The majority of COVID-19 cases in Hawaii are now variants of concern, according to a report released today by the state Department of Health’s Laboratories Division.

“Variants of concern now make up more than 90% of the genomes sequenced by our lab,” said Laboratories Division Director Edward Desmond in a news release. “We detected our first variants in January and in just four months they have replaced the original COVID-19 lineages as the COVID we find most often.”

Since Jan. 21, when the first variant of concern was detected in Hawaii, the division has found 1,023 specimens of variants of concern, almost double what it was in April.

Variants of concern, including the B.1.1.7, or UK variant, and B.1.429, or California variant, are more easily transmitted from person to person, and therefore may spread more quickly through the community and be harder to contain, according to acting state Epidemiologist Dr. Sarah Kemble.

They can also cause more severe disease, leading to hospitalizations and death.

“The variants that we’re seeing emerge really have moved pretty quickly,” said Dr. Kemble.

Among others detected in Hawaii, so far, are the B.1.427, a California variant closely related to B.1.429, the B.1.351, or South Africa variant, and P.1, or Brazil variant.

The report also found a growing presence of the P.1 variant, which is highly infectious and may be more resistant to antibodies from vaccination or previous infection.

“We’re very happy that our case numbers are going down, but the presence of variants in our state suggest we should be very attentive to getting as many people as possible vaccinated as soon as possible,” said Desmond.

UK variant now dominant

The B.1.1.7 variant, which was first detected in the United Kingdom, became the dominant variant in the state in late April, according to officials, surpassing the B.1.429, or California variant, which had been more prevalent in March and early April, resulting in several clusters on Maui.

Earlier this month, the B.1.1.7 variant accounted for at least 61% of variants circulating in the islands. It is now the predominant variant circulating in Honolulu County.

It has been detected 304 times in Hawaii, with most cases, 201, found in Honolulu County.

This, according to health officials, is concerning, but also came as no surprise, considering that it is now also the dominant COVID strain in the rest of the United States.

“It’s showing a very similar trend to what we’ve seen in the rest of the United States,” said Dr. Kemble, “here we initially saw B.1.1429, especially in the western states predominating for a couple of months, and then B.1.1.7 just creeping up, and then really taking over. We saw that same trend mimicked here in Hawaii maybe a month or two later.”

It is more concerning than the California variant because a study has shown it to be more likely to cause severe illness, hospitalizations, and deaths among those who are unvaccinated, she said. The California variant, while more transmissible, does not necessarily put more people in the hospital.

“This might be be one of the reasons that we continue to see hospitalizations even though we’re seeing less disease overall right now in the state,” she said.

On the other hand, more data is showing the COVID-19 vaccines available in Hawaii work against these variants, she said.

The P.1 variant, first detected in the state in March has been found in 36 specimens in Hawaii, including 22 on Maui and 13 on Oahu.

The B.1.617 variant, a highly contagious variant believed to have originated in India, also known as “the double mutant,” has not yet been detected in Hawaii.

The Health Department’s Laboratories Division began whole genome sequencing last June, and now examines 75 specimens containing SARS-CoV-2 statewide a week.

VARIANTS OF CONCERN IN HAWAII*

>> B.1.429, California, 631 total (first detected in the state Dec. 31, 2020)

>> B.1.1.7, United Kingdom, 304 (first detected Jan. 21, 2021)

>> B.1.427, California, 40 (first detected Dec. 7, 2020)

>> P.1, Brazil, 36 (first detected March 21, 2021)

>> B.1351, South Africa, 12 (first detected Feb. 16, 2021)

* All of these variants were also detected in specimens the first week of May

Source: Hawaii Department of Health