The average number of COVID-19 cases reported in Hawaii continued to fall as the World Health Organization’s leader declared an end to the pandemic was in sight.

WHO Director-General Tedros Ghebreyesus on Wednesday said weekly deaths from COVID last week were the lowest reported since March 2020, and that the world has never been in a better position to end the pandemic.

“We are not there yet, but the end is in sight,” said Ghebreyesus at a Geneva news briefing. “A marathon runner does not stop when the finish line comes into view. She runs harder, with all the energy she has left. So must we.”

The WHO released six policy briefs outlining key actions all governments must take to finish the race. “If we don’t take this opportunity now, we run the risk of more variants, more deaths, more disruption and more uncertainty,” he said.

There should be continued efforts to vaccinate 100% of the most at-risk groups, including health care workers and the elderly, and maintaining testing and sequencing of the coronavirus as part of regular surveillance systems. Also, government leaders should integrate care for COVID-19 into primary health care systems and plan ahead for surges, among other initiatives, such as debunking misinformation.

In Hawaii, meanwhile, overall downward trends for coronavirus cases are holding steady. On Wednesday, the Hawaii Department of Health reported the seven-day average of new cases fell to 161, down from 190 reported on Sept. 7. Actual numbers are estimated to be at least five to six times higher since home test kit results are not included.

The state’s average positivity rate, meanwhile, ticked up slightly to 6.7% compared with 6.4% reported the previous week, possibly due to a Labor Day weekend bump. Both the daily average and positivity rate have been on a downward trend since early June.

Additionally, hospitalizations continued to decline, with a seven-day average of 83 COVID-19 patients hospitalized per day, down from about 100 the previous week, according to the Healthcare Association of Hawaii.

Bivalent boosters and flu shots

With a wary eye on the possibility of another surge this fall and winter, health officials are encouraging eligible residents to get the updated bivalent booster recently approved by federal agencies.

The reformulated boosters contains messenger RNA coding that targets the spike protein of the original COVID strain as well as of omicron subvariants BA.4 and BA.5, which are currently dominant in the U.S.

The Pfizer bivalent booster is available to those ages 12 and older, and the Moderna bivalent booster to those ages 18 and older, if at least two months have passed since the previous vaccination with either the primary series or earlier boosters.

As of Wednesday the DOH reported 77.4% of the state population had been vaccinated with their primary series, with about 45% having received a booster.

More than 11,000 bivalent booster doses, which became available for free over Labor Day weekend, have been administered in Hawaii so far. The new boosters are available at pharmacies, community health clinics and various hospitals.

The Queen’s Health Systems on Sunday held a drive-thru vaccination clinic at its West Oahu campus, and administered more than 500 COVID-19 vaccinations, mostly the bivalent boosters, and about 300 flu shots.

Keri Althoff, associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, said in a recent media briefing that the bivalent vaccines are anticipated to offer broader protection. They can serve as a helpful guard against infection, given that masking requirements and other mitigation are now dropped, which increases the likelihood of encountering someone with COVID-19 in one’s community.

Further, she warned that influenza will be circulating over fall and winter months as well, and that flu shots are also important, particularly for younger children who have little immunity due to lack of exposure. Health officials said people may get the COVID-19 shot and flu shot at the same time.

Johns Hopkins virologist Andrew Pekosz said the bivalent boosters can also play a role in limiting the emergence of new variants. “Bivalent boosters need to be used widely if they are to be effective in helping to limit the emergence of new variants,” he said.

Still, new variants of the coronavirus will continue to emerge. “Viruses mutate,” he said. “That’s what they do.”

Tim Brown, epidemiologist at the East-West Center in Manoa, said the benefit of the bivalent boosters is not only in reducing risk of infection from BA.4 and BA.5 in the first few months, but a broadening of one’s T-cell responses against severe illness and death.

“If we get good uptake of boosters, it will help, even if another variant comes down the pike,” Brown said.

In Hawaii, BA.5 makes up 89% while BA.4 is 3% and BA.4.6 is 5% of strains circulating in the state, according to the latest variant report published Tuesday.

The DOH reported 1,343 new COVID-19 infections over the past week, an increase from the last weekly count, bringing the total since the start of the pandemic to 342,072. There were 10 more deaths, bringing the state’s coronavirus-related death toll to 1,665.