All eyes are on omicron subvariant XBB.1.16 as the federal public health emergency related to the COVID-19 pandemic expires on May 11.

The subvariant, also known as “Arcturus,” has been detected in sewage samples from Hawaii and Kauai counties, according to the latest wastewater report available from the Hawaii Department of Health. It has also been detected via genome sequencing in Honolulu and Maui counties, according to the latest variant report released Wednesday.

The World Health Organization recently designated XBB.1.16 a variant of interest, noting a weekly rise in its prevalence and that its presence has been reported in 33 countries.

The variant, which fueled a surge in India, is a recombinant of two BA.2 descendant lineages, according to WHO. It appears to have a growth advantage over other variants, but shows no signs so far of greater severity in populations.

The latest variant report showed XBB.1.16 made up only 2%, while XBB.1.5 made up 86% of variants circulating in Hawaii, for test specimens from the two-week period ending April 8.

Health officials are recommending residents get the bivalent booster, which targets omicron variants, if they have not done so yet.

The Centers for Disease Control and Prevention recommends Americans ages 65 and older and those who are immunocompromised get a second bivalent booster for additional protection.

Those who have not yet been vaccinated with the original, monovalent COVID-19 vaccines, which the CDC no longer recommends for use in the U.S., can now get the updated bivalent one.

Dr. Scott Miscovich of Premier Medical Group said this spring booster is important due to waning immunity and the more immune-evasive variant, with kupuna currently the most impacted.

“Don’t wait,” said Miscovich during a recent “Spotlight Hawaii” conversation. “If you’re in that category the reason there is an approval is because there’s significant evidence that shows it’s going to help you.”

Miscovich said he is seeing more patients walk into his office and urgent care clinic with COVID-19.

The official case counts are undercounted, he said, due to unreported home tests — as well as people who no longer test at all when they have symptoms.

The Hawaii Department of Health on Wednesday reported a seven-day average of 114 new COVID-19 cases a day, down from 133 a day reported on April 19. The state’s average positivity rate was at 7.9%, the same as reported on April 19.

On Wednesday, there were 63 patients with COVID-19 in Hawaii hospitals, with five in intensive care, according to the Healthcare Association of Hawaii. The average for the week was 68 patients per day, down from 72 per day the previous week.

In the U.S., XBB.1.16 is gaining ground, making up an estimated 10% of new COVID-19 cases, up from about 6% the previous week, according to the CDC.

Six more deaths were reported in Hawaii, bringing the state’s COVID-19 death toll to 1,884.