The Hawaii Department of Health on Wednesday cut the state’s COVID-19 isolation and quarantine time requirements in half to align with U.S. Centers for Disease Control and Prevention recommendations.

Effective Monday, those who test positive for COVID- 19 regardless of vaccination status must isolate for at least five days and remain in isolation until symptoms are gone. They must also wear a mask for five days after isolation.

If exposed to COVID-19, those who are boosted or fully vaccinated within the past six months — two months for Johnson & Johnson — do not need to quarantine. However, they should wear a mask for 10 days and get tested on day five.

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If not boosted or fully vaccinated, then individuals exposed to COVID-19 should quarantine for five days, wear a mask for five days after quarantine and get tested on day five.

The new policies underscore the benefits of booster shots, according to Health Director Dr. Elizabeth Char, who emphasized that people who are boosted and have no symptoms will not need to quarantine after exposure to someone who is COVID-19-positive.

“We put a lot of thoughtful consideration into this,” she said. “I think it’s really a balance and our thought is that it would be less burdensome on the residents, it would be something people could comply with, and it would help to protect our critical infrastructure.”

The guidance acknowledges the waning immunity officials are seeing over time after initial vaccination, said State Epidemiologist Dr. Sarah Kemble in a news release.

“There is still much we do not know about transmission dynamics of the omicron variant,” Kemble said. “We will continue to follow the science. We should all anticipate that guidance may continue to evolve in the coming weeks as we learn more.”

Gov. David Ige on Wednesday said the state will not be revising its Safe Travels Hawaii program or its definition of “fully vaccinated,” which currently covers those who completed only their initial vaccine series.

Ige said the program was under evaluation but any changes would not take place for at least another two weeks.

DOH also reported three new coronavirus-related deaths — two on Oahu and one on Hawaii island — and 1,561 new infections statewide, bringing the totals to 1,085 fatalities and 106,158 cases.

The new cases include 1,322 on Oahu, 26 on Hawaii island, 134 on Maui, 58 on Kauai, 12 on Molokai, two on Lanai and seven Hawaii residents diagnosed outside the state.

The seven-day average of new coronavirus cases in Hawaii climbed to 1,485 on Wednesday, the highest point in the epidemic curve since the pandemic began nearly two years ago.

The average statewide positivity rate — or percentage of people who tested positive for COVID-19 — also reached a record high of 13% on Wednesday, up from 9.6% a week ago. On Oahu, the average positivity rate spiked even higher, to 15.3%.

“Positivity is very high, so that means we are high risk,” said Monique Chyba, a mathematics professor with the Hawaii Pandemic Applied Modeling Group.

What’s concerning, she said, is the higher number testing positive even as the volume of tests has declined.

HiPAM thinks omicron is already the dominant variant in the state and that it has been spreading in the community since mid- November.

Omicron has indeed overtaken the delta variant, according to DOH’s latest variant report, accounting for about 66% of the variants circulating in the state and 78% of variants in Honolulu County.

In a revised forecast published Sunday, HiPAM’s models show coronavirus cases in Honolulu rising to an estimated 4,500 infections and hospitalizations hitting 250 by Sunday. Based on the current trajectory, HiPAM also predicts Honolulu’s new daily cases will peak in the first two weeks of January.

This is a middle-of-the-road forecast, assuming omicron is 50% less likely to result in hospitalizations than delta.

DOH also named two events in its latest list of clusters in public venues that took place in the past 14 days: Hawaii’s Finest Musical Festival, Dec. 17 and 18 at Bishop Museum grounds, and an after-party for the music festival at the Moani Waikiki at International Market Place on the same dates.

DOH did not offer further information on the clusters but said all who attended should get tested for COVID-19.

The Hawaii Emergency Management Agency listed 127 COVID-19 patients hospitalized in the state as of Wednesday, with 18 in intensive care and nine on ventilators.

“The greater infectiousness of the omicron variant of the coronavirus means we could reach that peak very soon, within just two weeks or less,” said Hilton Raethel, president and CEO of the Healthcare Association of Hawaii, in a statement. “Even with breakthrough infections, most of the people with COVID in the hospital are not vaccinated, or boosted.”

The association said there were 2,220 patients in Hawaii hospitals as of Wednesday, just shy of 2,365 during the peak of the delta surge in September.

“This means the hospitals are pretty full, even without additional COVID patients,” Raethel said.

At the same time, many hospitals are seeing some of their own staff call in sick or having to isolate due to potential exposure. The Healthcare Association is asking for more than 700 supplemental health care staff to be brought in with funding from the Federal Emergency Management Agency, with the first wave expected to arrive Jan. 10.

Health officials continue urging all eligible residents to limit large gatherings over the New Year’s weekend, to mask up at public indoor spaces as mandated statewide, and to get a booster dose right away to help protect against the omicron variant.

“We don’t make the policy but we certainly will encourage people to do the right thing from a public health standpoint,” Char said. “We try to encourage people to limit their gathering size because we know that that’s higher risk. We’re very concerned about New Year’s and hope people will behave accordingly to minimize the risk.”

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New quarantine policy for COVID-19

>> If COVID-19 positive regardless of vaccination status: Isolate for at least five days and remain isolated until symptoms are gone. Continue to wear a mask for the next five days after isolation.

>> If exposed to COVID-19 and boosted or fully vaccinated within past six months (within past two months if J&J): No need to quarantine. Wear a mask for 10 days and get tested on day five.

>> If exposed and neither boosted nor fully vaccinated: Quarantine for five days and wear a mask for five days after quarantine. Get tested on day five.

Source: Hawaii Department of Health