, but it does range all the way up to like 50, 60 feet. So that doesn't help in certain senses. And it can go through walls so that doesn't really help from that vantage point either. Page 9 PSC -13 September 1, 2020 GPS gets down to nine -foot level resolution. The social distancing from current epidemiological standards is 16 feet. And the aerosols can last up to three hours. So that's within those proximities. So we decided to go GPS route specifically because in order for—first of all not everybody's going to download the app. And secondly, those who do not have phones necessarily wouldn't have access to the information if it was only Bluetooth. Bluetooth is pretty much just a phone -oriented thing and no location information. So that doesn't really help any manual contact tracers like Department of Health necessarily from a specific geolocation vantage point in identifying who was at what location at what time. So that those without the app and/or without any kind of mobile phone or tablet, they can still be notified through manual contact tracers. So for example, if somebody tested COVID positive; they had their GPS data, only on their phone by the way, at the point that they test positive, that's the only time at which that data is optionally shared by them. And they can share either all the information anonymously or a portion of that. And they can do so through a few different vehicles. So let's just say that an individual went to McDonalds; there was 30 people in McDonalds within the 16 -foot radius that they had crossed paths for a certain duration on that date and time. So if that person then lets folks know anonymously that they had been at the McDonalds. All of those that have also the app would be notified immediately of that information if it matched the distance, date and time; and the duration. If they didn't happen to have a phone or the app downloaded on a phone, the manual contact tracers can still contact McDonalds and at least let all the employees know, and/or there can also be a pin on a map that's just on a website that says that somebody, which the identity cannot be known, because we don't ever have that information, somebody was at McDonalds within the last 72 hours, so there is a concern for exposure there. Just for people to be aware of it and for McDonalds to then do what needs to do to clean the space. So as far as privacy is concerned, all of the data is only ever on an individual's phone. It's never shared with anybody until they voluntarily choose to do so, but only when they've tested COVID positive. And then they share whatever amount of data they wish either with the assistance of a manual contact tracer or themselves through the app. MR. KANEALI`I-KLEINFELDER: That is very important. And to touch on it briefly, the platform your app uses is developed by Harvard and MIT, and it is called Safe Paths, correct? Page 10 PSC -13 September 1, 2020 MR. VACCARELLO: So, yes, we initially started working with Safe Paths early on, and we ended up being kind of technical partners with them. I was working directly with the chief technology officer of that entity. And we ended up fixing a few of their security protocol, and then we realized that that was a good starting point, but it wasn't the best, surprisingly. We do have a team ourselves from MIT, Stanford, Harvard, Princeton, Caltech (California Institute of Technology). So we've got similar level of capacity from a technical implementation vantage point. And most of our guys have been hired guns for the person with the large Fortune 100 companies as well. So technically we have the same basis but then we improved a lot of the code and functionality; improved the privacy and security in particular. DR. YAN: And one of those improvements are, just to add, because this was one the of the stickler points. The difference between the two is that the app that Kevin made had an enhancement for self -redaction. So let's say, I am a COVID positive individual, I go on the app, I look at where I've been the last 14 hours. I can take away all the private information; immediately publish my data for the public to be notified who are in close contact with me. The Harvard MIT Safe Paths app will only allow me to save that location data, and I have to email it or text to a manual contact tracer. Then the manual contact tracer will give me a call and say, "Hey, let's work this out." You know, where are the public places and private places you want public. And to me, that takes time. That takes away from the 24 hours of having epidemiological control. And then it has the same blockage as we have now. Number of contact tracers will be the limiting reagent there. The limiting factor there. And with the enhancement that Kevin made, somebody can redact their own information, take away their personal information and immediately notify the public. And if they don't care, like people on Facebook these days, they're telling people, "This is where I've been. Get tested or see your PCP if you were in these places." They also have a choice to say, "Publish all my information." If they don't really care about their privacy. Well it still doesn't have their names on them, but it has the location. Then the last thing is that there's a way to connect somebody to contact a manual contact tracer if they have language barriers, technology barriers. So that's the third option in the app that's available. MR. KANEALI`I-KLEINFELDER: That's good. So I think what I'm hearing is that this app is privacy secured and built on platforms you've actually improved on regarding privacy. But it alsoI think what's really important is that it will notify if you've come into contact with someone or within the vicinity of someone who had it. But it also lets you know in real time, if you're going to Page 11 PSC -13 September 1, 2020 enter a situation where you could be in contact with a place that has had a recent case or with an individual that's positive. So you can actually be preventative, is that correct? MR. VACCARELLO: That's correct. MR. KANEALI`I-KLEINFELDER: And I think that is most important thing we are looking at with the app is that you can help prevent COVID from happening. And you can prevent COVID cases. Because that's something that we have yet to figure out how to do is prevent it. We can tell people if they've got it. They can go get tested. But I will also say, that if you go get tested right now, you have to wait five days for your results. And in the meantime, there's a lot of question marks as far as who's doing the tracing; who's being notified. You are now negative or positive and you're in a limbo area. And you're walking around not knowing what you are, and you're kind of stuck in a gray area. So this helps immediately get these results online and published so people will start to see and make decisions regarding their own health as soon as possible. DR. YAN: And Matt, the biggest difference I think for me on the ground who has to deal with the clinical people on the ground is that the GPS versus Bluetooth, the GPS allows us to map out locations for the last 72 hours with hot spots. So the kupuna and the people that I work with, or my patients that don't have access to a smartphone, they can see a map and say, "Okay, so the last 72 hours, this area has really hot with COVID. I'm going to avoid that." Whereas Bluetooth you don't have a map and you only get notification if you're in the proximity. And I thought that didn't really have equity because ones that are at risk, the kupuna; all that. We have to go in hiding if we don't have that map to tell us what to avoid. So I feel like the biggest difference with Bluetooth and GPS is that Bluetooth kind of gives us the equity where we don't have—it's kind of a weather map. Whereas Bluetooth, somebody who doesn't have a Smartphone or Bluetooth is just not participating. We just hide out. People with asthma like me who doesn't have a Smartphone will just hide out for that entire time we have a pandemic. And I didn't think that was fair or equitable. MR. KANEALI`I-KLEINFELDER: So you're basically enhancing social distancing with the use of an app. You know, is this being used anywhere currently? MR. VACCARELLO: We did get approval from Apple and Google to do beta testing. So those beta tests are occurring right now in Kauai County. MR. KANEALI`I-KLEINFELDER: I think in Waimanalo too, is that correct? Page 12 PSC -13 September 1, 2020 MR. VACCARELLO: We do. We're doing our own testing, really preliminarily in our community in Waimanalo, yeah. MR. KANEALI`I-KLEINFELDER: Okay, that's good. That's great. And then you've already entered into an agreement with those two Counties? MR. VACCARELLO: Honolulu County would be wonderful. We're having conversations with them. We're trying to speak with Maui County as well. But again, we have to have county level approval; state level, or endorsement for us, so we can bring that to Apple and Google. Or we get community health centers, hospital, clinics, insurers or educational institutions. Those are the only kind of legal entities that are allowed to use COVID related apps for security purposes. So we went through significant levels of rigor and had to provide 20 -plus documents of federal agenda contracts that we have proving that we're a nonprofit that's been health oriented in community benefit for the last 17 years. And so we got approved for that. MR. KANEALI`I-KLEINFELDER: Thank you. And the, I mean I can see this being used by our first responders. I can see Fire Department personnel, Police personnel. You know, if you're going to a scene and you can actually check and see if there's any COVID positive cases in the area you're going to and make a decision to protect the level of our first responders and our frontline personnel. I mean I think that's a beautiful thing. MR. VACCARELLO: There's one thing too to mention to touch on one of your earlier points of the fact that some of the tests take five days. So, Stephanie and some colleagues, Dr. Ignacio, have been putting together these testing protocols, and the FDA (Federal Drug Administration) has EUA (Emergency Use Authorization) tests that they're constantly updating. And what the goal is, is to identify how rapid the response can be, 15 minutes or less; the price point, $20 or less; the quality from a specificity, sensitivity, and LOD (level of density) advantage point. And accessibility based on those. So our platform also is agnostic to receive the data of whether it's an inconclusive test, positive test or a negative test. What that means is that we can immediately then tell the individual patients whether they are positive or negative. If positive, then they can then have the choice to immediately do exposure notifications. So we're not talking about five days, four days, three days, two days, one day. We're talking about minutes or hours potentially. Page 13 PSC -13 September 1, 2020 MR. KANEALI`I-KLEINFELDER: Kind of like what we had talked about in the beginning—was this along with a suite of other measures, like rapid testing, rapid results; different styles of quarantine. We begin to make really quick changes in the way we approach documenting COVID and letting other people know where it is and where it has been. DR. YAN: Correct. Because it has EHR (Electronic Health Record) enhancement, which is it has connections to 95 percent of the EHR across the United States. It can also help with travelers. So travelers who need to prove that they truly have FDA EUA negative test from a legitimate clinic can be verified on this app. And then this app can also follow them through in their quarantine and randomly check them and notify them, "Hey take a selfie, or scan the QR (Quick Response) Code at your location so that we can check you really are where you're supposed be." And then it can also remind them, "Hey it's been five days, go get your test." If we have that program, the testing opt out data with quarantine, you know, get tested in the closest location so that you can get out of your quarantine. So it has the testing portion, connection to the testing site; it has the travel verification of FDA EUA approved testing from different clinics. And then it also has the quarantine solution all in one comprehensive app, because it doesn't make sense to have people get app fatigued. There's one app or one website to register for quarantine. There's another website to check for where to get tested. There's another app to get, you know, this and that. And people will just get crazy with a different app and get confused as they are now. I get so many phone calls like, "What's this app coming out?" And I'm just saying the Safe Travels that the state is coming out with is not a contact tracing app. It's not a quarantine app. It's basically a way for people not to fill out the paper form on the airplane, but a way for them to do it online so that you don't need a data based person to type in the stuff on their program on their Excel sheet. MR. KANEALI`I-KLEINFELDER: Thank you for mentioning that. Is there any relation between your nonprofit and this $638,000 failed glorified spreadsheet online from the state that came out Friday on the news? MR. VACCARELLO: No, there's no direct relationship at all, and sadly we actually presented our platform a couple of months ago to the State Senate COVID Taskforce where the State CIO (Chief Information Officer); the Director of the Department of Transportation; and Dr. Park, former COVID Response Taskforce person, or I'm sorry, contact tracing lead. They were all in the meeting. They saw all the solution sets, and then we even further went into conversations directly with them, which included their engineers. They asked me for all of my data schemas, security protocol and everything. And decided to go Page 14 PSC -13 September 1, 2020 some other odd route and spend a lot of money and time, and I don't really understand that to be honest. MR. KANEALI`I-KLEINFELDER: Wow, so you mentioned the test. Is that similar to the Siena test that's got five-minute results? So in conjunction with your app, if those are used in conjunction with each other, how quickly we'd have information back? MR. VACCARELLO: That's the intent, yeah. We built our platform so that we can allow for any single type of test to be included in the results of those tests directly from the lab technicians who are approved. MR. KANEALI`I-KLEINFELDER: That's amazing. And how much, you know, if this was to be allowed in our County, what is the cost for some to use this app? MR. VACCARELLO: It's a free app. The intent was always for everybody here to use it for free. We, of course, do have costs. We've spent a lot of time and money developing it. The hope is that we can get some of the CARES (Coronavirus Aid, Relief, and Economic Security) Act funds to basically pay for that at some point. But if not the mission of our nonprofit organization is community health and wellness, so that's why we built it. MR. KANEALI`I-KLEINFELDER: And I'm a restaurant owner and I understand that you had a restaurant. But you, I mean if you don't mind sharing a little bit of that story that you told me on the phone? MR. VACCARELLO: Sure, yeah. So we have a plant -based restaurant in Waimanalo called `Ai Love Nalo. We've been running it for five years successfully, and when COVID hit we basically lost 90 -plus percent of the business, as most restaurant owners understand. So one of the goals for us was to create a safe vehicle again from a selfish vantage point, if we can have a mechanism that we can build so that restaurant owners, small business owners, can actually use a thorough protocol to reopen so that customers are seated, employees are safe, employers are safe from liability, that would be wonderful. So I would love to able to reopen my restaurant and serve the community healthy food again in a more expeditious fashion. And these types of tools would enable that. So that's the other part that's kind of frustrating is we haven't been able to get that out there because of some of the bottlenecks in dependencies. MR. KANEALI`I-KLEINFELDER: I think that's why this is so important, is because you actually came up with a solution from a real-world perspective on something to help us start to reopen, because that's what we've been missing. And the plan that I've seen from the state level so far, has, I mean really faltered. Page 15 PSC -13 September 1, 2020 That's a really nice way of putting it, and then getting blasted from all different angles. And so I think it's come to us now to try and figure out something that works, and this is just one piece of the solution. I mean these Sienna tests cost $25. They give you results in five minutes. Coupled with that information being sent directly to your app, you start to see a real clear picture of people educating themselves on their own health and transmitting that information to others and allowing us to make realtime quick decisions on what we do that just helps us get to a point where we have some sense of normalcy again. And we start pushing back on COVID. And not just, you know, being reactive. And that has been my issue from the beginning is that we've seen very reactive measures to COVID. Not proactive. And that's why I brought this up today and why I really appreciate you, you know, giving us this time today to help us understand this. You know, one last question before I let my counterparts kind of ask you to go down the list, how will the app be used if a person were to test positive for the antibodies and already had the virus? MR. VACCARELLO: So the data actually, and I just read some of it today, there was a 25 -year-old male in either California or Nevada, I can't remember which state, but you can get COVID again for a second time. So antibodies are inconclusive as far as immunity response, unfortunately. So antibody tests aren't really super helpful at the moment. We need to get more data, to really, from an epidemiological vantage point, confirm how safe that ends up being for individuals. So antibody or serology tests are still kind of not scientifically rigorously defined yet. DR. YAN: Yeah, it probably won't be confirmed by the app, and they'll probably be directed to get a PCR -based (Polymerase Chain Reaction) or antigen -based test to further delineate, because there's different kind of antibodies, IgM, IgA, IgG (immunoglobulin classes). And it differs on how many days they've been sick or what antibody shows up. So it's not one of the tests that is approved for a positivity on the app. MR. KANEALI`I-KLEINFELDER: Okay. And then, I forgot this too. If someone from Hilo had the app and they went to Oahu, does the app cross County boundaries? Can it be used within the state or within the country for that matter? MR. VACCARELLO: It's by jurisdiction according to Apple and Google's rules. So what you could do is use itif you're a resident of Hilo for example, it would still work throughout the different counties because you're still a resident of that Page 16 PSC -13 September 1, 2020 particular location. But if we had it statewide, it's a different story. Having it statewide because we have visitors coming in, the normal ten million visitors would also be covered. So there is an opportunity to do that. If we wanted to really extend it further state to state, we would have to kind of go through a similar process and get jurisdiction. We'd have to get approval or endorsements from those government, education, hospital, insurer's -type of thing again. So that's one of the drawbacks, but again, we can have it in the purview of the location including those who are coming to visit. MR. KANEALI`I-KLEINFELDER: Okay, I'm going to yield for now. I appreciate your time. This gives a chance to everyone else on the Council to ask questions if they have any. If not, then we'll wrap it up, but I yield for the time being. Thank you, Chair. CHR. VILLEGAS: Thank you, Mr. Kaneali`i-Kleinfelder. Do we have questions from anyone else on the Council? MR. CHUNG: Yeah, Madam Chair? CHR. VILLEGAS: Is that Chair Chung? MR. CHUNG: Yeah. CHR. VILLEGAS: Okay. MR. CHUNG: You know, let me start by saying what we all agreed with, and is it Stephanie? Is that your name? DR. YAN: Yes. MR. CHUNG: Okay, you know, like you, I'm a parent. I have kids, and I have asthma too. I'm not a doctor, though. I can only use my good sense here and, you know, we are all concerned about this situation. I was recently quoted in the papers saying that public safety is paramount above all else right now. So I think we're all on the same page. And any technology that can help us, of course, I'm all ears. But I'm somewhat troubled by, you know, either the information or lack of information I have here. Because, you know, what I've been reading about for at least the two months has been the anticipated rollout of the Department of Health's endorsed digital contact tracing application, which you know, according to this resolution say's it's not yet ready and that yours is ready. Okay, we can talk about that later. But my understanding again, I'm not an expert in this area Page 17 PSC -13 September 1, 2020 by any stretch of the imagination, but it is going to be done via GPS and Bluetooth notification, just like you had stated yours is. What we don't have here today is persons from the Department of Health. I think it's called Aloha Safe or something. Another nonprofit organization, just like yours who has said they said somehow they have an approval with the Safe Paths, which is an MIT developed platform as well. I'd like to hear from them too. See, what you're proposing today and what's being suggested today is that this is something absolutely new. It's revolutionary. Yours is just another application, right? It's not the first. It might be the first, I don't know, but it's one of several that are being considered. Now, for me, you know, a lot of times I might say, hey the more the merrier, especially when it comes to public safety. This might be one such situation. On the other hand, there's another part of me that might say, wait a minute. Look, I know the Department of Health right now is an embattled department. They have a director who is leaving, and nobody can tell me that he's retiring, not in the throes of this kind of pandemic. He's been asked to leave, there's no question in my mind, okay. So let's call a spade a spade here. I mean, I don't have direct information on that, but that's just my best guess, right? Who in their right mind is going to retire at this kind of time? What responsible individual anyway? So it's easy to kind of throw stones at the Department of Health right now, but at the same time, they are our go -to agency. And they are partnering with a nonprofit right now, I don't know about this $600,000. I don't know about any spreadsheet, but I do understand that is a digital contact tracing application, just like you've described. For me to make a good decision, excuse me, for me to make a good decision, because I don't want to just hear from you guys, I want to hear from other guys too. Okay, because I'm not here to debate you because I don't have information. I'm here to obtain information. But I'm only hearing one side. The main guys I want to hear from is the Department of Health. I want them to defend their endorsed app or at least to say, "Hey these two can coexist under certain circumstances." And that would be fantastic. Don't get me wrong, I'm not discounting you guys. But now, there is a statement in our resolution that says, and you know, again Kevin had stated earlier that they can have one of four types of approvals. One of which would be the Mayor and others. I don't know where that came from, okay. And maybe, our Managing Director has been sitting here patiently. Maybe he might have—be able to shed some light on this. Roy, do you want to come up Page 18 PSC -13 September 1, 2020 here? Are you here to listen or you want to talk? What's required of the Mayor in this situation? What do you know about this? (Note: At this time, Managing Director Roy Takemoto came forward to address the members of the Committee.) MR. TAKEMOTO: Roy Takemoto, Managing Director. The requirement for some endorsement, I think it's coming from Google and Apple. So as far as a legal authority from state or federal, whatever, you know, it never occurred to us that we had to approve. I think this is coming from Google or Apple. So, I totally support your comments that there are alternatives that merit examination before jumping in on one of them. And one of the main players that need to be heard from is the Department of Health. MR. CHUNG: Oh, thank you. We didn't talk about that, right? Yeah, so independent of one another, right? We're agreeing, thank you. So, yeah, I mean, you know, there's a part of me that say's, okay I can just vote "yes" on this thing; But I'm going to be voting "no" today, okay. Because this still has to go to the full Council, and at that time perhaps we can get more information. Because if these things can be compatible and they can work in tandem with one another, how wonderful, right? I'd be the first to say, hey it has my endorsement. But I've got to hear from the other side too. Because I don't want to get into a back -and -forth with the Kevin and Stephanie here. I'd just prefer waiting to get more information on this because I would hate to put you guys, now the Mayor in a position where he's going to be endorsing something that runs counter to the state endorsed app, right? That wouldn't beI don't think that would be a smart thing to do right now. It'll cause more confusion, more miscommunication to the public. Let's throw all of the things out on the table at some point, you know, so that we can make a good decision. I think it would be good for you guys too, Roy, actually, there might be something that we can learn from all of this. DR. YAN: Can I give a little bit of history with the other developers? MR. CHUNG: Well, you know, again they're not here, so I would prefer not to go there. You know, I can't really stop you from saying it, but you know, we don't have the other guys here. DR. YAN: But we were working with the other guys to come up with one app for Hawaii. And when the DOH wouldn't go for the full set of solutions, they only wanted to go for the diary, the group, the coalition decided on a two-pronged approach, because we knew we'd finish our app faster than DOH could do their approved app. So we decided on this two-pronged approach. And Kevin's app was always going to have data; always be available for DOH. So once they're on Page 19 PSC -13 September 1, 2020 board with public notification, once they're on board with digital contact tracing app, they will have all that data to put into their system. So whatever they're system that they create which will be coming out at some point will have full integration with our data, so there's not two different data sets going on. That's just one insight I can give you. And then the reason why we're stressing GPS versus Bluetooth is that there are qualitative and very real implications to having only Bluetooth notifications for the community when it comes to equity and inclusivity. MR. CHUNG: And you know, it makes perfect sense. But I just don't know, because I have to hear the other side of the story. And it could very well be that when you and the Department of Health are standing next to each other trying to advocate, well, you for your app and the Department of Health defending their selection of the other app, yours might look fantastic, and then the Department of Health might look silly. I don't know. But I cannot only listen to one side of the story, yeah. Especially on something like this where we're asking the Mayor to now put his stamp of approval on something. I mean we do that all the time, you know, we urge him to do this and that. But on this one, I think it's so vital for us to really get all of the information that we can on this, okay. And that's all. That's all I'm saying. MR. VACCARELLO: Yeah, if I may too, and thank you very much for sharing all that information. We agree 100 percent that everybody should have a voice and say in everything, and we've been very actively promoting collaborations for five months, and there'll be a lot of nothing. So a lot more deliberation isn't going to help anybody reopen safely. And with all respect to that. And we would love to engage everybody concurrently in the same room at the same time. That would be a pleasant set of conditions to us. We've done it in the past, we've been working with these folks in the past. We would love to continue working with everybody. To us, we're in a pandemic right now, and we're five months in. Lives are at stake, livelihoods are at stake. We kind of need to move forward on something and pulling the trigger to make—at least give the public an opportunity to have a say in their own lives and livelihoods. MR. CHUNG: Look, we're all on the same page, I think. I think there's no disagreement on any of the points. And I don't think we're holding up anything, because this still has to go to the full Council. It's not like we're deferring this matter, right? So that's where I stand right now. On this one, it's not so much a "no" vote. I'm not saying, no, I don't like this whole idea. It's just given the consequences, the potential consequences of, you know, sending out mixed signals to the community at this point, I cannot put my stamp of approval. I've done it on many other occasions on non-binding resolutions, but this one is so important. I've got to make sure that I have all the information from all sources. Page 20 PSC -13 September 1, 2020 And it could very well be that after everything is over we might get the impression that, hey, the Department of Health made a mistake. They should gone with these guys, right? And then I shall put my stamp of approval to at least have the Mayor think about it, right? Okay, thank you. MR. VACCARELLO: Sure. And just to be clear on one particular point. There's no reason why any particular technology itself is independently required. As Stephanie was mentioning, there are very simple ways to integrate and collaborate. We've built our platforms specifically for that purpose. I just got off the phone with Department of Health, which prior to coming on to this hearing, specifically talking about ways to integrate data points. MR. CHUNG: And that would be fantastic. That would be great, you know, as I said, this might be a case where the more the merrier. But I don't know. I really don't know, because I'm only hearing one side. Yeah, okay, thank you. MR. VACCARELLO: Thank you. CHR. VILLEGAS: Thank you, Chair Chung. Would anyone else like to ask any questions? MR. RICHARDS: Yeah, Richards. CHR. VILLEGAS: Mr. Richards. MR. RICHARDS: Thank you, Chair. And I'm going to throw these questions out. I appreciate the time. We were told there's no cost, but there's got to be some sort of server or data host of some sort. Where is that server going to be? MR. VACCARELLO: We have currently an Amazon Web server, and that server we went through the laborious efforts of becoming HIPAA (Health Insurance Portability and Accountability Act) compliant and SOC 2 (Service Organization Control) level of security protocol which follows over 78 different types of security measures, which is comparable to bank level of security as well as hospital and other medical security. So even the fact that we're almost entirely having folks keep their information on their own phones, in the occasion that personally identifiable information even anonymously shared comes to the server we still went through the effort so having HIPAA and SOC 2 protocol. MR. RICHARDS: Okay, so that will be hosted by then Amazon, alright. Question on this, and you already touched on this. You said you went through beta, so this is still in the beta cycle of developing the app. And you said you had Page 21 PSC -13 September 1, 2020 talked to City and County of Honolulu. And you've talked to Kauai, but we don't really have this out in the field as of yet. Did I understand that correctly? MR. VACCARELLO: The beta testing is in the field. MR. RICHARDS: But it's being beta tested. So we're not actually using it right now? MR. VACCARELLO: The use is constrained by Google's rules that we need to have an endorsement for public access. But if we did have that then absolutely it would be available. MR. RICHARDS: Okay, so but you have no endorsement as of yet. Is that correct? MR. VACCARELLO: That's correct. MR. RICHARDS: Okay. And then, I'm puzzled, you know, I'm listening to the data and I have to agree with Chair Chung on this. Running the numerical models, what percentage of the population are you calculating you must need to make this statistically accurate as far as tracing? And we know this is just one small portion of the overall COVID control, because without the social distancing; without the mask wearing, etcetera, etcetera, etcetera; without hygiene, nothing's going to work. But what percentage of the population do you think must need this, because if you have five percent of the population, it's not going to work. And my background is doing disease investigation surveillance, and so I'm curious what your expectation of population need to have this to make this work. MR. VACCARELLO: On our end, the need is different between Bluetooth and GPS. And the reason for that is that GPS allows for the anonymous locations to be shared on a website for anybody to look at, whether they have a phone or not. If they just have access to being able to see a website to know where those locations are. So ours is very different from a modeling prospective. Bluetooth requires easily 60 percent market penetration. MR. RICHARDS: So what's your expectation for this to be effective or accurate? MR. VACCARELLO: The people that use it. I mean anything that we use to keep moving forward, ten percent is more effective than zero percent. DR. YAN: Then you have to differentiate between COVID-19 positive patients joining in, or is this just the general public? You don't have to have any of the general public join in, as in downloading their app if they can see the map and avoid it, you have epidemiological effects there just by people avoiding the hot Page 22 PSC -13 September 1, 2020 spots. But the COVID-19 positive patients or persons joining in would be the most crucial part of it, so that they can have their locations mapped out. MR. RICHARDS: And I get that part. And that would be helpful for certain demographic of the population. But you reminded me of one other question I wanted to ask. When you say that this app will be able to verify a negative COVID test result, how? MR. VACCARELLO: There's four different ways that can be done. One is if individuals optionally have access to their EHR's (electronic health records), their electronic medical records. That allows for any test to automatically get uploaded by the lab technician and then automatically downloaded by the patient. So that's one vehicle and that's just by leveraging the Affordable Care Act. There by law, patients are required to be given their digital electronic records. Another route is through direct API (Application Programming Interface) integration with Department of Health. Another route is direct API integration with the various labs and clinics. And the fourth is through the testing results themselves from the different FDA EUA approved tests. So for example, Oceanit (Oceanit Research Foundation) has a test that's coming through. They're going through the FDA EUA approval. Once that's done, any of the lab technicians who are going through can use our app. They can scan a QR code of the patient. And then they could just submit inconclusive, positive, or negative. And then it immediately gets access to them. MR. RICHARDS: Okay. Alright, appreciate that. I'm going to yield in the interest of time. Chair, thanks, I yield. CHR. VILLEGAS: Thanks, Mr. Richards. MS. POINDEXTER: Rebecca. This is Val. CHR. VILLEGAS: Yes. MS. POINDEXTER: Yeah. I told myself I wasn't going to speak, but I've got to speak. Okay, I'm going to support this because like Council Chair said, "The more the merrier." And it has to go up to Council. And at the same time, I want to talk to some of our FQHC's (Federally Qualified Health Centers) on this island. I know around the state—have you had a chance to speak with, I forgot the main group that the FQHC's normally sit under on Oahu. That umbrella group that they, you know, I forget what they're called. But, have you been able speak with them about endorsing it, because I don't see why they wouldn't either. Oh, go ahead. MR. VACCARELLO: No, I'm sorry, I didn't mean to interrupt. Page 23 PSC -13 September 1, 2020 MS. POINDEXTER: No, I was asking, yeah, if you got a chance to speak to any of the FQHC's. You know, Waikiki Health Center? You know, all those different FQHC's on the different islands. The community health centers. MR. VACCARELLO: Yeah, so we have a longstanding partnership with Waimanalo Health Center, and we have NEHA (National Environmental Health Association) specifically, and we've been speaking with the folks at Papa Ola Lokahi. And so tomorrow I'm actually going to be speaking with the heads of the groups from Molokai, Lanai, Kokua Kalihi Valley, and then all the groups from—shucks I forgot the name now. MS. POINDEXTER: But, so if you would get endorsed from a FQHC on this island, say Hamakua, Kohala Health or Bay Clinic, even Kona Community Health Center. Those are the big FQHC's on this island. I think that would be important, because they have the target population that we need to have data on, right, because they—most of them, I know at Hamakua Health Center at one time, the Marshallese, we were working with, you know, the language barriers that we have with the different populations. And those are the ones that we definitely need to do the tracing on. If you look at what was happening out there and the spread, they were talking about the language barrier or the culture barrier that we needed to somehow be able to do some tracing on them. So if you're meeting with the FQHC's, to me that is a real important population or the groups to meet with. The organizations. Those community health centers, because they have the target population we need to get the data on. So and I can help with that too. And I'll go look back on my computer on who that organization on Oahu has because they all kind of meetI know we used to meet every month but then, you know, I don't know what's happening now with COVID, but you know, that's in the central location that can get all the FQHC's on board. And when you talk about the electronic medical records, and you know, hopefully that you can integrate that type of data that they may already have. I know some of them already have, because they're working with those cases, right? So, yeah, and then I'm hoping that Council Member Matt Kaneali`i-Kleinfelder, from now till when this moves to Council, will get someone at the Department of Health to come in and talk with us as well. But in the meantime, it's working with the FQHC's. I would strongly encourage that you continue to do that on all of the islands. So thank you. Thank you very much for taking the time. Aloha, I yield at this time, Chair. Page 24 PSC -13 September 1, 2020 MR. VACCARELLO: Thank you very much, and if I may, just to put one point forward. As a longtime native Hawaiian nonprofit, one of our Board Members is Dr. Maile Tauali`i. And she's the former founder of the Indigenous and Native Hawaiian Public Health Program at the University of Hawaii. She's an epidemiologist in genetesis and a federal level bioethesis, who also works now at Kaiser Permanente in diversity research. So she's actually been helping us extensively throughout the Papa Ola Lokahi groups and getting into the types of entities that you're speaking of. So our core mission actually is for Native Hawaiian and Pacific Islanders, and actually representing the supporting those that are most vulnerable. So if we had one request, it would actually be to have an endorsement to support those that are most vulnerable. DR. YAN: And what we've been doing the last two months too, is that we've been going from different community and different groups like the HMA (Hawai`i Medical Association), the Maui Medical Society, the HI-COVID group, different health care providers and trying to give them a lecture and also a live demo of this app. Because I come from an international development background with emphasis on International Health, and adoption for anything, you know, technology related is even harder. And adoption will only take if you educate the public about the—you know, without dumbing it down, to educate them about the disease; and also the app or whatever you're trying to adopt. So that's what we've been doing for the last two months. We've had over—about ten live demos to different large and small groups, and Facebook live chats, just so that we can kind of dispel the myth about the surveillance digital contact tracing, because it's nothing like that. Taking a picture or using your Google maps has more security risks than this app. So basically we built that on the ground, you know, education platform in order to have adoption. And it's not just, once it comes out in the news, it's not just tidbits of this. People are actually, like, "Yeah I know that app, I know what it entails." So you avoid a lot of the hearsay about the surveillance state when this app comes out. So we've been doing that for the last two months that this app has been available. MR. CHUNG: Madam Chairman? Rebecca? CHR. VILLEGAS: Yes. Mr. Chung. MR. CHUNG: Yeah, I have a few more questions. CHR. VILLEGAS: Okay, was there anybody else over there that wanted to ask anything before we come back to you, Chair Chung? Page 25 PSC -13 September 1, 2020 MR. CHUNG: Ashley actually wants to talk. CHR. VILLEGAS: Okay, if that's okay with you, Chair Chung? I'll just go ahead and let her. MR. CHUNG: Yes, please. MS. KIERKIEWICZ: Thanks, Chair Villegas, I appreciate it. You know, I really appreciate what Mr. Kaneali`i-Kleinfelder is trying to do, but I would have liked to have seen a bit more options. A constituent reached out to me and put me in touch with the developers of the NOVID app, Professor Po -Shen Loh, and I was able to connect. And I was interested to learn that the iOS development for the app is actually is being done by a gentleman that lives in Council Member David's district, Peter Holk, so it's great to see that on -island capacity happening. My understanding is that this app is already being utilized by Georgia Tech (Georgia Institute of Technology). It's been piloted by Harvard. Their system or their apps, you know, is different from others because it provides that pre -exposure type notification. And they're also leveraging ultrasound technology, which has really interested MIT. So I just want to see more options being presented to us. And so if there could be an inclusion of having a letter of endorsement sent for NOVID, but that we could also hear from these app developers as well as the folks that are developing the app that the state is taking a hard look at kind of endorsing. I think that would be really helpful. So I just wanted to put that out there that there are many options, and I think that good decision making is grounded in having all the available data, and while I appreciate the presentation today, it would have been great if we had other app developers here to present as well. So thank you, Chair, I yield. MR. CHUNG: Rebecca. CHR. VILLEGAS: Yes, go ahead Chair Chung. MR. CHUNG: Yes, and you know, I really appreciated what Kevin said at the tail end of his last statement, you know, about focusing in on the high-risk group or vulnerable groups. And certainly not to point finger, and I don't want to cause any kind of, you know, xenophobia. I've said that we should not, you know, get into something like that. But, you know, the potential is there and I think we all know it. I really appreciate that statement. I would like to see something done in those groups so that we can give them the support that they need. But at the same time, and you know, I'm going to reiterate, I really do want to vote in favor of the application. I'm hoping that it can be done in tandem or, you Page 26 PSC -13 September 1, 2020 know, with other, not just one maybe other applications, too. That would be the greatest thing, but I don't know right now. You know, Kevin, you stated earlier that you needed one of four types of approvals. What were those approvals again? MR. VACCARELLO: One is government, and it could be municipal or state, and that's anybody who's got decision-making authority as a signator for that jurisdiction. The second is insurers. The third is educational institutions. And the fourth are hospitals, clinics, and community health centers. MR. CHUNG: Okay, and did you have a meeting or conversation with our Mayor? MR. VACCARELLO: I did not. MR. CHUNG: Did you reach out to our Mayor? MR. VACCARELLO: No, I have not. I didn't—I've been absurdly busy, honestly. I'm the guy that's on the ground trying to make this stuff work. MR. CHUNG: You know, and I was kind of listening again in concert with what Ms. Poindexter said, and this kind of peaked my interest. Have you gone to any of the hospitals? She's opened the door. You know, she's invited you to reach out to her so that she could connect you to some of her contacts, but have you done that? MR. VACCARELLO: Yeah, we've been doing that in many occasions. MR. CHUNG: And were they willing to sign off on it or not? MR. VACCARELLO: We didn't talk about that in particular, about the sign -off yet. What we've talking about is the use for the community at large. DR. YAN: I went to the Maui Memorial Medical Center and I talked to the CEO (Chief Executive Officer) about the app and he wanted me to go through the Mayor's Office in order to get sponsorship for the app. He was unwilling to kind of stick his neck out for an app that could be seen, you know, as something negative in the public. So he wanted the Mayor's approval for it, and we have reached out to the Mayor of Maui County. And Kevin and Kumu Ramsay actually had a meeting with the Mayor's Office here. MR. CHUNG: Okay, and so if you got the approval from the Maui Mayor, it would be only good for that jurisdiction? Okay, so, what if you got one from the Governor, then it would be for the whole state? Page 27 PSC -13 September 1, 2020 MR. VACCARELLO: That's correct. MR. CHUNG: Have you met with the Governor? MR. VACCARELLO: We were endorsed by many physicians. MR. CHUNG: No, I mean, did you meet with the Governor? MR. VACCARELLO: The physicians met with the Governor and provided our suggestion for our platform, yeah. MR. CHUNG: But he didn't? MR. VACCARELLO: They spoke with Oshima (Alan) recently who also spoke to the Governor yesterday. DR. YAN: And Kevin has presented it to the Senate COVID Committee as well. MR. CHUNG: Okay, so but you're ready to go, you say? MR. VACCARELLO: Yes. MR. CHUNG: So then I'm just wondering, why didn't you just go and talk to your Mayor? We have like about a three or four weeks, you know, lag time in getting something approved. And if you guys are ready to go, and if this is something, you know, and I'm not being facetious or anything like that. But if this is something that's ready to go, and if this is something that can really help our community stem the tide of this growing pandemic, why not go the fastest route? MR. VACCARELLO: We're going the routes that are to us, we only have "X" amount of social capital and time ourselves. And I can only be in so many places at once. So, I work 16 -plus hours a day, seven days a week. We funded this thing ourselves, so I'm spread remarkably thin. It's been five months straight, nonstop doing all this. Whatever the paths are that are presented that seem reasonable are the ones that we end up going with. A lot of other folks have more social capital and access to the right people, that I simply do not, nor do I have the bandwidth for. DR. YAN: So we didn't have any channels open to the Mayor. How we got Mayor Victorino, a meeting with him was through personal ties. And then how we got meeting with Kauai's Mayor was also through a personal ties with his staff. So we don't really have a direct connection to the Mayor here. And we know everybody's busy. And so we've sent out like these mass emails to Page 28 PSC -13 September 1, 2020 different senators, different Council members, to be able to push this up. And I'm actually glad that you guys are asking for other options and wanting to see more. And I think by supporting this app with the stipulation that you want to see more, it might make it faster to kind of adopt things along the way. And just to keep pushing it up to keep up, you know, going with it because this is what's available and this is what's presented, and along the way ask for those different options to contrast and compare. I think that's really important. But you've got to keep moving because everything is urgent at this point. We can't keep on waiting for those people that are not willing to talk to us and not willing to open those channels up. MR. CHUNG: Wait Stephanie, I'm sorry to interrupt you but you guys just said you never reached out to our Mayor. So it's not like they're avoiding you folks. See what I would suggest you guys do because speed—time is of the essence on this matter, right? I think we all agree with that. And you know, Kevin you've been on the line over an hour and ten minutes. And I cannot speak for the Mayor, but I think it might have been really productive to just call up Mayor Kim. He's been very available. He might do most of the talking, but at the same time, I think it would have been less than an hour and you would have gotten a "yes" or a "no." And if you got a "no" and you come here, and you know, we do our thing. And we can urge him to do something that he refused to do. But in the meantime, I would suggest have a call, you know, Roy guys are really accessible. I've never heard anybody say they cannot get in touch with, you know, our Mayor. And Roy has been sitting here patiently over the last hour -and -a -half already listening to all of this. Why don't you guys reach out to him, okay? MR. VACCARELLO: That'll be MR. CHUNG: And then follow-up on what Council Member Poindexter said with the hospitals. Try to do that. Utilize all the resources, so you can fast-track this thing. It kind of flies in the face of everything we've been trying to say in terms of time is of the essence. If this is a good thing let's do it as fast as we can. DR. YAN: So to the Mayor of the Big Island, we don't have a personal connection and it's always faster when there is a personal connection. MR. CHUNG: He's right here. No, Roy Takemoto, our Managing Director is right here listening to all of this. You don't need a personal connection, he's right here. You guys can call up the office. He knows your names. DR. YAN: That would be helpful. Page 29 PSC -13 September 1, 2020 MR. VACCARELLO: Yeah, that's wonderful and I appreciate the suggestions for sure. Absolutely, we'll follow-up. MR. CHUNG: Alright. DR. YAN: But now you guys have also gotten an hour of education on the app and contact tracing. And I feel like that's valuable. It's all about feeding the ground up and having the underlying support, because once you have tidbits in the news about it. We have you guys now. We have you familiar with the app and part of it is the education. You've got to spend time. Public health, it's all about time with the people that's going to roll out with the app, that's going to be dealing with questions from the public about the app. And we are so grateful you're giving us this time right now. MR. CHUNG: And Roy has been here every minute of this meeting. Roy Takemoto, the Managing Director; the Number Two man for the County of Hawaii has been listening to everything you guys have said. And he's indicated that he's willing to listen to you and maybe—not maybe, probably broker a meeting with Mayor Kim. MR. VACCARELLO: That's great. Yeah, thank you. MR. CHUNG: Yeah, alright. Okay, thank you. Bye. MS. POINDEXTER: Rebecca, this is Val. I have another follow-up. CHR. VILLEGAS: Okay. MS. POINDEXTER: Yeah, Roy, this is for you; question. Have you guys been working to seek out something like that? MR. TAKEMOTO: For the contact tracing. So there's contact tracing, there's the Safe Travels Hawaii for the airport monitoring, there's the resort bubble proposals. Yeah, all of those kind of intersect each other. Specifically on the contact tracing, we've been in touch with the Aloha Trace people. MS. POINDEXTER: So, but nothing in place, right yet? So this is what I did already. I already texted the COO (Chief Operating Officer) of Hamakua Health Center and he texted me back. We're going to be talking after this meeting. I really need to get this going because we're always the `Johnny come lately' when it comes to something of an emergency such as this. This COVID-19 is such a dramatic, stressful—it's a disaster happening right now. We're just, you know, and everybody wants to look at the buffet of what is there Page 30 PSC -13 September 1, 2020 to offer before we select. We don't have that kind of time. People are dying as we speak. Probably a lot of deaths today. Here, maybe on this island. I know we've been having deaths, you know. We just had a moment of silence for three people who died on this island. And there's more to come. I am afraid. I am so afraid for my family; for even my daughter. Special needs; if she gets this, she'll be in the hospital. I can't be with her, and you know what, she's going to be alone. She has no clue what's going on. That would be so, so dramatic, not only for her that it will be a trauma, it'll be a trauma to me too, and everybody else. And every one of us, we have families; we have children. We're concerned about this disaster, this pandemic, that is here. I say let's run with something, and we've got to do it. And I hate to say this, but coming to the County Council sometimes, it'll take a while, because you've got to come to Committee; then you've got to go to Council for two more readings. And you know, a reading depending what it is, and it's slow. And to tell you the truth, you look at what is our Administration doing right now in this situation when our island is being—we have so many cases now. How many cases today, Roy do we have, do you know? You would have to check, okay. CHR. VILLEGAS: Council Member Poindexter? MS. POINDEXTER: Yes. CHR. VILLEGAS: According to what I've seen, there was 19 more today and one more passed on this island. MS. POINDEXTER: One more death and 19. When are we just going to bite the bullet and do something? Something is better than nothing. So, I'm working on it. I will be in contact with you. I will get your information from Council Member Matt Kaneali`i-Kleinfelder, and I'll be working with you on this. So let's just make it happen on this island. It doesn't have to be through the Mayor. It can be through our health facilities. And I'll work on that with you. That's my promise, okay? I yield at this time. Thank you, Madam Chair. MR. VACCARELLO: Thank you very much. If I may really quickly, I apologize. What we as a nonprofit that's dedicated to Hawai`i's most vulnerable, Native Hawaiian, and Pacific Islanders specifically, we have the technology capacity, and we're 100 percent willing and always said from the beginning, whether it's NOVID; whether it's Aloha Safe or any others, everything can work together. Technically, that is a non -issue. That is a very, very easy thing to do. It's other things, political and business interests that are challenging. Technically, it's simple. We have the capacity technically to do it. We need the political will Page 31 PSC -13 September 1, 2020 to help support it. It can be done collaboratively with everybody, and we'd be more than happy to do it. That's what the intent and mission of our entity is. First, we've got to address lives, health and wellness. Second, livelihoods; get people back to work. Third, we reduce the liabilities that are impacting the government, businesses, and educational institutions. And we do it through testing, tracing, and treating. That's the simple mandate. And the technology platform can bring everybody together under the same thing in partnership with the Department of Health and all the other technology vendors. It's not difficult. DR. YAN: And there was a time where we were actually knocking on the State DOH and the different county DOH's, especially Maui, weekly. If not twice a week, to be like, "See what we have." And we're very inclusive and designed the apps or the technological solutions to have that integration ready when they are ready. CHR. VILLEGAS: Thank you. Appreciate that. Is there anyone else in Hilo that has any other questions or statements? MS. LEE LOY: Yes, Chair. Please. CHR. VILLEGAS: Ms. Lee Loy. MS. LEE LOY: Thank you. Like Mr. Chung, I actually have way more questions on my notes here. Like Ms. Poindexter, FQHC. I'm not even sure why, you know, some of our health care providers like HMSA (Hawai`i Medical Service Association), Kaiser, Queen's isn't listed on this. On top of, you know, the resolution title itself says, "Safe Travels Contact Tracing Application." And even the title is inaccurate. And I don't like doing this, but what captured my attention is the nonprofit as it relates to the wellbeing of Native Hawaiians. And we know historically, Native Hawaiians do not, do not do well with foreign diseases. And so I'm going to take a huge leap of faith, and vote "yes" with reservations, because I think any information that we can get to protect the most vulnerable of our population is worth exploring. But between now and then, which is the next reading at Council, I hope this is enough for people within the Administration; on this dais to put great minds together to help our people. Like Val, I have a son with special needs who would never be able to communicate if he were to get sick from this pandemic. So I don't want to hear anymore. I want us to vote and just move the matter forward because clearly, this has gotten enough attention. And we should be focusing on solutions. I don't know why Kauai didn't endorse. I don't know why HMSA is not at the table. I don't know why DOH isn't here to give the other side of the story. But Page 32 PSC -13 September 1, 2020 like Ms. Poindexter, enough already. It's time we start putting something into action. Chair, with that I yield. I know Ms. David hasn't shared anything, but I really want to call for the question, because I don't want to sit here when we have the attention from the Administration. And let's just get to talking to the people who can make the decisions. I yield. CHR. VILLEGAS: Thank you, Ms. Lee Loy. Ms. David. MS. DAVID: Thank you, Chair. And thank you, Ms. Lee Loy for recognizing that. And this discussion has been very moving and concerning at the same time. I appreciate everyone's input. And everything that everyone says rings true because we're all in this, and I think what I'm hearing is frustration and not knowing who's going to make decisions that we can move forward on. With this I will definitely thank you, Mr. Kaneali`i-Kleinfelder for this. Whether this is the one to go forward and whether it's in proper form or not, I think I agree with what's been said. We need to do something and get this moving. So between now and when this comes back, as was eluded to by everyone, hopefully this will put some sort of convincing on the decision makers that have the power to make these decisions, as we're just requesting at this point in time. But I really feel that the urgency was loud and clear on this discussion. So I will support the resolution and I thank everyone, especially for the presenters, by raising an issue that I think we all think about that this should be about the safety of people and not the process and who's going to be doing it or who's going to take credit for this. I think that is secondary. And with that said, I think I will just yield for now and express my support for this resolution. Mahalo, I yield. CHR. VILLEGAS: Thank you, Ms. David. Did I hear someone in Hilo? Okay, I think we're done. With that I just have a couple of statements I wanted to make. First off, I love your restaurant, "Nato." I've been there a number of different times. Great food, great energy. Yeah, just a really, really special place. So I know that you are juggling and balancing the world, it may seem, on your shoulders. So thank you for that. You're going the extra mile for our community. I also really want to thank Matt for bringing a viable option that's ready to go to the table for us to take a look at. And this option, it too, resonates very strongly with me that you are taking into consideration and focusing on serving our most vulnerable. And myself, I really see it as a reflection of relationship, which is so much about what Hawaii focuses on. And opportunities to connect with those that you know and getting the educational component out there into communities where there may be the Page 33 PSC -13 September 1, 2020 greatest need and the least amount of understanding, instead of trying to petition those in perceived positions of power, authority, or you know, decision making. You're doing this from a grassroots, it seems, standpoint which resonates with me really strongly. I also want to put forward again that this is a voluntary participation, to participate in this app for any constituents in the County of Hawaii, that might have that concern. I alsoI had a quick question. Now with giving permission for the use of this app in Hawaii County, which is a requirement of Google. Google requires and endorsement by a municipality before the app can be released within the parameters of our County. Would that eliminate any other apps from being able to enter into our County and participate in this system? MR. VACCARELLO: No, there's only one constraint that exists and that's with the (inaudible), and that's only with the Department of Health. All other COVID related apps are open to being allowed from those four entity types. By Google and Apple if they get the endorsements. CHR. VILLEGAS: Great. Thank you. So moving this forward isn't eliminating the opportunity for other organizations or app groups to also bring an option? Okay. I'd be remiss to not point out that we have otherwise seen a lack of information and a failure by our Department of Health in moving these kind of projects forward in a timely manner that would earn back some of the trust. And that's what often times is most tragic in a circumstance like this. So thank you once again, Matt. And I'm not sure exactly how you guys connected, but I love the serendipitous nature of our connectivity in the islands. And you know, you mentioned that, about moving things forward and going where you know people so that things can flow, because people do business with people they know and like. And we have the tendency to trust those that we had prior relations with and connection with accountability and kuleana in that capacity. So I also wanted to, I guess for myself, the reward far outweighs the risk when we're looking at this resolution right now. We really appreciate the terminology used as of being technically simple, but what we need is political will. And I'm grateful that what I'm hearing from our County Council members, my colleagues, is that we have that political will in this room today. And with that I'd like to call for the vote. If no one else has anything they'd like to say. MR. KANEALI`I-KLEINFELDER: Chair, can I say one more thing? CHR. VILLEGAS: Okay, Matt. Page 34 PSC -13 September 1, 2020 MR. KANEALI`I-KLEINFELDER: Thank you. Kevin and Stephanie, I appreciate your time today. There's a lot of different opinions in the room. Like you said, you've been ready for months. We don't have time to wait. I don't want to argue semantics over wording. The point was there's an option on the table. There's a tool in the toolbox, we can add to our toolbox. We can make a difference, we can be proactive or we can sit on our thumbs and be reactive. I'm sick of being reactive. I'm sick of arguing semantics. We don't have time to screw around. We need to make choices that are good for the people. So with that, we as leaders have to be responsible in that aspect. Why didn't our Mayor go to them? How long do you want to wait for the DOH to make decisions to make us safer? We're five months in. Do we want to keep waiting? Do you want to watch more businesses go under? Do you want to watch more people die? You want to see people get sick? Is that where we're headed? We're going to wait and see what happens? The Mayor could sign this endorsement right now. You don't need my resolution. You didn't need me to bring it to the table. Anybody could have found this. I spoke to Po (Po -Shen Loh) regarding NOVID. They're all options. This is not the only app that we can use, but it's a way of using technology in our benefit. We don't have time to screw around. Our community relies on us to make good decisions. This is one of them. Thank you for your time today. Kevin and Stephanie, I think you did amazing, and I appreciate your efforts in what you're doing to keep our community safe as a whole. I look forward to meeting with you and helping you develop relationships with other entities in our County that may be willing to do this and may be willing to take the risk. Because as Rebecca said, I think the reward outweighs the risk. So thank you for your time today. I appreciate what you've done here. From one business owner to another, you know, mahalo. And mahalo for the Council's time. Thank you, I yield. MR. CHUNG: Rebecca? CHR. VILLEGAS: Yes, Chair Chung. MR. CHUNG: Yeah, I just wanted to make one last comment, too. And it's probably in response to what Matt said. And in defense, you know, to the Mayor. See this resolution, and why I'm going to, you know, vote against it today, is that it suggests almost that—and there is some suggestion that the Mayor wasn't trying to do his due diligence or put forward his best effort in finding different options. Page 35 PSC -13 September 1, 2020 But I just look at it from a real common sense standpoint. If I had an app that I had full faith and belief in and this thing was ready two months ago, and all I needed was the signature and endorsement of a Mayor, I wouldn't say I don't have time to see that Mayor. I would go over there and I'd pound on his door. I'd say, "Hey this thing can save lives. You might not believe me, but I'm going to make whatever effort I can to go and see you, because I believe in my product." If this thing actually gets approved at some point—and you know, maybe it might be the upshot of some discussions that you guys have. And I expect you, Roy, to really look at it critically too, of course, you know. And I know you will do that. But at the same time, let's say this thing gets approved by the Mayor with one signature. That means we loss two -and -a -half months about, right? Just dicking around, it's kind of crazy. So I had to make that comment. Thank you. MR. VACCARELLO: Yeah, I'll do a quick closing on my end. I'm just really appreciative of everybody and the opportunity for being able to share some of the information that we've been working on relative to a solution for the community. I do want to share that we've tirelessly been pounding the pavement in every direction that we can. I've spoken with multiple leaders in the military; state level, and county level. Some folks in economic development in the County as well as the Fire Department Chief. So conversations have been moving forward. And again, there's only so much time and so many people to speak to and so much bandwidth that so few people can engage. And tons of blockages, tons of politics, tons of abstractions and assumptions of who can and cannot do what. There's a lot of privileged positions rather than a direct connection to what's happening on the ground with people. I'm only going to care most about myself, my friends and family staying with the rest of the community members. That's why we're driving it. Nobody's going to care more about me, my family, and friends than me, my family and friends. And we want to be able to provide them the capacity to care for themselves. That's all it comes down to. If there's ways to get to others in decision making capacity that can assist and resonate with that, that's great. We're very happy to collaborate at all times with anybody. And we've been trying our best to move forward for five months and continue to get caught up in these stupid games. So we're happy to move forward. Appreciate any support that's provided. Mahalo. CHR. VILLEGAS: Thank you, Kevin. I appreciate those final words from you. There's nothing more frustrating than being wrapped up in politics when your heart is for public service. And people are getting sick, and people are dying. Historically, the Big Island sometimes struggles with Oahu -centric thinking or projects. So just the fact that this has come to the Big Island in this timeframe and Page 36 PSC-13 September 1,2020 we have this opportunity. I just really want to thank you for that. And so with that I'd like to call for a roll call vote, please. Vote on Res. 716-20: The motion to recommend adoption of Res. 716-20 was (Approved) carried by the following roll call vote: Ayes: Committee Members David, Kaneali`i-Kleinfelder, Lee Loy, Poindexter, and Chair Villegas— 5. Noes: Committee Member Chung, Kierkiewicz, and Richards—3. Absent: Committee Member Eoff— 1. Excused: None. (Note: Ms. Lee Loy voted"kanalua"then "aye," and Mr. Richards voted "kanalua"then "no.") BILLS FOR The Chair directed the Committee to proceed to the next order of business, ORDINANCES: Bills for Ordinances. (There were none.) CHR. VILLEGAS: Thank you. Can I move to adjourn? ADJOURN- There being no further business, at 4:06 p.m., Ms. David moved to adjourn MENT: the meeting. Seconded by Ms. Kierkiewicz and carried by the following voice vote: Ayes: Committee Members Chung, David, Kanealii-Kleinfelder, Kierkiewicz, Lee Loy, Poindexter, Richards, and Chair Villegas— 8. Noes: None. Absent: Committee Member Eoff— 1. Excused: None. CHR. VILLEGAS: We are adjourned. Approved: /-7/a..0. 6 Ms. Rebecca Villegas, Chair (Date) Public Safety Committee RV/dt Page 37