Although the omicron surge has peaked and daily coronavirus cases are on a downward trend, infectious disease expert Tim Brown warns against easing restrictions too quickly.
“I think we’re in a fairly good position right now,” said Brown, an infectious disease modeler and senior fellow at the East-West Center in Manoa. “I think the fact that omicron did turn out to be less severe than previous variants had been, in terms of fatalities and hospitalizations, has worked out in our favor.”
That, combined with the effectiveness of COVID-19 vaccinations, helped Hawaii “dodge the bullet,” he said.
On Monday the state Department of Health reported 833 new coronavirus infections, bringing Hawaii’s total since the start of the pandemic to 227,284 cases.
The seven-day average of new cases dropped to 1,065 on Monday, a 70% drop over two weeks ago, and the average positivity rate — or percentage testing positive — was at 10.2%, half of what it was at the height of the surge.
Brown said it’s clear that the omicron surge peaked sometime in January and that case counts are now moving in the right direction. He warned, however, that case numbers may be skewed due to testing capacity limits and the fact that more people are using home tests, which are not reported.
“I think we still have got to be cautious,” said Brown during a conversation Monday on the Honolulu Star-Advertiser’s “Spotlight Hawaii” livestream program. “As we let down our precautions, we need to do it gradually and monitor carefully what’s going to happen.”
Maui County Mayor Michael Victorino, meanwhile, announced that effective Monday, the county would no longer require proof of a booster to be “up to date” on vaccinations for entry to restaurants, bars and gyms. Instead, the requirement would be changed to a recommendation.
The rule had been implemented just two weeks ago.
Victorino — who himself tested positive for COVID-19 recently — said he decided to drop the rule because of the downward trend in new cases in the county and statewide, as well as lowered demand for the county’s health care facilities.
During January alone — when the booster requirement was proposed — the county recorded more than 15,000 cases, he said, which exceeded the prior 21 months combined.
On Monday the state’s dashboard reported 229 patients with COVID-19 in hospitals, a 43% drop from the high of 401 in late January. Of the 229, 28 were in intensive care and 15 on ventilators.
Despite hints from other officials that Gov. David Ige would announce changes to the state’s Safe Travels program this month, no announcement has yet been confirmed, according to his office.
Brown said he would recommend requiring boosters for Maui’s Safer Outside, Safe Access O‘ahu and the state’s Safe Travels programs as a way to reduce transmission of the omicron variant.
Without boosters, he said, the initial doses of current vaccines are only 10% to 20% effective, which means those without it still risk getting infected and passing the virus to others at places like restaurants and bars.
The boosters, however, bring protection levels up to 70%, he said, and also broaden immune T-cell and B-cell response to better deal with future variants.
The benefits of adding a booster requirement to Safe Travels, he said, would be to help prevent tourists from getting sick and landing in Hawaii hospitals while also reducing transmission on airplanes.
“It’s a major step in reducing risk of breakthrough infections,” he said. “We can bring that down lower with the booster.”
As of Monday, DOH reported 75.2% of the state completing their initial vaccine series, with 35.6% boosted. Of those eligible in the state, 56.6% have been boosted.
Brown forecasts case counts lowering to maybe several hundred a day but said the state should prepare for the next surge.
“There will still be a substantial amount of virus out in the community,” he said, “which means if people totally drop their guard, we could start to see some surges again, hopefully not as large as what we’ve just seen.”
The state should prepare by having a good surveillance system in place, stockpiling high-quality masks and rapid tests ahead of time, and making sure treatments are available to respond quickly to the next surge.
“In terms of where the virus is likely to go, I’m not one to subscribe to after omicron it’s over,” said Brown. “We said the same thing after alpha, we said the same thing after delta, we’re saying the same thing now, but it’s up to the virus to determine where things go from here.”
With only about 60% of the world vaccinated, there are bound to be future variants down the line, Brown warned, with as-of-yet unknown characteristics.
During the omicron surge, Hawaii’s average positivity rate reached a high of about 20% in mid-January.
Then the state put a pause on reporting the rate because its electronic data collection system was overwhelmed with the volume of test results to be processed.
On Feb. 1 DOH resumed posting the state’s average positivity rate online using a proxy for the number of tests processed.
The state was processing only positive test results from about 80 different labs through its software, according to DOH spokesman Brooks Baehr, while pausing negative test results. However, DOH still received negative test result numbers from labs through its reporting system, which were used to determine the total tests or denominator, to calculate the average positivity rate for the past week. Those negatives, however, did not go through a software that vets out duplicates.
As of Monday, Baehr said DOH was once again up and running and able to feed all test results through the software to improve its accuracy.
On Monday, DOH resumed posting average positivity rates by county, which stood at 18.3% for Kauai, 12.3% for Hawaii, 10.8% for Maui and 9.7% for Honolulu.
No new virus-related deaths were reported Monday, and the COVID-19 death toll remained at 1,226.