The evolution of the virus driving the COVID-19 pandemic continues, with the latest chapter being the rise of omicron subvariants BQ.1 and BQ.1.1. The two, described as among the most immune-evasive variants yet, are gaining ground in Hawaii as well as nationwide.

The BQ.1 lineage now makes up at least 11% of variants circulating in Hawaii, according to the state Department of Health’s variant report published Wednesday. The proportion is likely higher still since this figure is based on the genome sequencing of test samples from the two-week period ending Oct. 22. Two weeks prior, BQ.1 was just a blip on the radar, representing some 3% of variants in the state.

The increase in Hawaii was expected, given that over the span of one month BQ.1 and BQ.1.1 — both offshoots of BA.5 — were responsible for a sizable jump in overall U.S. coronavirus infections — rising to 35% from 11.4% of all new cases, according to the Centers for Disease Control and Prevention.

However, the rise of BQ.1.1 so far does not appear to be driving up hospital admissions in places where it is dominant, experts have said. Eric Topol, professor of molecular medicine and head of the Scripps Research Translational Institute, noted that BQ.1.1 has become dominant in France, and is on the path to dominance in the United States.

Even so, new COVID-19 hospitalizations have been on the decline, which is reason for some optimism. In New York, where BQ.1.1 is the highest in the nation, Topol pointed out that there has not yet been any indication of an increase in COVID-19 hospital admissions.

Another immune-evasive variant, XBB.1, has also been detected via genome sequencing. Four cases have been detected in the state — three of them in Honolulu — in samples collected between Sept. 30 and Oct. 7.

The new variants are concerning because they can get around protections from monoclonal antibody therapies such as Evusheld, which can protect a patient’s weakened immune system.

The latest COVID-19 case counts in the state, meanwhile, reflected no significant changes. The DOH on Wednesday reported that the state’s seven-day average of new cases declined to 154 Wednesday compared with 165 reported on Nov. 2. The state’s average positivity rate also declined to 5.3% compared with 5.5% the previous week.

Hospitalizations of COVID-19 patients remained about the same, with a seven-day average of 68 in Hawaii hospitals over the week compared with 69 the previous week.

Officials also reported five more deaths, bringing the state’s coronavirus-related death toll to 1,717.

Pfizer, meanwhile, announced that clinical trials of its bivalent booster elicited about four times more antibodies against omicron subvariants BA.4 and BA.5 when compared with the original COVID-19 booster for adults older than age 55.

“These data demonstrate that our BA.4/BA.5-adapted bivalent vaccine works as conceptually planned in providing stronger protection against the Omicron BA.4 and BA.5 sublineages,” said Dr. Ugur Sahin, CEO and co-founder of BioNTech in a news release. “Our goal is to provide broader immunity against COVID-19 caused by SARS-CoV-2,” including omicron and other circulating strains.

Uptake of the new bivalent booster, however, remains dismally low in the U.S., with only 8.4% of the eligible population ages 5 and older having received one, according to CDC. In Hawaii, the uptake is more robust, with about 16.5% of the state’s eligible population, or 182,919 residents, having received the new bivalent booster.

Hawaii pharmacies and health centers continue to offer the updated boosters, which all residents ages 5 and older are eligible for if at least two months have passed since completion of the primary vaccination series or previous booster.

The Queen’s Health System is conducting a vaccination event from 9 a.m. to 2 p.m. Saturday and Nov. 19 at Palama Settlement, 810 N. Vineyard Blvd., with bivalent boosters for those ages 12 and older. Participants can preregister for a time slot at bit.ly/PalamaVaccination.

Kaiser also offers the Pfizer bivalent booster at community vaccination events, and will be at the Legacy Christian Church in Kailua from 10 a.m. to noon Sunday.

For more information about COVID-19 vaccination sites, visit hawaiicovid19.com/vaccine.