For Kaimuki resident Jan Hayashi, it started with a headache halfway through the workday.

Hayashi, 67, went home early on June 3, took a COVID-19 test — and tested positive. Symptoms quickly developed afterward, she said, into chills, body aches, then a terrible bout of nonstop coughing, and temporary loss of taste and smell.

It was her second time testing positive for COVID, and it was a miserable experience.

“I got it in 2022 and the symptoms were hardly anything,” she said. “This time around, (symptoms) came on fast and were really intense.”

Hayashi urges people to take all necessary precautions and to mask — as she continues to do in public spaces because she is immunocompromised — as this was a terrible experience that wiped her out for several days.

She was prescribed Paxlovid by her doctor, and has since recovered, fortunately, but was only able to get back to her morning swim routine recently.

COVID cases in Hawaii continue to rise, with the state Health Department on Wednesday reporting a daily average of 175 new cases per day over the week.

Hawaii’s average positivity — or percentage of all tests positive — continued its ascent to 16.7% on Wednesday, up from 15.9% the previous week. By contrast, the average positivity rate May 1 was at just 4.3%.

In Honolulu, the average positivity was even higher than the statewide average, at 20.1%.

While no new COVID-­related deaths were reported Wednesday, the number of residents visiting emergency departments and landing in hospitals continued to rise.

The average number of hospitalized COVID patients in Hawaii reached 126 per day this week, the highest level since the summer surge last August. An average of six COVID patients per day were in ICU.

The percentage of patients visiting emergency departments with COVID in Hawaii also rose to an average of 5.0% as of Friday, with the highest rate among residents ages 75 and older.

“We’re still in a rising stage with some signs of slowing across the indicators, so we should peak in a week or two,” said Tim Brown, an infectious disease expert with the East-West Center in Manoa. “After that I expect a decline over the next month to month and a half.”

He said people should be taking precautions until there are lower levels of circulating COVID.

This means masking in crowded settings, improving ventilation, getting vaccinations up to date, testing if symptomatic or exposed, especially if living with someone more vulnerable — and seeking treatment if at higher risk.

“If sick, please stay home and don’t share the wealth at your workplace,” he said. “Not everyone in the subsequent infection chains you start at work or in your family will have a mild case and some of you may develop long COVID. So stay safe to protect others.”

FestPAC precautions

The uptick in COVID activity began in May, when more immune-evasive “FLiRT” variants gained a foothold in Hawaii.

Hawaii’s latest variant report shows the proportion of these variants — KP.1.1, KP.2, KP.3 – continued to grow in the islands over the past month.

Hawaii’s lab also has detected the LB.1 variant, a descendant of JN.1, via genome sequencing of COVID PCR-positive test specimens collected from across the state.

The rise in cases occurred in concurrence with Hawaii hosting the long-awaited FestPAC on Oahu, which drew an estimated 500,000 attendees.

The festival was originally scheduled to take place in 2020, but was postponed due to the COVID-19 pandemic. Unfortunately, the virus still had an impact.

The world’s largest Indigenous Pacific Islander celebration, which brought delegates from 28 island nations together over 10 days to share music, dance and culture, happened to take place as the uptick was occurring.

The Hawaii Department of Health on June 12 urged the public to be vigilant due to high levels of COVID activity.

DOH’s new Respiratory Disease Activity dashboard categorized the COVID level as red, indicating the virus was circulating at high levels compared with historic trends.

On Wednesday, the dashboard continued to rank COVID in the red category.

Dr. Scott Miscovich of Premier Medical Group said the state Health Department distributed thousands of free COVID test kits and offered N95 masks to FestPAC participants.

Additionally, free testing was provided on-site at SimpliFi Arena at Stan Sheriff Center and the Hawai‘i Convention Center in Waikiki, said Miscovich, who ran the testing program.

In all, he said, about 500 tests were administered at the festival, yielding a positivity rate of about 13%. Roughly a quarter of positives were among Hawaii residents, while the rest were among FestPAC participants.

Miscovich also offered telehealth visits for those eligible for Paxlovid, which was made available through state and federal resources. The number of prescriptions he offered was in the single digits.

Participants should use the test kits, take precautions as they return home, and monitor symptoms in the next week, he said.

Hospital precautions

The majority of Hawaii hospitals also have brought back masking precautions amid the surge.

Kaiser Permanente Hawaii on Monday began requiring masks for all physicians, providers, and staff.

“We believe this additional safety precaution is necessary at this time to mitigate the spread of COVID-19 within our facilities and minimize the spread in our greater community which not only threatens the health and safety of vulnerable individuals but has the potential to cause staffing shortages that could impact our ability to deliver care,” said Kaiser in a statement.

Kaiser is strongly encouraging visitors, patients and members to use masks as well while visiting its facilities. Masks may be required in some areas such as the NICU, oncology and mother and baby areas.

The Queen’s Health System is requiring caregivers to wear masks in all clinical areas, and implementing additional screening such as testing patients upon admission.

“The Queen’s Health System continues to monitor the SARS-CoV2 virus and emerging variants and trends,” said spokesman Cedric Yamanaka in a statement.

“Beginning in mid-May, we began to detect an increase in COVID-19 cases across the nation, Australia, and Asia, and across our state and within our health system.”

Statewide, the seven-day average is up, he noted. Across The Queen’s Health System, the count of COVID positive patients is up to 33, and a handful of staff members have tested positive.

“Additionally, for the first time in a long time, we are seeing patients who require intensive care due to the effects of the virus,” he said.

Kapi‘olani Medical Center for Women & Children likewise is requiring masking for all employees, patients and visitors “in designated patient care areas impacted by increased pediatric hospitalizations due to viral infections.”

Patients at Hawaii Pacific Health facilities such as Pali Momi and Straub Benioff Medical Center also may request staff wear masks at any time during their care.

Miscovich said he required masks among staff five weeks ago due to the uptick.

Patients who test positive for COVID should seek Paxlovid, he said, if they are ages 60 and older, immunocompromised or at higher health risk, which includes conditions such as diabetes, asthma or obesity.

He also recommends residents get the updated COVID vaccine when it becomes available this fall, hopefully by early September.

Hayashi is grateful she had access to Paxlovid, which is ideally taken within the first five days of experiencing symptoms.

She said it gave her mouth a “rusty metal flavor,” but seemed to really help. She took cherry cough drops to counteract the metal taste, and was able to ease body aches with prescribed cannabis.

And she continues to mask in public because she is immunocompromised due to a liver condition.

“I don’t want to get it again,” she said. Her advice to others is: “Do what you have to do to stay healthy.”