 Yeah, this is Think Tech Hawaii and this program, this show is the state of the state of Hawaii today on October 11, 2021. Welcome to this show. I'm your host Stephanie Stoll Dalton. And today we are talking about very important topic Hawaii and it's COVID-19 condition, and we are most fortunate to have an expert spokesperson from the Department of Health to come in and talk to us about it and show us some data and do some explanations of it and also let you know that you can have access to that data anytime to take a look at what's going on in Hawaii with regard to COVID-19. We'll also ask some questions about Delta too and see what Brooke has to talk to us about that. The Brooks Bear is the COVID-19 and pandemic response administrator for the Hawaii's Department of Health and I certainly do welcome here. So glad he can spend some time with us at Think Tech because he's busy. So thank you Brooks. Welcome. And I'm just real excited that you can, you know, focus on this topic here with with us for the little time we have to keep viewers up to date and to give them a little skill in, you know, where to go get some info if they want to deal with it themselves. But I did want to start out by saying can Hawaii still be proud? It is Hawaii and still number one state for being vaccinated? We're at the 69% level and does that put us on the top of the heap? Well, Stephanie, first of all, thank you very much for having me back. I appreciate it. And yeah, we have been busy here at the Department of Health. That's have a lot of people who work in healthcare in Hawaii because, you know, late July turned into that big surge involving the Delta variant in August and September were just really, really tragic and very busy times for us here for the Department of Health. Thanks for your patience. And I appreciate the opportunity to come back on and to answer your question, you know, top of the heap, I don't know, but I'll tell you what it was reported over the weekend that Hawaii is the first or will be the first to get a 90% of those eligible vaccinated. So Hawaii is doing really, really well as far as vaccination. But, you know, we still have, we still have some work to do because there's still a lot of people out there who are not yet vaccinated. Some of most of them eligible, but others including children who are not yet eligible but we expect they will be soon. That is very exciting. Another first for Hawaii. So many times Hawaii has stepped out there on healthcare for keeping everybody safe from sickness and illness and other firsts that this state takes on and practices and then all of a sudden it disappears from the radar as others catch up and take away the news cycle. But no, I'm really glad to hear that. I wanted to know for a basic question before we get started with your data and talking about it. The basic question is, are COVID-19 and Delftop variant counted separately? Or does the data be, is it condensed into a COVID number? Can you just talk about that? Yeah, no. When you see a new case count, you know, every day we put out a new case count, whether it's, you know, hopefully going down. But last week, I think on Tuesday we had 91 cases, which was refreshing after all the triple digit numbers. Today's number is 113 cases. And there is a look at today's exact situation. You see today's case count, 113 cases. That includes Delta variant cases and any other strains of COVID, perhaps original COVID. But we do know that 99% to 100% of the cases that we have subjects to genomic sequencing here in Hawaii in the past several weeks have been Delta. Delta took over and Delta is now the dominant, if not the only strain of COVID here in Hawaii. Well, that's very interesting. So that when we're talking COVID-19, for right now, for what numbers you have now, those are actually Delta figures. Yeah, that's the Delta is really the only thing we have going right now. And we don't want anything else. We don't want Delta, but we sure don't want any new strains. Well, that was my other basic question is now, is anything getting into Hawaii other than the Delta, because are we isolate a little bit in the Pacific for not having these others that are, you know, are showing up in other places, we're not getting those right. Well, we did have other strains, but really the Delta was just so strong it kind of squeezed everything out. In fact, some people are asking about something called the Mew variant, which came from South America. And we actually had a few cases of the Mew that we found here at our state laboratory in June and maybe early July. But again, the Delta has taken over. And it's not surprising because the Delta is so highly transmissible. It jumps from person to person with great ease. And so it kind of took over the Delta, the COVID landscape, and is the thing that we've been dealing with throughout September, August, September, now into October. That is frightening. And, okay, so, well, let's, let's talk about how it's taken over then. Would you show us some data to let us know what the tsunami of another sort is all about. Well, let's go back to that graphic page we looked at for just a moment. And that showed us that we had today 113 new COVID cases. Our seven day average, thankfully, has gone down steadily over the last couple weeks. We're down now to 167 cases a day. Our positivity rate is 2.8%. And boy, wouldn't we like to get that down below 1%. But I'll tell you, we had that thing up around 89% at the peak of the surge. And so, you know, at least the number is headed in the right direction. And if we look at the next page, we're really going to see what the surge has done. You can see that in July, the numbers were relatively small compared to what they were in late August and early September. And that is when we really saw the peak of this delta variant surge. And since then, Hawaii has done a wonderful job of masking up of maintaining distance. We had the new requirements, you know, to get into restaurants and things. We had new restrictions and no one wants new restrictions. But they were really necessary to bring us back down the other side of that epi curve. And then you saw where we are now, we're getting down close to 100 new cases a day 113 today. And we just got to remain vigilant for a couple more weeks. And we think we can get the numbers down further. And then if you go to the next page, you can see the results. Before you go, would you would you just go back over that positivity rate so we all understand exactly what that means. So that positivity rate. You said it was up to eight that sounds scary. It absolutely was scary and unfortunately resulted in a lot of hospitalizations and death but what that means is that for every 100 people that are tested 2.8% of them are positive. We know that that 2.8% is is an artificially low number, because as you know, there are a lot of vaccine requirements and vaccine mandates, but people, you know, for work, for work, yeah, people have been asked to either get vaccinated, or they're given an option to test every week. Well, a lot of people are now testing every week. They haven't they don't know that they've been exposed to COVID. They don't have symptoms, but they're testing so they can maintain employment. So here are people who feel healthy. Don't think they've been exposed. Yet, they're, they have to go test. So, some of them are testing, and those test results are, are deflating our number just a little bit. So 2.8% might be a little lower than than what we have out there, but we're headed in the right direction and if we just can keep it up a little bit longer. I think we're going to be in a much better place. Okay, and then those people have no, there are no problems with the tests any longer remember that's where we started, which was not having enough tests to do the diagnosis so now that's not an issue with plenty of tests for people to have that option if they can't do the inoculation. Is that well during the surge, we were testing upwards of 10 and 11,000 people every single day and now we're testing much fewer, maybe 234,000 people a day depending on the day of the week. And so they're still high demand for tests. There can still be a wait for tests depending on where you go, but you will be able to secure a test if you needed a diagnostic test certainly through your healthcare provider. There are, you know, home testing options and things like that available so things have loosened up a little bit in the testing area, but you know, more tests are better definitely we we you know we want people to have easy access to test. And so that's why the Department of Health is standing up testing at various locations around the state. Okay, that's very that's very good news then that's, that's an option. Some people must have for a variety of reasons right and the employers have allowed that, even when there's a mandate to be tested before coming to work. Okay, working in Hawaii very good. Yeah, okay. So what all those cases that we showed you what that resulted in was actually tremendous and tragic death. September was the absolute worst month we had a, we had 193 people reported as, as having died from coven in the month of September alone today tragically reported reported for additional deaths. And in the past seven days 34 additional deaths. So death is a lagging indicator so you see the case counts go up. And then several days later, a percentage of people land in the hospital and tragically, some of them do not survive. And so, while the case counselor up here, it takes the death a while to catch up. While case counts are coming down, we're still seeing a significant number of deaths and that may continue for a couple more weeks. Now, but Brooks you know this is probably getting more into the medical category but is it that people come to the hospital too late to get the treatment that might save them, or does it. Is there's a course it's going to take in people that are vulnerable to it and that's there's not much to do. Look, we're learning more and more all the time about treatments and, and, you know, things like the monoclonal antibodies are proving to be effective if the treatment is administered fairly early on after infection is detected. COVID can be just so dangerous, and so deadly that even those things aren't always going to work right we're getting better with the treatments. But even if you catch someone early and you get in the monoclonal antibody treatment and any other kind of, you know, top notch treatment in our hospitals. COVID some sometimes is going to spell doom for people. It is just that horrible of a virus. We have enough of that, all of those interventions in Hawaii we're not in any way deprived of those because of our distance or isolation so everything's supplied and ready to go for. Yeah, FEMA really helped us out during the peak of our surge and they sent a team of about 30 people from the mainland out here, just to help us administer the monoclonal antibody treatments. And we regularly order monoclonal antibodies treatments from the mainland. And so few weeks ago I know we had 600 plus that came in. And the week before that we had actually administered fewer than 500 treatments so it's not it's not right for everybody your doctor has to prescribe it, and you have to be a high risk of severe illness, and they have to catch it early on. Because if you administer the monoclonal antibody treatment too late, it's literally too late. You have to get it within the first several days of infection. Oh my. Okay, that's very interesting, but reassuring that wearing good shape and FEMA is looking after us too. Okay, just wanted to check on that. Well, well that is great. Well, go ahead and go through your slides with us so we can see any of the other numbers that you have to show. Well, in a moment we can take a look at our data dashboard because I think everyone will want to know where those resources are but let's go back to the slides that we have not yet looked at, because there are a couple other numbers I would like to share. And here's our vaccination rate, check out Hawaii 69.6% completed. I mean that that's terrific, but we still have work to do. 77.9% initiated. Now those numbers are out of our entire population. We've got more than 1.4 million people in Hawaii, and these numbers include all the people, even the youngsters who are not yet eligible to be vaccinated. So we know that we have been administering third doses booster doses for several weeks now, and so far we've given more than 45,000 booster doses. I really want you to take a look at this next slide though, because this next slide talks about COVID vulnerabilities. Okay, some people say hey 90% of those eligible are vaccinated. Well that's fantastic really good Hawaii way to go right on. We had about 432,000 people who are not yet fully vaccinated, and they really come from three buckets. We've got the eligible to be vaccinated, but they have not yet gotten vaccinated. We've got those who have gotten their first shot, they've initiated vaccination, but they haven't completed vaccination that's about 117,469 people. There's been 207,000 youngsters who are not of age yet to be vaccinated. Now we're not blaming them and saying that they should be of course they can't be until the vaccine is approved for them. But what we are saying is that they're not vaccinated. So the delta variant can get into that population of youngsters. And while kids don't get that sick not as sick as adults do the COVID can bounce from person to person to person until it finds somebody who is vulnerable. It can be mom or dad or maybe grandma or grandpa, and then the consequences can be tragic so we've got more than 430,000 people, not yet fully vaccinated. We want everyone who's initiated to make sure they get completed if you've got that first shot. Please go and get that second shot really important because that first shot yet gives you some protection, but why not get it all get as much as you can. And isn't that the source of the variants is when, when they have moved around and into the hosts and they thrive there and then all of the time they're doing like these science fiction movies with these replicators, they're constantly trying to grow more legs or heads or tails or whatever they do, and they go through thousands of these developments but they don't take but then they'll get one and take, and that's when we got it got a delta and then, because those opportunities are there for them to reside in the population that's on facts is that kind of work. You're exactly right no exact right you hit it right on the head there there can be no mutation without replication so the more replication or transmission of the disease there is the greater chance that there's going to be a mutant of a variant. And, and, you know, what we really don't want to happen is things like the delta variant, which leads to increase transmission, perhaps link up with some kind of a variant that might lead to more severe illness, because then you have a lot of transmission with more severe illness, but the delta variant was bad enough on its own. We don't want any more mutations no more variants. Let's just, we just kind of stay the course. And if we, if we stay the course, and I think we can have a pretty good holiday season. Well it looks like that may be off on offer if. Yeah, we just do you see this also dependent on the mask wearing and the following up guidelines and there should be some coming out today right I heard that the governor and the may be announcing some opportunities. Well, let me tell you these things right here. These things are, are, I mean, they're fantastic. You obviously you won't see me anywhere without one, except here in the privacy of my own office, but the masks have proven proven to be so effective. And, yeah, do I like wearing it. No, I'd rather not, but given the risk of not wearing it I'm going to continue wearing it until we really put this thing in our rear view mirror. So, it is really smart for people to continue to wear masks, you know, option number one definitely get vaccinated. Then when you're indoors indoors where your mask and avoid large crowds, you know we got Halloween coming up and a lot of people are saying, can my kid go trick or treating. Being outdoors, a lot safer outdoors with the fresh air and the wind blowing around. If you're going to do anything indoors, you want to wear your mask you want to wear your mask if you're going trick or treating in a mall or something anything indoors you want to wear the mask, but if you're outdoors. It's a whole lot safer and I think we're going to be able to do trick or treating this year. And you know what, if you got a costume, maybe integrate the mask as part of the costume and then then you're really safe. There you go. That's a great idea. Yeah, we usually wear the mask on the top half of our faces for Halloween. So now we're introducing the bottom half of the faces with masks. So it's the opposite but that works that'll still work right. Yeah, absolutely the mask the masks are terrific. And Stephanie I know leading up to this you had expressed interest in knowing where the COVID is right. I thought that would be interesting to know more about yes, if we can your producer Eric I think has his magic fingers on a web page and and this is our Department of Health disease outbreak control division web page. And look, this is easy to find it's right there on the internet. Anyone can find it. You go to Google and just type in Hawaii COVID data. I mean that's that's the easiest way, but Hawaii COVID data just you know, do a do a search for that in a search engine. Who can remember disease outbreak control division right just Hawaii COVID data. So that's the, that's the page that opens up. And that shows you right off the top it shows you that you know we've had 113 brand new cases today. And to the right of that is the number 81614. That is the total number of COVID cases that we have documented during the pandemic. And then there's an island by island breakdown both of today's new cases and all the cases that we've had over the course of the pandemic. And the tragic number on here is is in the lower right hand corner there, cumulative deaths, 845 deaths attributed to COVID or COVID related during this pandemic. And the two most important pages on that website are the next two pages. So if you scroll down, the next page you're going to see is this one. This is the summary metrics page. This is the page that has all the information about COVID cases. And since you asked me where the COVID is well, you can look around and see there's a rectangle for each county Hawaii County Honolulu Kauai and Maui. They tell you how many new cases per day, the seven day averages. And then there's also a little graph that shows you what's been happening over the past seven days. And fortunately, Stephanie, you see a downward trend on all the islands, which is which is good news. And over there on the left in the in the box shaded gray, you see the 113 new cases and the seven day average, which is now at 167 cases. But I'm going to ask Eric to click on the little rectangle up there that says the word map. It is just above the Hawaii County box there and that brings up a map of all the islands. Now this is a heat map. The more COVID cases or the hotter the map, the darker the green shade. So Eric, if you pick an island like if you pick a Wahoo just because or yeah just because a lot of people we have our population basis here. If you pick a Wahoo on the left hand side, you will see the all the islands. Yeah, right over there and you click on it on the map of a Wahoo comes up, and then the map is coded to show you the number of cases per 100,000 residents in the past 14 days. And what you see is that the darker shades has has more cases. For example, look at the Y and I coast. They've had a really difficult time lately. They're doing a wonderful job now embracing vaccines. But they're playing catch up in that arena. And unfortunately, it's led to, you know, too many infections. And so that dark green means there have been more than 300 cases. And if you put your cursor right over it, the number pops up a 406 cases in the past 14 days per 100,000 population. And that's why it gets that dark, you know, that dark green shade. So it's, it's interesting to be able to look around here and see the, you know, where, where the cases are high and where they're not. But here's something important to remember. COVID doesn't just reside where you reside. Right. COVID, you can go to work, like you can live out in Y and I, and you can drive somewhere to work or to play, and you can get COVID elsewhere, and then bring it home and it's going to register as if, you know, you got it there or it resides with you. But remember COVID travels with you. So, you know, I'm looking at downtown. Well, what do we got there like Pearl Harbor areas is not too dark, but it's kind of a light green. It doesn't mean that people didn't go, you know, from somewhere else in there and, and bring COVID with them. But there are also these other factors, right, because I mean in the Pearl Harbor area with so many military people are young and healthy there, whereas in wine I and it looks like that other dark, darkly shaded areas is wine and Nellow. You've got a multi generational family situations there, right, people of all ages, including the, you know, capuna. So, you know, each one has all these different characters that confound it. Yeah, and make it more likely to spread. Yeah, whereas Pearl Harbor people are pretty much monitored there for health. I mean, another interesting page is while we have a few or a few, excuse me, a few more minutes, if Eric scrolls down to the next page, which is kind of the vaccination page. And this gives us a wonderful snapshot of what is happening with vaccinations in the state of Hawaii. As you can see, there's a bar, a green bar across the top that says 69.6% completed. And we've initiated some 77.9%. So, we're, you know, obviously we're going in the right direction. Again, there's a county by county breakdown, but Eric click on the map, because there's often a correlation between the map you see here. If you go down there's another map tab, it's the gray box at the bottom that says map. And you can go, you can look between this visualization and the heat map for COVID cases. And you can often see there's a direct correlation between locations that have low vaccination rates, they will have high COVID-19 count rates, because they don't have as many people protected. So, a lot of really good tools here you see there's also an age bar that breaks down vaccinations by age that is interesting to look at. And that'll show you how, you know, with a wonderful job our kupuna are doing and getting themselves vaccinated. And our 12 through 17 year olds, even though they were the last ones to be eligible to be vaccinated. They're really catching up. So, I encourage everybody to go to this page. There is just so much more data than we're going to have time to look at here. But if you just Google Hawaii COVID data, you'll find that page. And, you know, I can spend hours in there getting lost and trying to look at the data interpreting it. In fact, I'll go for one question. I noticed that the Kauai Island is usually green because it gets the most rainfall in the world, right? But here it looks like it's a little bit greener than the rest of the islands. Is that Kauai up there? Or what's the one at the top? Yep, no, Kauai is up there. Yeah, Mount Waialaeale, what is the spot on the earth is green? That whole coastline is green up there. And they're dark here. They had a tough time during the variant. Now remember, Kauai has a smaller population, the smallest population of any county, so it doesn't take as many people per 100,000 to turn that a darker green than say Oahu, which has so very many people. So the Kauai had a tough time. They definitely saw more cases than at any other time during the pandemic. Has there been any thinking about that? What were the factors that were involved in increasing it? Well, it's the same thing as there is everywhere. We, every two weeks we publish something called the cluster report, and it will highlight, you know, it'll talk about restaurants or workplaces or events where people got together. There was transmission, and the moral of the story almost always is that transmission happens when people are indoors and they don't wear their mask when they gather and when they're unvaccinated. And so that's why we sound like a broken record at the Department of Health, but, you know, get vaccinated, wear your mask indoors, and avoid large crowds. I haven't been to a restaurant more than a year. I go and get takeout, but I don't go inside because I just want to protect my family and my co-workers because we're going to get through this. We're getting there. Definitely. Unlead the nation in doing it. It looks like it's going to be like that. And I hope we'll get some good, the state will get some good credit for making an effort such as the Health Department has done such an excellent job of monitoring and reporting. I wanted to say that the other question, which doesn't seem to be so much a factor, is it's not our visitors coming in that are bringing so much infection, right? I don't hear you saying that. I hear we're doing it to ourselves. Community transmission is really a buzz phrase, right? And certainly visitors will bring it from time to time, as will returning residents. But here's the difference. If I'm a visitor, I go to Hawaii, maybe I come with my family. I kind of stay in my bubble, right? I've got my family and we rent a car and then we go here and we go there. But when I'm a resident and I travel and then I come back to Hawaii, well, I got to get together with my buddies. I got to see my friends. I'm going to go to work. I already have this established network of people and it's more people than the visitor will interact with. The visitor might go to a restaurant and the waitress comes up and the waitress or waiter is wearing a mask and they don't spend that long standing there. And so the virus doesn't have as much of an opportunity to jump from one person to the other. So the visitor doesn't transmit it as much as the resident. We come back, we spend a lot of time with our friends, our family, our coworkers, you know, we get together with our sports teams or youth leagues or whatever. And there's a lot of opportunity that interaction between people is really when it spreads. And because we live here, because we already have those relationships, we're bound to see more people and spend a lot more quality up close time in close proximity with more people than the visitor will. They move here, they move there, they want to see the sites and they keep moving and don't have those prolonged exposures with as many other people. Well, that is so explanatory. That is very interesting. This presentation has been most thoughtful and most interesting and informative books. I so appreciate that you've been able to take some time to spend it here with us on Think Tech Hawaii. And I know I seriously know you're just a worker B for sure for this entire year. And thank you very much for that effort. That's a tremendous gift to the, to the state of Hawaii. So I think that we're getting to Aloha time. And I just want to thank you again for being a guest on the show. The show is the state of the state of Hawaii. And we've been talking with Brooks Bear was a COVID-19 and pandemic response administrator for Hawaii's Department of Health. And as Hawaii looks like it might be leading our nation in the right direction as out to manage the COVID-19 pandemic. I'm going to thank him again Mahalo Brooks and Mahalo viewers for your viewing of the Think Tech program today. And we'll see you again in two weeks on the state of the state of Hawaii.