The Hawai‘i State Department of Health reminds the public to be vigilant due to high levels of COVID-19 activity in Hawai‘i. The DOH Respiratory Disease Dashboard shows COVID-19 disease activity level is in the red, or high activity level, indicating the virus is circulating at high levels compared with historic trends. This high level means that recommended precautions are more important for reducing risk.

DOH continues to monitor this activity and recommends the following:

• Get your COVID-19 shot if you have not yet received the 2023-24 COVID-19 vaccine, or if you are eligible for an additional dose (adults 65 and over and those with immune compromise). Keeping up to date lowers your risk of severe illness, hospitalization and death from COVID-19.
• If you are feeling sick, stay home and away from others. Return to usual activities only if fever-free for at least 24 hours without use of fever-reducing medicines, and symptoms are improving. After returning to usual activities, wear a mask when around people indoors for five additional days to avoid spreading germs to others. Consider testing when you will be around people at higher risk of severe disease.
• Wearing a well-fitting mask indoors with other people can help protect yourself and those around you, especially if you are recovering from COVID-19 symptoms.
• Staying outdoors or in well-ventilated areas is a simple action that can help reduce COVID transmission. 
• Practice good hygiene. Cover your coughs and sneezes, clean frequently touched surfaces, and wash your hands often.
• Take a COVID-19 test if you have symptoms and might need treatment. Antiviral treatments for COVID-19 and influenza can prevent hospitalization and death. Treatments work best when taken as soon as possible after symptoms begin.

COVID-19 activity is on the rise, according to a new Respiratory Disease Activity dashboard released by the Hawai‘i State Department of Health (DOH). 

The dashboard, developed by the DOH Disease Outbreak Control Division (DOCD), provides an at-a-glance snapshot of current respiratory disease activity statewide, including COVID-19. The dashboard addresses not only COVID-19, but other acute respiratory illnesses, including influenza (flu) and respiratory syncytial virus (RSV).Respiratory diseases occur year-round in Hawaiʻi. 

Currently, COVID-19 is at the yellow, or medium activity level, meaning the virus is circulating at higher levels than would be expected based on historic trends. COVID-19 activity is also increasing. Flu and RSV remain at green, or low activity levels. Overall acute respiratory disease is at the medium level.

“The new Respiratory Disease dashboard provides, in one place, a summary of what is happening with several major respiratory viruses that contribute to respiratory disease in Hawai‘i. This helps people make informed decisions about their health,” said State Epidemiologist Sarah Kemble. “This week, the dashboard shows that COVID-19 test positivity is higher than expected and climbing, and that ED (emergency department) visits and hospital admissions for COVID-19 are also going up. Based on this information, I would recommend checking whether you’ve had the 2023-24 COVID-19 vaccine, and if not, or if you’re eligible for a repeat dose, go get it today.”

Current dashboard trends show that COVID-19 remains a health concern, and the public should take reasonable precautions to avoid getting sick. Among them:

1. Stay up to date on COVID-19 vaccines.
2. Stay home if you’re feeling sick and return to usual activities only if fever-free for at least 24 hours without use of fever-reducing medicines, and symptoms are improving.
3. Wearing a mask when you are indoors with other people helps protect you and those around you. Wearing a mask when you have or are recovering from COVID-19 symptoms is particularly important to prevent spread of illness to others. 
4. 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-19 and influenza can prevent hospitalization and death. Treatments work best when taken as soon as possible after symptoms begin.

Additional strategies for reducing COVID-19 and other respiratory disease spread can be found at health.hawaii.gov/docd.

Visit the new dashboard here.

The Hawai‘i Department of Health reports it is in general agreement with today’s updated COVID-19 guidance from the Centers for Disease Control and Prevention, effectively dropping the five-day guidance on COVID isolation.

The recommendations suggest returning to normal activities when, an individual has been fever-free without the use of medication for at least 24 hours, and symptoms are improving overall.

“The new guidelines reflect the current level of risk, while still protecting the most vulnerable,” DOH officials said. The advisement eases some restrictions and more closely aligns COVID-19 with the broader category of respiratory viruses, which include influenza and RSV (respiratory syncytial virus).

The DOH reports that the trend in Hawai‘i is similar to that nationally, in which significant declines in COVID-19 hospitalizations and mortality have been associated with the high degree of population immunity, availability of vaccinations, and access to treatment.

“As the threat from COVID-19 more closely resembles other common respiratory viruses, CDC is issuing Respiratory Virus Guidance, rather than additional virus-specific guidance,” according to a DOH news release.
“The new pan-respiratory guidance makes it easier for people to take actions to prevent disease spread, even if they are unable to identify the specific respiratory disease.”

DOH will be reviewing CDCʻs guidance over the coming week as the department prepares updates to state-level guidance to align with these changes.

To read more about the CDC’s changes, visit Protect yourself from COVID-19, Flu, and RSV. CDC offers separate, specific guidance which has not changed for health care settings (COVID-19, flu, and general infection prevention and control).

The State of Hawai’i Organization of Police Officers and Maui County have reached a negotiated settlement agreement on hazard pay for Maui officers who remained on duty during the COVID-19 pandemic, according to a SHOPO announcement.

Under the agreement, officers who worked a patrol through the pandemic will receive 20% hazard pay, based on the number of hours worked during the pandemic. All other officers will receive 15% hazard pay. Initially, Maui County denied the union’s request for hazard pay for officers.

In addition, all officers will receive 15% hazard pay for overtime hours worked during the pandemic, calculated at a straight time rate, not the time-and-a-half overtime rate. Time used by officers for vacation, sick days or any other leave is ineligible for hazard pay. The settlement agreement is fully executed.

“We believe the agreement honors the risks taken by Maui’s police officers who worked through the pandemic, putting their health and the health of their families at risk so they could serve our community,” said Nicholas Krau, SHOPO Maui County Chapter chair. “We appreciate Mayor Bissen and the Maui County Council’s leadership and support of Maui’s police officers, and we are thankful for the accessibility and professionalism of Managing Director Josiah Nishita throughout this long, but civil process.”

“SHOPO commends Maui County for being the first county to step forward and recognize the sacrifices and professionalism of Hawaiʻi’s police officers throughout the pandemic,” said Robert Cavaco, president of SHOPO. “We are hopeful the other three counties follow Maui’s lead and work with us in resolving the hazard pay issue for the rest of our officers.”

Following the settlement with Maui County, SHOPO has three active grievances at various stages of the process in Honolulu, Hawaiʻi, and Kauaʻi counties.

The Hawai‘i Department of Health and the US Centers for Disease Control and Prevention recommend use of the new 2023-2024 COVID-19 vaccines that recently were approved and authorized by the US Food and Drug Administration.

The new vaccines protect against the XBB-lineages of the Omicron variant that accounts for 99% of COVID-19 cases in Hawai‘i.

These vaccines replace the previously approved and authorized Bivalent mRNA vaccines.

State Health Director Dr. Kenneth S. Fink said the new vaccines come at a good time.

“We are seeing increased numbers of COVID-19 cases and hospitalizations,” he said. “By getting the new 2023-2024 COVID-19 vaccine, you are taking steps to help minimize the spread of disease in our communities. This is especially important as we approach the holiday season.”

The Food and Drug Administration announced the approval and authorization of the updated vaccine formulations on Sept. 11. The next day, the US Centers for Disease Control and Prevention recommended the updated vaccines for all persons 6 months of age and older.

For persons 5 years of age and older, the new vaccines are to be administered as a single dose, at least two months since a person’s last dose of any COVID-19 vaccine.

For persons under the age of 5, recommended doses and vaccination schedule will vary depending on the child’s previous vaccination history and vaccine brand administered. If you have any questions, please consult with your child’s physician for guidance.

For children 6 months through 18 years of age, the new vaccines will be available through the Vaccines For Children Program, with health insurance coverage for zero out-of-pocket cost. The new vaccines should be available wherever children currently receive their other routine childhood immunizations. 

Unlike previous COVID-19 vaccines, the new vaccines are not being exclusively distributed by the US government to vaccination providers. The new vaccines also are available through traditional pathways for purchase, distribution and payment, including health insurance coverage.

Initial public and private sector orders of the new vaccines have begun shipping and are expected to arrive in pharmacies and provider offices on Friday and Saturday.  However, not all providers will have vaccines available at the same time as shipping timeframes will vary between manufacturers, vaccine distributors and provider locations.

It is recommended to give providers time to ensure vaccines are received in good condition, stored properly and inventoried in their systems, in order to properly administer and document the vaccination of patients.

Scheduling of vaccination appointments will be done by individual vaccine providers once they receive delivery of their vaccine supply. 

Persons seeking vaccination may search for vaccine providers on the Vaccines.gov – Find COVID‑19 vaccine locations near you website.

For uninsured and underinsured adults, the website will be updated to include a filter feature to identify locations participating in the Bridge Access Program. 

The Department of Health reminds the public that in addition to getting the new vaccines, masking and physical distancing continue to be effective for protecting yourself and others against COVID-19. Good hygiene practices, such as frequent handwashing, also are highly recommended to prevent the spread of the virus.

State health officials say they are seeing early signs of increased COVID-19 cases on the island of Maui.

This morning, state epidemiologist Sarah Kemble, spoke from the Lahaina Comprehensive Health Center to media over Zoom that cases seem to be mild at this time, however, she encouraged people to get vaccinated and boosted.

The Maui wildfires, that ignited on Aug. 8 and turned Lahaina Town’s Front Street into ash, forced thousands to flee their homes. In response to the disaster, several congregate shelters were opened throughout Central Maui to help the displaced residents.

Kemble said testing at these shelters was available. “Testing for COVID is not top-of-mind when you’re worried about where you’re going to sleep,” she said.

Those shelters have since closed and more than 2,900 individuals are sheltered at 12 hotel locations around Maui, in coordination with the American Red Cross.

Kemble said there are 14 new COVID cases per day on Maui, including cases of the flu. Over the past week, 112 coronavirus cases were reported. A new variant, BA2.86 has been reported but there are no confirmed cases in Hawai‘i.

While she couldn’t say the exact cause of the increase in cases, Kemble advised people to wear N95 masks if they are staying at a shelter and other public places. She said these masks are also helpful to those returning to areas impacted by wildfires to protect from smoke, ash and debris.

Kemble said health workers aren’t seeing the illness in older immune-comprised people but also in children.

“Don’t delay. Take care of your health,” she said.

Boosters and vaccines are available at pharmacies and the Lahaina Comprehensive Health Center.

The COVID-19 pandemic swept the globe in 2020. It wasn’t until May that the World Health Organization determined the virus to be an ongoing health issue, no longer a public health emergency of international concern.

Since the beginning the pandemic, there have been 44,931 cases on Maui.

More than three years since COVID-19 was introduced to the world, most Hawaiʻi residents consider their health to be good or excellent. But there are significant differences across socio-economic and demographic categories, including ethnicity, according to the results of a Rapid Health Survey released on July 12 by the University of Hawaiʻi Economic Research Organization.

The University of Hawaiʻi Economic Research Organization Public Health Report, “Shaping Health in Hawaiʻi: The Influences of Poverty, Housing and Food Insecurity,” surveyed 1,575 adult residents across the state. The study examined the links between mental health, food security and socio-economic determinants, such as housing conditions and poverty status.

The report shows that those experiencing housing insecurity, food insecurity and poverty were more likely to have been negatively impacted by the pandemic and reported worse physical and mental health.

“The survey underscores the intricate links among health, socio-economic status and lifestyle conditions in shaping individual well-being,” said lead researcher Ruben Juarez, University of Hawaiʻi Economic Research Organization-Hawaiʻi Medical Service Association endowed professor in Health Economics. “The pervasive impacts of the COVID-19 pandemic, particularly Long-COVID, highlight the continuous need for multifaceted interventions that address economic stability, housing security and equitable healthcare.”

Long-COVID affected 35% of respondents, up from 30% in 2022. Juarez said that there is a clear association between long-COVID and unemployment, with 49% of unemployed vs. 28% of employed individuals reporting long-COVID in May 2023.

Other key findings include:

• General health outcomes: More than 70% of participants considered their health to be good to excellent, but Native Hawaiians and Filipinos tended to report lower health ratings in comparison to Whites and Non-Filipino Asians. Individuals with high income or food security tended to have more positive health perceptions, while those dealing with the long-term effects of COVID-19, or who had delayed healthcare, especially mental health services, reported lower health scores.
• Mental health and well-being: One-third of participants reported symptoms of depression, with significant risk factors being unemployment and recent COVID-19 positivity. Housing instability, housing cost burden and poverty were also correlated with higher rates of depression symptoms. About 80% of respondents reported no food security issues, but—compared to findings in 2022—there was a small increase in those reporting very low food security. Unemployment, recent COVID-19 positivity, younger age, certain ethnicities such as Native Hawaiians and Filipinos, poverty and housing instability all correlated with increased food insecurity.

This report is based on results from the third wave of the University of Hawaiʻi Economic Research Organization Rapid Health Survey conducted in June 2023 by its public health team, in partnership with the Pacific Alliance Against COVID-19. In future reports, the team aims to increase the sample size of survey respondents and deepen its exploration of these findings, including exploring causality and cost, to offer a more thorough understanding of these complex social determinants of health.

Read the full report on UHERO’s website.

While the pandemic may be over, the risk of COVID-19 is still real and as a result the Hawai’i Department of Health recently updated its guidance documents to ensure local keiki are protected from the virus at school.

According to a recent report, the new guidance documents spell out safe practices and recommendations for local students that include home isolation and exposure, return to work guidance, identifying and talking to close contacts, and home care and prevention. 

According to the updated comprehensive K-12 school guidance, there are new protocols for students and staff who may show sickness.

For starters, if a student or staff has become sick at school, they should immediately be separated and go home or to a healthcare provider based on symptom severity.

Here’s a look at a few other guidelines:

• Individuals who are sick should wear a face mask, if possible.
• Identify an isolation area to separate anyone who has COVID-19 symptoms.
• Ensure students are isolated in a non-threatening manner, within the line of sight of an
  adult, and only as long as necessary.
• Ensure staff managing sick students or employees are appropriately protected from
  potential exposure to COVID-19.
• Staff caring for a sick student or staff should be provided appropriate personal
  protective equipment, including an N95 respirator or equivalent (or double
  masking with a surgical and tight-fitting cloth mask if a respirator is not available) and
  follow standard and transmission-based precautions.
• Gloves, gowns and face shields are not routinely required, but consider using during
  interactions with a student or employee who is actively coughing or with special medical
  needs.
• Refer to CDC guidance on “When and How to Clean and Disinfect a Facility” for guidance on appropriate cleaning and disinfection procedures after a case is identified.
• When performing notification, schools should rapidly identify the impacted group setting and notify any potentially exposed group members of contact with a person with COVID-19 infection, while keeping the person’s identity and personal health information confidential.
• If your school is experiencing a suspected outbreak, notify the Hawai’i State Department of Health within 24 hours via the online COVID-19 Outbreak or Case Reporting Tool. The principal, supervisor or program contract manager is responsible for reporting the suspected outbreak to the DOH.

The federal Public Health Emergency (PHE) for COVID-19, declared under Section 319 of the Public Health Service Act, will expire at the end of the day on May 11, 2023, state officials announced today.

This comes after the Centers for Disease Control and Prevention (CDC) announcement last week that COVID-19 is now an established and ongoing health issue, and no longer constitutes a public health emergency of international concern.  

As the PHE ends, high levels of vaccination, widespread population immunity, and available treatments have significantly reduced the risk of severe COVID-19 disease, hospitalization, and death, according to a state news release.

“We mourn the loss of loved ones from the pandemic.  However, our experience demonstrated what we can accomplish when we come together as a community, having the lowest mortality rate in the nation,” said Hawaiʻi State Health Director Dr. Kenneth Fink. “Although the federal PHE is ending, we’ve learned that we must remain vigilant and continue to invest in public health preparedness.”

In terms of what the end of the PHE means for the public, the CDC and the US Department of Health and Human Services provided the following information:

• Vaccines will remain available. Access to COVID-19 vaccines will generally not be affected for now. The U.S. government is currently distributing free COVID-19 vaccines for all adults and children.  To help keep communities safe from COVID-19, HHS remains committed to maximizing continued access to COVID-19 vaccines.
• COVID-19 at-home tests may not be covered by insurance. Insurance providers will no longer be required to waive costs or provide free at-home COVID-19 tests. COVID-19 tests ordered by healthcare providers when clinically indicated are generally expected to be covered by insurance but may have cost-sharing.
• For people with Medicaid coverage, COVID-19 testing and treatment will remain covered at no cost through September 2024.
• No cost testing may be available to people without insurance or in areas of high social vulnerability through CDC’s Increasing Community Access to Testing (ICATT) program. Participating community and pharmacy partners can be located through CDC’s No Cost COVID-19 Testing Locator.
• CDC will discontinue reporting of COVID-19 Community Levels and some other COVID-19 metrics like percent positivity. These changes are because of changing laboratory requirements with the end of the PHE, and also because case data has become less reliable as self-testing gains in popularity.

In addition to the information provided by the CDC and HHS, the Hawai’i Department of Health is notifying the public of the following:

• Sometime later this year, COVID-19 vaccines are anticipated to become commercially available, and DOH will provide more information on this transition to providers and the public as it becomes available. DOH remains committed to working with providers and federal agencies to ensure equitable vaccine supply for Hawai‘i residents.
• DOH will continue to partner with long-term care facilities, other healthcare and congregate settings, schools, and community organizations to investigate illness clusters and outbreaks of concern, provide technical assistance, and educate partners and the public on how to mitigate the impacts of COVID-19.
• DOH will continue to maintain dashboards that provide situational awareness of COVID-19 trends and impacts in Hawai‘i.
• While masks are no longer required in public settings in the state of Hawai‘i, use of a properly fitting high quality mask remains an important tool for preventing COVID-19 and many other respiratory illnesses. Those with high risk of severe disease, such as kupuna and those with chronic medical conditions, as well as those who interact closely with these groups, should consider wearing a mask in situations where social distancing is not possible. 
• The DOH reports that vaccines are still “the best tool” for preventing infection or severe illness from COVID-19. The COVID-19 vaccine is recommended for anyone over 6 months of age. Anyone who has not yet received a bivalent vaccine dose should get one. And anyone who is at increased risk for severe infection and has received a bivalent dose should consider receiving a second dose.  Bivalent vaccines provide better coverage for the variants of COVID-19 currently in the community. Detailed vaccine recommendations can be found here. Find your nearest COVID-19 vaccine provider at Vaccines.gov.
• Vaccinations and masking are particularly important for people who are immunocompromised or for those who have frequent contact with individuals who fall into this category, according to the DOH.

The World Health Organization today said that COVID-19 is now an established and ongoing health issue, and no longer constitutes a public health emergency of international concern.  

This comes more than three years after the organization declared it a crisis back in March of 2020. Today’s announcement marks a transition to a downgraded response.

The announcement came with a list of recommendations moving forward relating to vaccination efforts, ongoing transitions to lift international travel related health restrictions, and sustaining national capacity gains and readiness for future outbreaks.

The WHO Director-General, Dr Tedros Adhanom Ghebreyesus, noted that the number of weekly reported deaths and hospitalizations continue to decrease, but at the same time expressed concern that surveillance reporting had declined significantly.

He announced the publication of the 2023-2025 COVID-19 Strategic Preparedness and Response Plan which is designed to guide countries in transitioning to long-term disease management of COVID-19.

According to the WHO, “global risk assessment remains high,” but “there is evidence of reducing risks to human health driven mainly by high population-level immunity from infection, vaccination, or both.” The organization also said there is improved case management.

“While SARS-CoV-2 continues to evolve, the currently circulating variants do not appear to be associated with increased severity,” the organization reports.