Honolulu continues to surpass the thresholds for new daily COVID-19 cases to stay in Tier 3 of its reopening strategy. However, Gov. David Ige agreed with Mayor Rick Blangiardi to stay in Tier 3 for another four weeks.

Now Blangiardi has submitted a proposal to Ige to permanently modify the tier system.

While Honolulu waits for Ige’s decision on the modifications, a spokesperson from Blangiardi’s office said the city will remain at Tier 3.

Under the current tier system, if the number of new coronavirus cases exceeds 50 or the positivity rate increases to more than 2.5% for two consecutive weeks, Oahu was supposed to revert back to Tier 2 for at least four weeks starting today.

The less-restrictive Tier 3 allows social gatherings of up to 10 people, lets bars and restaurants seat groups of up to 10 people and lets gyms operate at 50%. Outdoor weddings of up to 100 people are permitted and outdoor sports have been able to resume.

The request to modify the tier system was submitted to the governor on Monday. Ige and Blangiardi were not yet ready to share any details about the potential changes.

However, Blangiardi has discussed some of his different ideas about the tier system publicly. One idea is to expand the daily case counts for Tier 3 to allow from 50-100, or possibly 120. He argues that the current tier system does not reflect the level of vaccinations being conducted.

Healthcare Association of Hawaii President Hilton Rae­thel agreed with this potential increase.

“We’re supportive of changing the threshold,” he said.

“We are in a very different environment because we have vaccinated so many people. … The risk level is less than what it was, but we still need to be concerned. This is still a dangerous disease.”

Another change Blangiardi has considered is changing the metrics to instead be focused on hospitalizations and deaths rather than daily case counts.

“We wouldn’t suddenly go back to normal … we would absent the tier myopia looking at case counts, (instead) keeping the metrics on deaths and acute hospital care and wanting that to remain down,” he said on the Honolulu Star-Advertiser’s Spotlight Hawaii last week.

However, Raethel explained that using hospitalizations or deaths is not the best indicator.

“The hospitalizations are a lagging indicator because it takes a while for the disease to develop,” he said.

“It doesn’t give you as accurate or as timely a window into what is going on in the community because of the lag between infections and hospitalizations. If the hospitalizations all of a sudden go up, that means that three weeks ago, four weeks ago, there was a very good chance that there was a significant rise in infections.”

Using hospitalizations and deaths to move between the tiers would sacrifice precious time to get a handle on infections if they were starting to balloon out of control.

Blangiardi also has considered restarting swim meets and allowing attendance at public venues with proper social distancing.

Raethel was optimistic about Hawaii’s vaccination pace as the state is just about a month away from hitting 70% of people over age 16 vaccinated — the lowest benchmark for herd immunity— and seven weeks away from hitting 80-85%, which is the goal.

“If we can get to that 80% mark that would be phenomenal. And that would mean that we’ve got a much safer community that we’re operating under, and suddenly the risk goes down dramatically,” he said.

“That doesn’t include the kids 16 and under because they can’t get it right now, but to have 80% of your 16-and-older population vaccinated, that would be a real milestone. I think most public health experts would agree with that.”

Radiant Cordero, the chairwoman for the Honolulu City Council Transportation, Sustainability & Health Committee, submitted a memo to Blangiardi requesting more information on the tier system by the next committee meeting on May 18.

“I respectfully request for an update on the next steps forward,” she wrote.

“I look forward to a presentation and advisement from the City Administration and their medical advisory group for a discussion about the next steps in our tier system or any changes to the system, evaluation of the increase in our 7-day average positivity rate, and our next steps forward.”

New cases

Hawaii Department of Health officials reported Wednesday one new coronavirus-related death and 64 additional infections statewide, bringing the state’s totals since the start of the pandemic to 485 fatalities and 32,794 cases.

No further information was immediately available regarding the latest death on Oahu.

The state’s official coronavirus-related death toll includes 375 fatalities on Oahu, 53 on Hawaii island, 52 on Maui, two on Kauai and three Hawaii residents who died outside the state.

The U.S. coronavirus-related death toll Wednesday was more than 579,000 and the nationwide infection tally was over 32.5 million.

Wednesday’s new statewide infections include 40 on Oahu, eight on Maui, six on Kauai, two on Hawaii island and eight Hawaii residents diagnosed outside the state, according to health officials. As a result of updated information, state health officials removed two Oahu cases from the count.

The statistics released Wednesday reflect the new infections reported to the department on Monday.

Inmates tested

Meanwhile, mass COVID-19 testing of inmates and staff at the Kauai Community Correctional Center has yielded no positive results, according to the Hawaii Department of Public Safety. State officials implemented the testing after an employee at the facility tested positive for the virus on Sunday.

A total of 128 inmates and 55 staff tested negative. Two tests are being redone due to problems with sample collection.

There are currently no known active COVID-19 cases within the state’s inmate population.

Nearly 2,000 Hawaii inmates, including those housed on the mainland at Saguaro Correctional Center in Arizona, have tested positive for the coronavirus since the beginning of the pandemic. The Kauai jail has had no reported outbreaks.