COVID-19 data trends in Hawaiʻi: monitoring variants, planning for the future

State health officials today say that while they are seeing a decline in COVID-19 cases, they are seeing notable deaths, which is a lagging indicator from the latest omicron surge. The department is also monitoring the BA.4 and BA.5 variants and reviewing recommendations for the upcoming school year.

State Epidemiologist Dr. Sarah Kemble and Deputy State Epidemiologist discussed today’s COVID-19 numbers, which included 4,381 new COVID-19 cases for the week of June 30 to July 6, 2022–981 fewer cases than the previous week

“We are happy to see cases coming down over the last few weeks,” said Dr. Kemble. “That being said, we do see some slowing in rate of decline now. So that raises the question of whether we may be hitting more of a plateau at this point.”

Dr. Kemble said the state also had a notable 20 deaths reported in the last week. “These deaths are not all deaths that occurred in the last week. These are deaths that may have occurred in preceding weeks, and just got reported to us… We do have on our website trend charts that show overall trends in deaths, and we are seeing now the impacts of this latest surge of omicron that we had over May and June.”

“As we know, deaths are a lagging indicator, and we do see those deaths emerge as the peak of the actual cases may be passing us by,” said Dr. Kemble. “These deaths are not really changed in character from what we’ve seen previously. We’re still seeing deaths predominantly in older age groups.”

To date, about 75% of Hawaiʻi residents, age 50 and older have not received a second booster dose, and about 61% of those 75 and older have not received a second booster dose.

Over the course of the pandemic more than 90% of COVID-19 deaths have occurred in people 50 years of age and older.

“We do know that boosters provide protection against severe outcomes from COVID-19, including hospitalization and death,” said Dr. Kemble, as she stressed the importance of booster shots, especially for older age groups.

The current daily average for COVID-19 cases statewide is 651 over the last week.

Meanwhile, the overall trend in hospitalizations has continued to decline with 155 hospitalizations reported today, down 41 from a week earlier. As of July 6, there are 11 people in ICU beds and six people on ventilators with the virus, according to the Hawaiʻi Emergency Management Agency.

Tracking variants and new approaches

BA.1 and BA.2 are still the predominant strains, according to Dr. Kemble, but the state is seeing some BA.4 and BA.5, but they are still a minority at this time.

“Based on what we’re seeing in the mainland US, I would say it’s likely that BA.4 and BA.5 will continue to gain a foothold in Hawaiʻi and we will continue to see an increase or a takeover of the ecology of COVID-19 in Hawaiʻi by those variants,” said Dr. Kemble. “Whether that will cause a surge is less certain. In some countries and jurisdictions, that has been the case, for example in South Africa; whereas in other jurisdictions, it’s less clear that that’s driving increased numbers of cases.”

In Hawaiʻi, health officials say, the state has already had surges of BA.1 and BA.2 recently, so there is some “cross-immunity,” but they will be monitoring hospitalizations and severe outcomes.

Dr. Kemble said getting boosters and masking is still helpful. “We do see that BA.4 and BA.5 are getting further and further away from what the original virus for which the vaccines were designed for, so there is some discussion at the national level of whether new approaches to vaccine might be in our future,” said Dr. Kemble, noting that much of the discussion is still speculative at this point.

Vaccine effectiveness, now available for younger kids

State health officials say the currently available vaccine still reduces the risk of getting severe outcomes like hospitalization and death. The department also advises that masking is still a useful tool.

“While some people are making less right now, we also don’t know other people’s circumstances,” said Dr. Kemble. “Maybe they already had COVID-19 in the last 90 days. So I think you’re going to see more of different types of behaviors at this point in time. But if you are concerned about your risk of COVID-19, wearing a mask is still protective and is a very good tool in the tool box.”

The department is currently reviewing school guidance and expects to release updates in the next week or two.

Vaccines are now available for children under five years of age.

• The new Pfizer vaccine is specially made for children six-months through four years of age and will be administered in a three-shot series. There should be three weeks between the first and second shots. The third shot is to be given at least two months after the second shot. Each dose is one-tenth the dose of the Pfizer vaccine given to adults.
• The new Moderna vaccine is for children six-months through five years of age and will be administered in a two-shot series. The second shot is to be given at least four weeks after the first shot. Each dose is a quarter of the Moderna dose given to adults.

Dr. Kemble said she does recommend getting children vaccinated if they are under five. “It is beneficial to protect against severe outcomes of COVID-19, including some of the conditions that we’ve seen like MIS-C (Multisystem Inflammatory Syndrome in Children), which can be an immune response condition that can be quite severe in children.”

According to state health officials, reinfection with COVID-19 is fairly common, but say it’s difficult to collect accurate data in this area.