State announces transition from emergency response to public health management

Governor David Ige announced today the state’s transition from emergency response to public health disease management.

“I think we all know that COVID-19 isn’t going away. In fact, case counts are increasing and experts expect that COVID will be with us for the foreseeable future,” said Gov. Ige during an afternoon press briefing on Wednesday.

As part of the transition, Gov. Ige said COVID-19 will be handled more like other diseases–something health care providers diagnose and treat. He touted the state’s work in having the lowest case counts per capita, and amongst the lowest death rates in the nation.

The state Department of Health will perform whole genomic sequencing to look for new variants, and the state will continue its surveillance system.

“We are not planning to impose new mask mandates or vaccination requirements at this point in time. We will continue to evaluate the situation and take actions as required, but we all must remain smart and careful as ever, as we transition,” said Gov. Ige.

4-fold increase in cases from March 18

State officials acknowledged that COVID-19 infections are up nationwide, as well as here in Hawaiʻi. Hawaiʻi’s current daily average reported case count is 362–representing a four-fold increase from a low of 88 cases per day on March 18, according to Dr. Sarah Kemble, state epidemiologist with the Department of Health.

“As the Department of Health watches this trend, we feel the state is in a good position to manage and respond the increase in COVID-19 infections. But we still urge the community to act with care,” said Dr. Kemble.

Dr. Kemble said the increase in cases is something that was expected as many of the restrictions throughout the state were lifted–including the Safe Travels Program and indoor mask mandates for public areas.

“People are returning to a greater state of normalcy and so they’re doing many of the things that maybe they haven’t been doing during most of the pandemic. People are going to more events and larger gatherings. They are traveling. More people are returning to work in person,” said Dr. Kemble, noting that variants may also be playing a role.

“So we are seeing the BA.2 variant make up a larger proportion of the circulating virus in our state. BA.2 appears to be more transmissible than the initial BA.1 omicron variant,” she said.

DOH officials also acknowledged that there are many more COVID cases in the community than are reported to the Department of Health. This is because of the amount of people that are taking home tests, which are not included in DOH data.

Hospitalizations are a lagging indicator

Because of all of these factors driving an increase in COVID-19 infections, DOH officials say the public must maintain a level of caution.

“I want to point out that the cases that we are seeing now are not so far, associated with a dramatic increase in hospitalizations. We do have reasons to be hopeful that more cases does not have to mean a large burden of critical illness and death,” said Dr. Kemble.

“When we look at the global landscape–in countries where vaccination coverage has been high before the omicron surge, even though cases shot up and hospitalizations also rose, ICU admissions and deaths did not show nearly the same level of increase as during previous surges,” said Dr. Kemble.

She said that this is in reference to countries where the proportion of the total population fully vaccinated was around 85% and above–close to where we are at now in Hawaiʻi.

“Also, while we unfortunately saw many hospitalizations and deaths due to COVID-19 during our omicron surge in Hawaiʻi, we can now expect that a more substantial proportion of our population has immunity from prior infection, in addition to the level of vaccine induced immunity we had going into the surge,” said Dr. Kemble.

She advised continued caution. “We’ve seen in every prior surge that hospitalizations are a lagging indicator. It’s too soon to conclude that we’re in the clear with respect to COVID-19. We must still use all of our available tools in our toolbox,” she said.

The DOH advises that people continue to stay home when they are sick, stay up to date on vaccinations and boosters, and be sensible about masking and other prevention measures, especially when attending large indoor gatherings. Dr. Kemble said masking still remains an important mitigation strategy in congregate settings including at nursing homes, shelters, and schools.

Indoor Masking continues at Hawaiʻi public schools for remainder of school year

As seen in the broader community, the state Department of Education is also reporting an increase in cases at schools.

“This marks the fifth straight week of increased case counts since spring break,” said Keith Hayashi, interim superintendent for the state Department of Education.

A total of 396 confirmed or probable cases were reported across the public school system last week. The system has 257 schools and more than 200,000 students and staff statewide.

“Under the Department of Health’s guidance, for K-12 schools, keeping this added protection in place means quarantining of in-school exposures is no longer required. This major shift in quarantine guidance aligns with our ongoing priority of maintaining in-person learning for our students,” said Hayashi.

“As much as we all want to return to pre-COVID practices… we are still in a pandemic and must act accordingly. Graduation ceremonies are coming up in the next few weeks. We want to be sure that our students can celebrate this special occasion that they deserve, but it has to be done safely,” said Hayashi.

According to the DOE, the department provided overarching guidance and safety parameters for schools to use in planning commencement events. There are different considerations for different venues. “Schools have the flexibility to determine event specific details to maintain the health and safety of all attendees,” said Hayashi.

To help with the DOE effort, they department has received 700,000 home test kits. Over the last three weeks, the DOE has distributed nearly 400,000 kits to schools. The department plans to meet with the DOH to plan safety protocols for summer school and the next school year. Hayashi said he will make those announcements when appropriate.

“We do know that we want to maximize learning opportunities for our students, for them to continue to learn in-person; and I think all of us are excited about graduations and being able to get to in-person events in some fashion,” said Gov. Ige.

DOH names 3 goals: Protect, Detect, Enhance resilience

Dr. Elizabeth Char, director of the state Department of Health identified three main goals as the state transitions to disease management, mirroring plans at the national level.

The three main goals as outlined by the DOH include:

1. Protect against and treat against COVID-19.
2. Detect and prepare for new variants.
3. Enhance community resilience.

Testing haș shifted from temporary community testing sites to testing by health providers and at-home tests.

There are eight free over the counter tests that members of the public can get per month, according to Dr. Char. “They’re available using your health insurance, either for reimbursement, or in some places they’ll just let you get the eight without having to pay anything upfront,” said Dr. Char.

“Case counts have climbed gradually for the past month nationwide, and in Hawaiʻi. Hawaiʻi is still doing well overall. The number of hospitalizations has started to increase over the past week, but hospitals still have lots of capacity to provide optimum care for these patients,” said Dr. Char.

She continued to advise individuals who are sick to stay home. “Avoid spreading your germs I think is probably one of the biggest things, and masks are a great tool to do that,” said Dr. Char.