Omicron subvariants BA.4 and BA.5 together now make up roughly 20% of variants circulating in Hawaii, according to the state Health Department’s latest variant report.

The report, published late Wednesday, found via genome sequencing that subvariant BA.4 and its sublineages represented 6% of test specimens collected in Hawaii between June 5 and 18. BA.5 and its sublineages represented 13% of those specimens.

For BA.4, that represents a more than threefold increase from the previous two-week period, and for BA.5, that represents a more than fourfold increase from the previous two-week period, the report said.

Omicron subvariant BA.2.12.1, meanwhile, made up 58% of COVID-19 virus variants circulating in the state, while BA.2 made up the remaining 23%.

The three subvariants – BA.2.12.1, BA.4 and BA.5 — are believed to have an increased ability to evade therapeutic monoclonal antibodies, and antibodies elicited by vaccination or prior infection, compared with BA.2.

The stat e Department of Health’s State Laboratories Division has detected 43 cases of BA.4 and BA.4.1, and 84 cases of BA.5 and its sublineages, in the state in samples collected in May and June.

All four major counties of Hawaii — Kauai, Honolulu, Maui and Hawaii — now have both BA.4 and BA.5 present in their communities.

“BA.4 and BA.5 are growing,” said Tim Brown, epidemiologist and senior fellow at the East-West Center in Manoa. “Bottom line, this is for the two-week period ending June 18. If we treat that as the midpoint, that’s a month ago.” That means that the data is a month old, said Brown, meaning there is likely more BA.4 and BA.5 than reported circulating in the state now.

The Centers for Disease Control and Prevention says there is no evidence that BA.4 and BA.5 are more severe than other omicron subvariants, The New York Times reported, but more people becoming infected means more people will be hospitalized.

The CDC, meanwhile, on Thursday kept Honolulu, Maui and Hawaii counties classified as orange, high-level communities for COVID-19 impacts even though the state’s average case counts and positivity rates have been on a downward trend.

Under CDC guidelines, those living in high-risk communities should wear a well-fitting mask indoors in public and on public transportation, regardless of vaccination status.

The metrics used by the CDC to determine community levels are based on coronavirus case rates per 100,000, new COVID-19 hospital admission rates per 100,000, and percentage of hospital beds occupied by patients with COVID-19.