Over the holidays, Hilo Medical Center saw a bump in COVID-19 hospitalizations, increasing from a daily average of between five and seven patients to 18 patients on Monday.
“Only two of them are here for the primary reason of COVID,” said HMC spokesperson Elena Cabatu, adding the average patient age was 73. “The rest are all incidental. It’s not as severe, but it is circulating in the community.”
Cabatu noted a majority of patients were vaccinated, and there was an increase in flu patients as well.
“It seems like a typical bump after holiday gatherings,” she said. “We’re reflecting the situation on the mainland.”
Both the state and nation reported a rise in COVID hospitalizations among those 70 and older.
“We were at about 60 people (statewide) in the hospital per day with COVID before the holidays,” said Tim Brown, infectious disease expert at the East-West Center during a livestream with the Honolulu Star-Advertiser on Friday. “After the holidays, the figures put us at about 80 cases in the hospital.”
Brown estimates the state is seeing a roughly 20% increase in COVID-19 transmission following the holidays.
In addition to in-person gatherings and travel, a new variant known as XBB.1.5 may be behind the increase.
“XBB.1.5 is a new variant, it’s the first recombinant that’s going global,” said Brown, who defined a recombinant as two different strains that come together during an infection to form a new variant with shared properties.
“It’s the fastest growing variant in the U.S.,” he said. “It started at around 1% (of total cases) a month ago and is now up to 28%.”
XBB.1.5 originated in the U.S. and was found in Honolulu County last week in the Department of Health’s wastewater reports.
“It’s reasonable to believe if (XBB.1.5) is on the mainland and in Oahu, it will end up in the neighboring islands as well,” said DOH spokesperson Brooks Baehr. “Just because XBB.1.5 didn’t show up on the Big Island (wastewater reports) this time around, doesn’t mean it’s not there either. It just wasn’t in the samples we sequenced.”
Wastewater data is collected from 3 different treatment plants throughout Hawaii County, covering 37,850 people, or around 18% of the county’s population, meaning certain variants escape detection.
Hospitalizations may also increase as a result of the variant.
“We’re seeing a lot more hospitalizations in places where XBB.1.5 is becoming more dominant,” Brown said, noting those 70 and up are at greater risk.
Vaccinations continue to be a key tool for minimizing illness severity, but booster rates remain low.
In Hawaii County, 18.4% of residents received a bivalent booster, as compared to the 78.4% that completed their primary series.
“If you got the two shots two years ago, you’ve got some protection against serious illness and death, but no protection against infection,” Brown said. “A recent infection will protect you for six months to a year, but it’s waning near the end of that year just like it does with other coronaviruses. Generally, the recommendation will be that most people will need to get boosted about once a year.”
Because XBB.1.5 is a subvariant of omicron, the bivalent booster offers some protection.
Treatment options for severe cases of COVID-19 include the medication Paxlovid, which needs to be administered within a five-day window from symptom onset according to the U.S. Food and Drug Administration.
“I think a lot of deaths that we’ve seen in Hawaii over the last year could have been avoided if people got Paxlovid, but they didn’t know about it, they didn’t get it soon enough, or their doctor didn’t prescribe it for them,” Brown said. “If you test positive and you’re in a higher risk category, go get a Paxlovid prescription from your doctor. It’s really important.”
The mortality rate of COVID-19 has improved throughout the state in recent months.
In August 2022, 73 COVID-19 deaths were reported by the DOH, but in December, that number dropped to 24. For the week of Dec. 25, there were no new COVID-19 deaths reported in Hawaii County.
Email Grant Phillips at gphillips@hawaiitribune-herald.com