Get ready. With the omicron variant already circulating in Hawaii, another COVID-19 surge is expected, health officials warn, just as holiday gatherings get into full swing.

A total of 12 unrelated omicron cases — including some with no history of travel — have already been detected on Oahu, indicating community spread. And suspected cases at The Queen’s Medical Center, involving six staff members and a patient, are undergoing investigation.

Health officials maintain that more cases are inevitable, given what is known about omicron so far.

“We know omicron is here and we are seeing lots of evidence internationally that it is more transmissible than even delta was,” said Dr. Janet Berreman, Kauai District Health Officer. “We saw a great big surge from delta earlier this year, and it happened very quickly. So, we should expect at least as big a surge, potentially more quickly, because of the increased transmission.”

Residents can help reduce the threat by getting vaccinated against COVID-19, and getting a booster shot.

“What we do know is that boosters help a lot,” Berreman said. “So everybody who’s eligible for a booster should be getting their booster today.”

Dr. Scott Miscovich said the urgency for booster shots needs to be shouted from rooftops, with pop-up clinics organized across the state.

In the United Kingdom, for instance, where coronavirus cases are doubling every two to three days, Prime Minister Boris Johnson is urging everyone 18 and older to get their booster shot by the end of the year to protect themselves against the omicron variant.

Miscovich predicted on Wednesday that in the absence of stepped-up public health action, Hawaii’s daily coronavirus numbers will reach 500 by the end of this month.

The warning signs have been there for the past few months he said. For a glimpse of the approaching omicron threat, Miscovich said Hawaii can look to trends in New Hampshire and Vermont, where cases are surging and hospitals are at capacity levels.

Honolulu may be at the beginning of a surge similar to the delta surge, according to a report released Monday by the Hawaii Pandemic Applied Modeling Work Group. The report forecasts omicron edging out the now dominant delta variant by mid-January.

On Wednesday, the state Department of Health reported five new coronavirus-­related deaths and 282 new infections statewide, bringing the state’s totals since the start of the pandemic to 1,063 fatalities and 89,875 cases.

Wednesday’s count by island includes 230 new cases on Oahu, five on Hawaii island, 28 on Maui, 13 on Kauai, two on Molokai and four Hawaii residents diagnosed out of state.

Statewide, the 7-day average of new cases rose to 180, representing a 103% increase over the past 14 days, with an average positivity rate at 2.8%, according to the state’s COVID-19 data dashboard.

But for Honolulu County, the increase was much higher. The number of new cases increased 219% over the past 14 days, with the 7-day average now at 145 and average positivity rate at 3.4%

“With transmission of COVID much higher than what it was in July before our first delta surge, another COVID surge in daily cases and, to a lesser extent, hospitalizations may be around the corner,” the report warned.

While Hawaii’s high vaccination rate — 73.2% of the population is fully vaccinated — and the Safe Access O‘ahu program help fend of infection, omicron may outpace protective measures.

HiPAM detected a rise in cases in Honolulu as early as mid-November, according to University of Hawaii mathematics professor Monique Chyba.

The models, which depend on a number of variables, also predict cases rising to four-digit levels for Honolulu in mid-January if current trajectories hold.

So far, it appears omicron does not trigger severe symptoms or increase hospitalization rates, the report said. However, it noted that the potential for increased transmissibility can result in a steep surge in cases, as well as a surge in hospitalizations.

Boosters can help keep the surge down. Currently, about 295,000 individuals, or 20.7% of the state’s population, has received a booster dose.

Miscovich contends that more-restrictive gathering limitations should be reinstated to help curb the spread of omicron.

“We really need to go back to limited capacity inside restaurants and at large events,” he said, “and we have to enforce it.”

In addition, Miscovich said the state’s Safe Travels program should require all incoming travelers to take a quality PCR (polymerase chain reaction) test 24 hours prior to getting on a plane to Hawaii, effective immediately, to prevent the spread of omicron.

Lt. Gov. Josh Green said, during a Honolulu Star-­Advertiser “Spotlight Hawaii” webcast that aired Wednesday, that Hawaii leaders are discussing whether there should be more restrictions, and touted boosters as a means to help prevent community spread. Of residents boosted so far, he said, the majority are over the age of 50.

“The more boosters we get, the higher that total immunity,” Green said.

He said discussions are also underway on whether the definition of fully vaccinated would eventually include boosters for Safe Travels.

Green said on Wednesday there were 35 COVID-19 patients hospitalized — a far cry from the peak of 448 during the delta surge in early September.

Green said he expected a modest surge in hospitals in January and February, but not at the same level as in September.

However, Miscovich said a higher transmission rate translates into a quick growth in the number of coronavirus infections, resulting in three to four times more hospitalizations.

People at higher risk need to be especially careful this holiday season, health officials said.

Berreman said it is important to take all the same precautions seriously — to wear a mask when indoors; limit gathering sizes, if possible; and stay home when sick. Also, whenever possible, take gatherings outdoors.

“We want people to be able to celebrate,” she said. “We understand how important it is and how long it’s been since people have seen each other. This holiday season, not only do we have the threat of the holidays, which means more mixing and gathering, we have layered on top of that omicron. … That’s a really unfortunate juxtaposition.”

While no omicron case has been confirmed on neighbor isles, Berreman said she believes it is inevitable.

The World Health Organization is warning that omicron is spreading faster than any previous variant, and is now found in 77 countries. Across the U.S., more than 35 states have confirmed the presence of the omicron variant.

GETTING BOOSTED

All Hawaii residents ages 16 and older are eligible for booster doses if it has been at least six months since receiving the initial series of vaccines.

>> Those ages 16 and 17 are eligible for a Pfizer booster shot six months after the initial series.

>> Those ages 18 and older are eligible for Pfizer or Moderna booster doses six months after the initial series, and can mix and match them.

>> All who received an initial Johnson & Johnson vaccine may get a booster after at least two months have passed.

Visit hawaiicovid19.com to find a vaccination site.