The daily average of COVID-19 cases rose the week after Thanksgiving in Hawaii, a possible indication of uptick in weeks to come as newer and more evasive omicron subvariants gain ground.

On Wednesday the state Department of Health reported a daily average of 182 COVID-19 cases — a jump from 137 reported Nov. 30. The state’s average positivity rate inched up to 6.5% compared with 6.3% the previous week. Also, the weekly average of COVID-19 patients hospitalized in the state bumped up to 70 compared with 62 the previous week, according to the Healthcare Association of Hawaii.

An uptick would be in line with concerning national trends, with the majority — California, Missouri and New York included — reporting an increase in COVID-19 cases and hospitalizations, according to The New York Times database.

Over the past two weeks the database shows the United States has seen a 28% increase in the daily average number of COVID-19 cases and a 29% increase in COVID-19 hospitalizations.

This is happening as more immune-evasive omicron subvariant pair, BQ.1 and BQ.1.1, continue to grow to dominance, accounting for about 63% of infections in the U.S. The BA.5 subvariant accounts for 14%.

The latest variant report for Hawaii showed similar trends, with BQ.1 and BQ.1.1 at about 42% of variants circulating in the state, while BA.5 is at 34%, based on whole genome sequencing results for the two-week period ending Nov. 19.

Health officials are continuing to warn Americans about a “tripledemic,” the possibility of contracting respiratory syncytial virus, or RSV, influenza and COVID-19 at the same time.

Flu season started early in the U.S. and is proving to be formidable, with nearly all states experiencing high or very high levels of influenza activity, according to the Centers for Disease Control and Prevention.

Dr. Rochelle Walensky, CDC director, has said hospitalizations for flu have been at the highest levels for this time of year in a decade. To date there have been a total of 14 pediatric flu deaths.

She urges Americans to get the new bivalent booster and flu shots, which are available to anyone age 6 months and older. She added that wearing a high-quality and well-fitting mask can also reduce the spread of respiratory illnesses during this holiday season.

But interest in getting the new bivalent booster — which targets the original strain and omicron subvariants BA.4 and BA.5, which are no longer dominant — remains woefully low.

Since its rollout over Labor Day weekend, only 12.7% of eligible Americans ages 5 and older have received the bivalent booster. In Hawaii, a total of 230,090 residents have received the bivalent booster, representing 20.8% of the eligible population, according to DOH.

Broken down by age group, only 8% of Hawaii residents ages 25-39 and 13% of those ages 40-49 have gotten the bivalent booster.

Among seniors, rates are higher as age increases, with 21% of those ages 50-64, 41% of those ages 65-74 and 46% of those ages 75 and older having received the bivalent booster.

Dr. Eric Topol, professor of molecular medicine at Scripps Research, said in a recent newsletter that seniors, especially those that have not been boosted in the past six months or at all, are the ones landing in hospitals for COVID-19.

Additionally, he noted that “masking has largely been abandoned,” along with many other mitigation measures such as rapid testing and improving air ventilation as people get ready to gather for the holidays.

“‘The pandemic is over’ attitude is pervasive and blatantly off-base,” wrote Topol on Saturday. “Ignoring the circulating virus doesn’t and won’t make it go away. We’re surely putting our elders and immunocompromised people at risk.”

DOH on Wednesday reported 1,371 new COVID-19 infections between Nov. 29 and Dec. 5, which was an increase from the numbers reported the previous week.

By island, there were 1,043 cases reported on Oahu, 105 on Hawaii island, 147 on Maui, 46 on Kauai, eight on Molokai and two on Lanai. An additional 20 infections were reported for Hawaii residents out of state.

DOH also reported seven more deaths, bringing the state’s coronavirus-related death toll to 1,744.