The mother of Faith Moore thanked hundreds of friends, family, and neighbors who gathered at a vigil for her daughter. It was held at the softball field where the high schooler played. 16-year-old Faith went missing over the weekend when a flash flood near her Arizona town carried away her car. Hundreds of volunteers have been helping firefighters look for Faith. Her car was recovered, but the teen was not inside.

Over the years Hawaiians must have grown wearily accustomed to reading news reports of individual snorkeling deaths, but looked at collectively the figures were stark. Between 2009 and 2018 there had been 206 snorkeling deaths – 189 of them tourists.

Compare that with the fatalities in that period of scuba-divers (28), freedivers (46), or swimmers (80).

In October 2017, at the behest of the state health department, a sub-committee was formed to address the growing public concern. This represented Hawaii’s health, tourism, and emergency services authorities and the state medical examiner’s office, and it took a deep dive into the problem.

Pulmonologist Dr. Philip Foti has been practicing in Hawaii for more than 50 years. Appointed principal investigator, he and the rest of the team prepared a preliminary report called the Snorkel Safety Study. It was published, though the full report is still awaiting peer review.

The study makes compelling reading because it points the finger of suspicion firmly at a condition not previously associated with snorkellers, and one that is contentious among scuba-divers – immersion pulmonary oedema or IPO, also known as “drowning from the inside”.

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