A mandatory 14-day self-quarantine for interisland travelers starting today comes as Hawaii begins to address a shift in COVID-19 cases from mostly out-of-state travel-related to more in-state.

Out-of-state travel accounted for at least 80% of Hawaii’s COVID-19 cases until about a week ago, state Health Director Bruce Anderson said Monday at a news conference.

“These were individuals who had traveled from other places where COVID-19 was widespread or came into contact with a traveler,” Anderson said. “Recently, we’ve had more cases where there is no travel history. … Clearly, we are moving away from travel-related cases and focusing more now on cases that are locally transmitted.”

Gov. David Ige announced the new interisland order Monday, saying it would take effect at midnight today and continue until April 30. Ige said it’s “more important than ever to continue to practice social distancing. We cannot let our guard down.”

The interisland order expands Thursday’s quarantine order for all out-of-state passengers. Since that earlier order, travel counts have dropped dramatically, and a majority of hotels across the state have suspended operations.

Normally, more than 30,000 passengers come through Hawaii’s airports on any given day in March, said state Department of Transportation spokesman Tim Sakahara. But only 826 passengers, some 167 of them visitors, came through the state’s airports Sunday, the fourth day of the state’s 14-day mandatory self-quarantine for all incoming passengers.

Ige said “essential infrastructure” and “essential businesses” will be exempt from the interisland quarantine. For more information, Ige said to email a question to covidexemption@hawaii.gov.

Maui Mayor Michael Victorino praised the interisland quarantine as a step neighbor island mayors had sought to flatten the COVID-19 curb.

“The vast majority of these cases have been residents who’ve traveled and returned home. We want to see interisland travel reduced to only those who must travel to provide essential public services, such as medical care for our residents,” Victorino said.

But the new idea doesn’t come without sacrifice. It puts even greater strain on the state’s interisland carriers — Hawaiian Airlines and Southwest Airlines — which already have taken major hits due to declining travel demand.

Hawaiian spokesman Alex Da Silva said Monday, “Hawaiian Airlines is proud to have carried workers who perform essential services for decades. During this unusual and difficult period, we will work to make sure we maintain a neighbor island schedule that can accommodate the vital needs of our community.”

Southwest spokesman Brad Hawkins said the carrier is evaluating “how these additional protocols will affect our interisland operation and the demand for essential air service to consider any short-term business changes.”

“Southwest intends a long-term relationship with the Hawaiian Islands and we are proud to serve our communities with much more than flights. Today and every day, we stand alongside our local employees and the people of Hawaii with a shared interest in protecting the health and safety of all residents of the islands,” Hawkins said.

The new order will create disruptions for Hawaii residents, who are used to going back and forth for work, school, shopping or visiting friends and family.

The order left Ewa Beach resident Serge Fort scrambling Monday to get his niece home to Kona.

“We were able to get her on a 7 p.m. flight Tuesday. They’ve reduced the volume of flights, so that’s the soonest that we could get her home,” Fort said.

While an interisland quarantine is a big ask of Hawaii residents and businesses, more containment measures could still follow.

State Sen. Glenn Wakai, chairman of the Senate Energy, Economic Development and Tourism Committee, is among those pushing for even more airport safety measures.

The state already is planning to add airport thermal temperature screens to its COVID-19 response. Wakai also wants to see all airplane passengers screened by a test from Abbott Labs, which President Donald Trump has touted for its ability to deliver “lightning-fast results in as little as five minutes.”

“Despite the steps we are taking, we still have more people coming into the state,” Wakai said. “Some of them may be infected but not showing symptoms. Quarantining passengers is a good first step, but we need to do more. We don’t want to be in New York’s situation.”

Wakai said he doesn’t think passengers would balk at rapid coronavirus testing any more than they do at current TSA measures put in place after Sept. 11, 2001.

“None of us have second thoughts about having to show up at the airport two hours early for screening. That’s been the way of the world since 9/11,” Wakai said. “From a traveler’s perspective, I think temporarily using Abbott Labs’ tests would be reassuring and provide peace of mind for future visits.”

The test, which is read on a portable molecular technology device, delivers positive results in as little as five minutes and negative results in 13 minutes.

“Point-of-care testing will be a game-changer in our communities. Obviously, the most immediate application would be in ICU units, where we want to be able to get a test result very quickly,” Ige said.

However, he added, “we are in discussions about what we would be able to do with similar point-of-care technology in the airline situation. If we could test everyone on a flight, obviously that would provide assurance to our community that there is no one who is infected on the flight.”

Ige said the state is still getting information on how many point-of-care test kits would be made available.

“As we receive them, we’ll be looking at how we can deploy them in the most appropriate way to ensure the safety and well-being of our community,” he said.