The Hawaii Department of Health is urging all eligible to get vaccinations and boosters as the number of new COVID-19 infections in Hawaii continues to surge.

On Wednesday the DOH reported the state’s seven-­day average for new cases had climbed to 925 — up from 722 on May 11, and marking the eighth consecutive weekly increase.

The state’s average positivity rate, meanwhile, jumped to 16.9%, up from 14.3% last week. It was the ninth week in a row that the DOH has recorded an increase in the positivity rate. In Kauai County, now a high-risk community, the average positivity rate rose to 23%.

“I’d say we’re absolutely in a surge,” said Tim Brown, an epidemiologist at the East-West Center in Manoa. “It’s a nationwide surge. The problem is it’s an invisible surge because the case reporting has been broken.”

If the real daily average is five to six times higher than detected, as estimated by DOH Director Dr. Libby Char, he said, “we are basically at the January peak, and still rising.”

Federal health officials Wednesday said about one-third of the U.S. population — mostly in the Northeast and Midwest — now lives in a high-risk area with rising coronavirus cases and hospitalizations, and should consider masking indoors.

Honolulu Mayor Rick Blangiardi is encouraging Oahu residents to voluntarily wear a mask around others in public, both indoors and outdoors.

“I think the best thing you can possibly do at this point — given the infectious nature, the pervasive nature of omicron — is to wear a mask,” said Blangiardi on the Honolulu Star-Advertiser’s “Spotlight Hawaii” webcast Wednesday morning. In the interest of safeguarding public health, he said, “Do everything you can, and … if you haven’t been boosted and you’re eligible to do that, please do that.”

He added, “I can honestly tell you from first-hand experience having gotten COVID that I felt the full force field, if you will, of having the vaccinations. I think I could have been a lot sicker and I just wasn’t, and I was really grateful for that.”

Blangiardi said it was too soon to say whether he would mandate masks for Oahu, but that it remained a possibility. Later in the day, however, he issued a statement on Twitter noting that his administration is “not considering reinstatement of any coronavirus restrictions at this time, including mask mandates.”

Vaccinations slow

Since February, the overall pace of vaccination rates in Hawaii has slowed. As of Wednesday, an estimated 77.5% of the state’s population had completed their primary series of COVID-19 vaccinations, with about 40% boosted.

More than 319,000 Hawaii residents remain unvaccinated.

A new national study found that approximately one-third of the 1 million lives lost to COVID-19 could have been saved with vaccines.

Researchers from the Brown University School of Public Health, along with Brigham and Women’s Hospital and others, analyzed Centers for Disease Control and Prevention and New York Times data and found nearly 319,000 deaths from COVID-19 were preventable between January 2021 and April of this year if every eligible adult had been vaccinated.

The most lives that could have been saved were in West Virginia, Wyoming and Tennessee, where vaccination rates were particularly low. Areas such as Washington, D.C., Massachusetts, Puerto Rico, Vermont and Hawaii, where vaccination rates were higher, showed the lowest counts of vaccine-preventable deaths.

Still, in Hawaii’s case, 734 lives could have been saved if 100% of the state had been vaccinated during that time frame. Even if just 85% of the state had been vaccinated, 312 lives could have been saved, according to the analysis.

“At a time when many in the U.S. have given up on vaccinations, these numbers are a stark reminder of the effectiveness of vaccines in fighting this pandemic,” said co-author Stefanie Friedhoff, an associate professor at Brown, in a statement. “We must continue to invest in getting more Americans vaccinated and boosted to save more lives.”

While the majority of kupuna in Hawaii have been vaccinated and boosted, few have gone back to get a second booster.

For those ages 65 to 74, 78% have been boosted once, while 20% have been boosted twice. For those ages 75 and older, 81% have been boosted, while 24% have been boosted twice.

Those additional boosters are important due to waning immunity, said Brown of the East-West Center, particularly with the growing rate of breakthrough cases among the elderly and vulnerable.

A Kaiser Family Foundation analysis found in February that the majority of adult deaths, 60%, were still among the unvaccinated, while 25% were vaccinated with just the primary series. But a growing percentage — 15% of adult deaths in February — were among those vaccinated and boosted compared to less than 5% back in November.

“I really wish that our health care providers would be reaching out, especially to the elderly that they’re serving,” Brown said. “They really should be reaching out to people, and encouraging them to come in and get boosted.”

On the other end of the spectrum, only 38% of keiki ages 5-11 in Hawaii have been fully vaccinated against COVID.

Vaccines for children ages 5-11 have been available since late last year, and the U.S. Food and Drug Administration earlier this week authorized boosters for the age group, which awaits CDC approval. FDA approval of COVID vaccines for children under age 5 is still pending.

Free COVID-19 vaccinations are still available at most community health centers in Hawaii as well as at pop-up vaccine clinics.

Kaiser Permanente continues to host community vaccination events throughout Oahu, and will be offering one from 10 a.m. to noon Sunday at the Mililani YMCA. All are welcome, Kaiser said, including those without insurance.

Hospitals stretched

Hospitalizations, meanwhile, continue to rise, with the state dashboard reporting 126 patients with COVID-19 in hospitals Wednesday — up from 91 last week. Of the 126, five were in intensive care and three on ventilators.

The number of patients with COVID-19 infection in Hawaii hospitals surpassed 100 on Saturday, with 102, according to the Healthcare Association of Hawaii. It increased to 119 on Sunday, and then to 130 on Tuesday before falling back to 126 on Wednesday.

“We are currently seeing a rise in COVID hospitalizations, which serves as a reminder that we are in yet another surge of this pandemic,” said Jason Chang, The Queen’s Health System chief operating officer, in a statement. “This means we need to focus on making sure everyone is fully vaccinated and boosted, and ensuring we are following basic infection prevention measures such as wearing a mask, staying home when we are sick, and being cautious when attending large gatherings.”

Chang added, “This surge is impacting many of us in the community and we all need to do our part in making sure we are taking care of each other.”

Daniel Ross, president of the Hawaii Nurses Association, said hospitals are stretched thin again due to ongoing staffing shortages. Like the previous omicron wave, many nurses are out because they or a member of their household have been infected with COVID-19, he said.

“Every day, almost every unit is short, and it’s not just nurses,” he said. “It’s secretaries, nurses’ aides, kitchen help and housekeeping. It’s just a shortage of staff.”

Nationally, there are now an average of over 99,000 new cases a day, according to the CDC Data Tracker, with cases rising in nearly every state.

The BA.2.12.1 variant — confirmed to be present in Hawaii — now accounts for at least 48% of new cases in the U.S.

On Wednesday, the DOH also reported 7,149 new cases over the previous week, bringing the total since the start of the pandemic to 265,571 cases in Hawaii.

By island, there were 4,922 new infections reported on Oahu, 850 on Hawaii island, 746 on Maui, 460 on Kauai, 26 on Molokai and 18 on Lanai. An additional 127 infections were reported out of state. There were also 12 more deaths reported Wednesday, bringing the total to 1,446.