In a possible sign of what’s in store this winter, the number of new statewide COVID-19 infections surged Friday to 797 cases, the highest count in more than three months, according to the state Department of Health.

The tally does not include any backlogged cases, as was the case Thursday when 395 new infections were reported. The average positivity rate also jumped to 4.2% from 1.4% just 10 days ago.

Gov. David Ige shared these startling statistics during a news conference Friday, urging Hawaii residents to get vaccinated, including boosters, and take extra precautions during holiday gatherings.

“We all know what’s necessary to reduce the risk to you individually as we enter the holidays,” Ige said. “We know what works. Wear your masks indoors, wash your hands and use hand sanitizer. If you get any symptoms, no matter how mild or how much you feel it’s just another cold, please go get tested and isolate until you get the test results. We do encourage you to limit your gatherings this year.”

Ige said he and county mayors are discussing what type of protocols might be required. The Hawaii National Guard Joint Task Force, meanwhile, canceled its draw-down ceremony Friday to continue supporting the state’s testing, contact-tracing and vaccination efforts.

Of the cases reported Friday, 712 were on Oahu, which recorded a 374% increase in average daily case counts compared with 14 days ago, boosting its average positivity rate to 5.4%, according to DOH.

Twenty-nine of the new cases occurred on Hawaii island, 23 on Maui and 14 on Kauai, and 19 were Hawaii residents diagnosed outside the state.

DOH on Friday also reported two new coronavirus-related deaths. Since the start of the pandemic, Hawaii has seen 1,067 COVID-19-related fatalities and 91,067 infections.

DOH Director Dr. Libby Char said the latest surge was driven by a combination of delta and omicron cases, with the latter expected to become predominant by early 2022.

Omicron cases rising

Confirmed omicron cases in Hawaii continue to grow after the first was detected Dec. 2 in an Oahu resident with a previous infection and no history of travel, indicating community spread.

Char said there were 31 confirmed cases of omicron as of Thursday night, up from the 14 reported in the latest variant report, with another 17 suspected cases undergoing whole genome sequencing. So far, all of them are on Oahu.

The variant report, released Wednesday, found 98% of the variants circulating in Hawaii were delta, while 2% were omicron, during the two-week period ending Dec. 4.

But omicron cases are expected to grow exponentially in coming weeks, inevitably spreading to the neighbor isles, which so far have no confirmed cases.

While omicron, so far, appears to be more transmissible and less virulent, Char warned against thinking it will not affect Hawaii’s hospitals or families, saying health care facilities might end up being worse off than during the summer delta surge.

Higher transmissibility means a higher volume of cases and potentially more COVID-19 patients hospitalized.

“If it’s that easily transmitted, just by the sheer numbers we’re going to see people ending up in the hospital, and we’re going to see people getting severely ill from it even if it is less virulent than some of the previous variants,” Char said. “So we need to keep our case counts down.”

More breakthrough cases are expected, she said, partially because more residents are now vaccinated but also because of the vaccines’ waning effectiveness. It is “tremendously important” for all those eligible to get boosters as soon as possible for protection against severe illness and hospitalization, Char added.

According to DOH, 73.3% of the state’s population has completed vaccinations, while 21.4% has received a third dose.

Sense of urgency

The situation is urgent and calls for immediate action, according to Dr. Scott Miscovich, whose prediction of reaching 500 coronavirus cases by the end of the month was surpassed Friday.

The spike in cases now portends much higher numbers ahead when the omicron variant, which doubles every two to three days, edges out delta in the isles.

“This is a tsunami, and the wave is already hitting our shores,” Miscovich said.

Unless immediate action is taken, Hawaii can expect to see 1,500 to 2,000 daily cases by the end of January, he predicted.

“If we use hospital beds as an indicator on how to manage COVID in the state of Hawaii, we will be in a crisis where no beds will be available in the next three to four weeks,” Miscovich said.

It is also too soon to know whether omicron is less severe, he added.

A recent study from the Imperial College in London found the risk of reinfection with omicron to be 5.4 times greater than with the delta variant. It also found no evidence that omicron has lower severity than delta, based on the proportion of people testing positive with reported symptoms or seeking hospital care after infection.

Miscovich advocates requiring a negative COVID-19 test 24 hours prior to travel for all travelers to Hawaii in addition to the current requirements under the state’s Safe Travels program.

During his Friday news conference, Ige said he has no plans at this time to change Safe Travels or its current rules, which require proof of vaccination without a booster, or a negative test, to bypass a 10-day quarantine for arriving out-of-state travelers.

Tim Brown, an infectious diseases modeler for the East-West Center in Manoa, agrees more needs to be done immediately.

“We are clearly in a surge, a surge which is far faster than the delta surge in July,” he said. “This is rising at least twice as fast as the delta surge, so we are definitely not in a good situation right now.”

Brown believes the current spike resulted from Thanksgiving gatherings and eased restrictions that went into effect Dec. 1.

People should cancel large Christmas parties, he said, and not gather in restaurants without masks.

“At this point there is no logical, sensible way to carry out a large event when omicron is widespread in the community,” Brown said. “Even if it’s just delta in the community, if that 797 (new cases) is largely delta and not omicron, that indicates there are not enough precautions to prevent the spread of delta, much less omicron.”

Multiple layers of prevention are necessary, according to Brown, including vaccinations, boosters, quality masking, preventing large crowds, improved ventilation and accessible testing.

Honolulu Mayor Rick Blangiardi on Friday urged people to protect themselves against a likely omicron surge and to take precautions, but announced no new measures.

“It appears the COVID fight is shifting to omicron and we have been advised case counts are likely to surge again,” he said in a statement. “We continue to monitor conditions very closely and consult with our medical experts. We remain hopeful omicron symptoms are mild and do not lead to more severe cases requiring hospitalization.”

Char said many of the infections have occurred through widespread community transmission fueled by large gatherings, travel and holiday get-togethers.

Businesses are following the rules, she said, but it is challenging with transmissible variants such as delta and omicron circulating. One cluster tied to the Scarlet Honolulu nightclub has so far resulted in 46 COVID- 19 cases, with some suspected to be omicron.

University of Hawaii campuses are also seeing an uptick in cases — with 34 in the past two weeks — prior to the winter break.

UH President David Lassner said surges usually occur after holidays, and he urged the UH community to get vaccinated, including boosters, avoid unnecessary travel and “exercise restraint” at all in-person gatherings.

Char said DOH is working to increase testing availability statewide and has been trying to procure home test kits for Hawaii but is competing with demand worldwide.

“We will try and have as much testing available as we can and make it as convenient as we can for people,” she said. “Likewise, we have hundreds of places in December alone that you can go and get vaccinated.”

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COVID-19 booster information

A booster is recommended for these groups:

>> Those ages 16-17 who completed their initial series of Pfizer vaccine at least six months ago

>> Those 18 years and older who completed their initial series of Pfizer or Moderna vaccine at least six months ago

>> Those who received a single dose of the Johnson & Johnson vaccine at least two months ago

>> Find a vaccination site near you at hawaiicovid19.com/vaccine-info.

Source: State Department of Health