23 June 2024
Hundreds of respiratory illnesses circulate through the human population. Most tend to be mild and people simply live with them.
Even if it eventually infects the majority of the world.
A nurse wears a mask Friday. (Photo by Nathan Christophel/Big Island Now)
The COVID-19 pandemic is technically over and most people go about their normal daily lives without thinking much about the coronavirus or any of the more than 26 variants of the original strain that have caused illness since 2019.
“But it is too soon to say COVID is no different from any other respiratory disease,” said Elena Cabatu, director of marketing, legislative and public affairs for the East Hawai‘i Region of Hawai‘i Health Systems Corp. “It still causes many more [emergency room] visits, hospitalizations and deaths compared to influenza and [respiratory syncytial virus, or RSV].”
So 5 years later, it’s not a bad idea to remain cautious, and just because COVID is no longer spreading rampantly because people have developed immunity after being vaccinated, that doesn’t mean hot spots can’t — and don’t — pop up.
Hawai‘i is one of them right now.
COVID cases in the Aloha State, including on the Big Island, have been on the uptick since the beginning of May. Because of the continued increase in cases, the Big Island’s healthcare facilities are again turning to one of the tried and true ways of protecting patients and the public from the spread of COVID and its variants — masking up.
Cabatu said at Hilo Benioff Medical Center, employees in clinical roles who have close and prolonged contact with many patients throughout their workday must wear a mask. It is highly encouraged for non-employees to do so, but not mandatory, and unless a vendor has direct patient contact, masks are recommended but not required.
Generally speaking, some patients also wear masks, but most don’t tolerate it 24 hours a day, 7 days a week.
Most of the Hilo hospital’s visitors are agreeable to wearing a mask, too, and if they don’t have one, staff can provide one. Again, however, it’s not mandatory.
Hilo Benioff Medical Center had 281 emergency room visits and 75 hospitalizations related to COVID between May 1 and June 17. There were 13 people hospitalized June 17 with COVID.
The hospital has also been seeing some flu and RSV cases since the beginning of May, but not nearly as many as COVID.
“Yes, we are back to masks for staff in clinical areas,” said Lynn Scully, marketing and communications manager at Queen’s North Hawai‘i Community Hospital in Waimea. “It’s encouraged for visitors, but not required.”
Caregivers and staff are required to wear a surgical or procedural mask in all clinical areas including inpatient clinical units, outpatient clinics, nursing stations, hallways, meeting rooms and other areas located within clinical units.
Masks are available in the front lobby and departments throughout the hospital.
Kona Community Hospital has no plans to institute a new mask requirement.
Anne Julia P. Padilla, community relations and program manager for the hospital, said while it was experiencing the same increase in numbers are other facilities throughout the past several weeks, the Kona hospital has been noticing a decrease in the number of positive cases visiting its emergency department.
“The hospital does ask patients who have symptoms to take appropriate precautions while seeking care at the hospital,” said Padilla.
Because of the increase in COVID and other respiratory viral infections in the islands, Kaiser Permanente Hawai‘i began on June 17 requiring masks for all physicians, providers and staff at its clinical facilities including medical offices, clinics and Moanalua Medical Center in Honolulu.
That requirement extends to everyone who works in Kaiser’s care delivery areas. Masks also must be worn in areas such as the intensive care unit, oncology, neonatal intensive care unit, pediatrics and pediatric intensive care unit, labor and delivery and mother and baby areas.
For staff and vendors working outside those areas, masks are recommended but not required.
“We believe this additional safety precaution is necessary at this time to mitigate the spread of COVID-19 within our facilities and minimize the spread in our greater community, which not only threatens the health and safety of vulnerable individuals but has the potential to cause staffing shortages that could impact our ability to deliver care,” said Tammy Brownfield, senior director of communications and brand management for Kaiser Permanente Hawai‘i.
Starting June 24, Kaiser will increase communications and post signage strongly encouraging the use of masks by all members and visitors.
Masks will be made available for members and visitors upon request.
“We will continuously monitor community patterns of disease, which is not limited to COVID-19, and other factors to ensure the safety of our members, patients, employees and physicians,” Brownfield said. “Masking requirements for Kaiser Permanente facilities are determined by our local infectious disease, infection prevention and safety experts and will be adjusted as necessary.”
None of the Big Island’s four largest healthcare providers have plans for any other precautionary measures, such as shortened visiting hours or proof of vaccination, while the summer COVID season continues.
The Hawai‘i Department of Health on Wednesday reported a total of 1,180 new COVID cases statewide, including 83 new cases on the Big Island.
Graphic from the Hawai‘i Department of Health
The state is seeing an average of 175 new cases per day throughout a 7-day period, an increase of 3 from the week before. It has a 16.7% test positivity rate. Hawai‘i has had a total of 424,748 COVID cases since case numbers started being recorded by the state.
Hawai‘i County is seeing an average of 14 new cases a day throughout a week, with a 6.6% test positivity rate. The Big Island has recorded a total of 47,229 cases since the state started keeping case numbers.
Between April 28 and May 4, the average statewide positivity rate was just 5.6%.
The increase in COVID activity started in early May and has carried over into June following unusually low numbers in March and April. It also coincides with a national COVID trend that is on the rise, that started in the West.
Dr. Peter Chin Hong, professor of medicine and an infectious disease specialist at the University of California, San Francisco, told ABC News earlier this week that the virus is gaining ground in more than 30 states.
Case numbers are growing throughout the nation heading into the summer months. Viral activity remains relatively low nationwide, but it more than doubled in the western United States during the past month, according to wastewater data from the U.S. Centers for Disease Control and Prevention.
The test positivity rate for the week ending June 8 across the nation showed an increase of 0.8%.
Even more interesting is that in previous years, trends of increasing COVID cases were seen in winter and summer months.
Cabatu explained that the original COVID spike in Hilo came in August and September of 2020. That was followed by a big spike in cases of the delta variant from July to September 2021 and then the omicron 1 variant from December 2021 to February 2022.
The next surge was from the omicron 2 variant from April to September 2022. Since then, there have been smaller spikes in December 2022, August 2022 and January and now June of this year.
“I think the challenge has always been that we were never quite sure what the frequency of sort of the ebb and flow of COVID would be over the typical season. We never sort of really got into that rhythm or if we did it looked like there might be a bigger winter surge most winters and a sort of a small previously kind of late summer surge,” said Dr. Cameron Wolfe, professor of medicine with the Infectious Disease Division at Duke University, to ABC News earlier this week. “Typically after July the Fourth was when we would see those increases. So maybe the fact that we’re seeing a slight increase now is not dramatically different than where we were in past years.”
Cabatu said it could be too soon to predict a pattern, but because of a number of factors, Hawai‘i is unique. At any given time, even before the pandemic, the islands could see all sorts of respiratory illnesses. Flu season is typically in the fall and winter, but it can be less predictable in Hawai‘i.
The recent spike in cases signifies a new COVID variant, one of several KP variants that seems to be more contagious than the variant previously circulating based on case numbers.
Cabatu said that compared to the beginning of the pandemic, yes, there are fewer hospitalizations, especially stays in the ICU and needing ventilators and fewer deaths. Initially, the KP variant did not seem to cause more severe illness, but just in the past month, it has started to particularly affect the elderly more severely.
The Hawai‘i Department of Health was already at the end of May recommending the public take extra precautions to protect themselves and others as COVID cases increased. Their No. 1 tip is to stay up to date on vaccines.
A Big Island first responder gets a COVID-19 vaccination Dec. 23, 2020, in Hilo. (File photo courtesy of Hawai‘i County)
Health experts say getting vaccinated is the best way to protect yourself from severe illness.
In a March 1 press release, before the most recent COVID case increase began in Hawai‘i, the state Health Department said the islands were trending similarly to the nation; significant declines in COVID hospitalizations and mortality were being associated with a high degree of immunity, availability of vaccines and access to treatment.
Unfortunately, vaccines have a relatively short efficacy. Cabatu said most studies show they only last about 6 months. So this most recent spike in case numbers also could have something to do with a mix of vaccines wearing off and people just not keeping up with their inoculations.
According to the state Health Department, only about 13% of Big Island residents are up to date on their COVID vaccines.
Wolfe told ABC News that the COVID vaccine should become just like the flu vaccine and get fresh each year. Click here to find a vaccine clinic near you.
COVID remains a health concern, and you can take several other precautions along with getting vaccinated and masking up to avoid getting yourself and others sick, including:
Stay home if you’re feeling sick and return to usual activities only if you are fever-free for at least 24 hours without the use of fever-reducing medicines and symptoms are improving.
Take a COVID-19 test if you have symptoms and might need treatment. Many respiratory viruses have similar symptoms, but treatments differ. Antiviral treatments for COVID and the flu can prevent hospitalization and death. Treatments work best when taken as soon as possible after symptoms begin.
Additional strategies for reducing COVID and other respiratory disease spread can be found online.