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The Conversation

Consider getting takeout at restaurants amid increased cases, Health Director Dr. Libby Char says

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Office of Gov. David Ige
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Hawaiʻi Department of Health Director Dr. Libby Char speaks at a press conference on April 27, 2022.

The latest COVID-19 data released Wednesday shows Hawaiʻi is still trending upward with a seven-day average daily case count of 925, and hospitalizations hitting about 130.

The seven-day positivity rate is 16.9%. About 11,800 cases have been reported over the last 14 days, not including at-home tests. Department of Health Director Dr. Libby Char says realistically that number could be five times higher. She shared the latest with The Conversation.

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DR. LIBBY CHAR, HAWAIʻI DEPARTMENT OF HEALTH DIRECTOR: The case counts are going up and so we need to be mindful of that. There is no need to panic, but we need to really be mindful of it. We need to make smart decisions. People know how to deal with COVID at this point. Stay home if you're sick, that's one of the huge lessons that keeps popping up over and over. People show up at work, and they thought, "Oh, it's just allergies," or "I wasn't feeling that bad so I decided to come to work." Now you just infected everybody else in the office. So stay home when you're sick, even if it's mild. Wear your mask indoors. We don't have a state requirement for it but that doesn't mean it's not a good idea. Wear your masking indoors and when you're around a lot of people, especially if you're somewhere that's crowded. Even if it's outdoors, if it's really crowded, wear your mask — that's going to protect you. And then avoid large gatherings. I think at this point, we're back to having to do that again. You know, for a while it was looking better, and it was okay. I think with the numbers that we're seeing now, we know that COVID is just widespread in the community. So as of today, we have 925 new cases being diagnosed in the community every single day — and that's just off of the PCR tests. So we know that the true number, depending on who you're reading in the literature — it's five times higher than that, up to maybe 10 times higher than that. So if we figure five times that, you know, we're approaching 5,000 cases a day, 4,000 cases a day. And I think that's probably realistic. So it's out there. It's everywhere in the community. Avoid large gatherings. Consider getting takeout at restaurants again until the numbers come back down. Get vaccinated. That's the one thing that we know absolutely works well. Get vaccinated and get boosted. It will keep you out of the hospital. It will keep you hopefully from getting very severely ill. This is nothing new. This is all stuff that we know already. But I think the point is, it's out there, it's in the community, don't panic, we know what to do. But when you're going through your day-to-day activities, think about it and make some thoughtful decisions.

Hawaiʻi COVID-19 Summary Metrics on Wednesday, May 18, 2022.
Hawaiʻi Department Of Health
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Hawaiʻi COVID-19 Summary Metrics on Wednesday, May 18, 2022.

CATHERINE CRUZ, HOST: So if it means not going to a graduation party — weddings have been resumed. There are just so many activities at this time of the year.

CHAR: It's graduation season and that's such a huge deal for so many people. And it's such a special thing. But if you're sick, really do you want to be the guy that infected everybody at the graduation party and got your family members and your friends sick? It's just not a good idea. If you're holding a graduation party, can you do it outdoors? Could you have a couple of smaller parties instead of having one really large party? And do it in the backyard or do it at the beach park or something else. I've been at Ala Moana Park recently, and there's a whole bunch of parties outdoors. Sure looks like they're having a great time, but they're doing it reasonably and safely outdoors, good ventilation, people are able to spread out. That's the kind of thing, that's a much better decision than trying to cram a bunch of people indoors in a restaurant or something.

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Ashley "'Auli'i" Aikau-Osurman
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University of Hawaiʻi at Mānoa

CRUZ: What can you tell us about hospitalizations at this point?

CHAR: We're watching the hospital numbers, and we're seeing them also go up. It's a lagging indicator, so the cases have been going up. I think this is about the eighth straight week now. Hospital numbers have started trending up in the past several weeks. So we're up to about 130 patients in the hospital. It's not mirroring the rate of rise that we are seeing in cases — and that's a good thing. And I think that's a tribute to our community being pretty well vaccinated for the most part. And then a lot of people also got sick on the last couple of surges that we had. But I would caution people in just looking at that hospital number because really the number that we should be watching, it's not even a number, it's what is our capacity to actually care for people in the hospital. So if you have a whole bunch of physicians and nurses and providers and technicians and everybody else in your hospital staff — and they're out sick, that limits the hospital's ability to care for patients. It's not just the number of COVID patients. It's how many of the hospital staff are out sick? What is our ability to care for people who are in the hospital?

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Hawaiʻi Emergency Management Agency
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COVID-19 hospitalizations in Hawaiʻi between December 2021 and May 2022. (May 18, 2022)

CRUZ: I believe it was Hilton Raethel of the Healthcare Association of Hawaii who said he would be concerned as the cases were starting to hit 90. Now we've exceeded that. I don't know what you can tell us as far as the mortality cases. Were they vaccinated? Did they have underlying diseases? Because nationally, they were saying that's really what it is, is the folks that are more susceptible are succumbing to this.

CHAR: So I think would be with the advent of the vaccine and now we have a bunch of COVID medications, it's really helping to keep people from becoming severely ill and ending up in the hospital and dying. That being said, we still do have many vulnerable people in our community. And just because you get vaccinated, doesn't mean that you can, you know, or that you should go out and do whatever you want. We still need to make thoughtful decisions. It gets tragic when anybody dies from something that could have been preventable. And so again, it gets back to us as a community. We're concerned about the hospital numbers and we know that they will continue to go up, even after the number of cases peaks because it's a lagging indicator. So it'll it'll lag that and it'll go up a little bit more before it comes back down. We're really keeping an eye on that. And we're also mindful of how many of our health care workers are out sick, that's part of our community, right. So when COVID goes up in the community, hospital employees are also getting sick, people that work in clinics, and in nursing homes, they're also getting sick. And so we really need to keep an eye on what is our capacity to care for people, not just COVID patients, but all the people that need health care.

CRUZ: Why can't we have better numbers on the cluster reports? It's been about two weeks since we had the last one and you identified proms at the time. What can you tell us? Are there clusters in the hospitals that we should know about? Are there clusters in restaurants?

CHAR: The point of the cluster reports when they first started was to try and help educate people as to where we were seeing large pockets of disease pop up — what kind of activities associated with what kind of places, venues, things like that. At this point, it is so widely spread in the community, that, if I said, "Oh, somebody had a party and a bunch of people got sick after it." That's all stuff that we know already. And so it's not particularly as useful in terms of shaping our behavior. We know where it's coming from — large gatherings indoors, not wearing your mask, being around a lot of people who are not vaccinated, being around a lot of people that are immunocompromised. You're going to see cases as a result of those kinds of gatherings where we know where it's coming from. And to that end, the cluster reports take a lot of time and energy. And so we felt that that energy would be better used in different ways rather than continuing to generate cluster reports when at this point, it is so widespread — you get 900 new cases a day. It's everywhere, not a matter of like, "Oh, there was a cluster in a certain place and so you should avoid that activity." We know what to do at this point.

CRUZ: We're seeing everything resume. We're seeing concerts and fundraising dinners. I went to one recently, and then I got a note saying someone tested positive, not at your table, but just FYI. And so I'm starting to kind of walk back on some of the events that I have booked thinking, maybe not.

CHAR: That's the kind of thoughtful decisions that I wish everybody would make. You have to determine the risk to you and to your family. If you get sick, what does that mean to your family members? Are you in proximity to a lot of kūpuna or to young children? And so by looking at your own choices to say, "Hmm, should I really go to that dinner?" And you know, "How important is it? Is it key that I be there or not? Where is it being held? Is it outdoors, indoors? Are the tables spaced apart?" And so I think things like that — we all want to get back out there. You know, is it a good idea to sit indoors like in a theater for a couple of hours? Are people wearing their masks or not? That all matters. And so I think those kind of thoughtful decisions are really going to help us as a community. People are so tired. They want to get back to things that they used to do and not have to worry about COVID anymore, but alright guys, it's still here. It's not quite done yet. You know, we need to be aware of that and we need to act accordingly.

CRUZ: The Health Department this week has reactivated its Joint Information Center in an effort to keep communication lines open across government offices. Char stressed that should you test positive, call your doctor right away to ask about treatments that are now available. Many should be started within the first five days of diagnosis to be the most effective. Again, Char is urging the public to avoid large gatherings and she recommends maybe the return to takeout versus indoor dining.

This interview aired on The Conversation on May 18, 2022. The Conversation airs weekdays at 11 a.m. on HPR-1.

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