A widely publicized prediction that Hawaii could see more than 3,000 Covid-19 cases a day in October is already being downplayed as the state’s vaccination rate inches upward and organizers cancel large gatherings.

An update to the forecast model generated by Hawaii Pandemic Applied Modeling Work Group, or HiPAM, last week showed new Covid infections on Oahu reaching 1,000 daily cases in September and continuing to increase to a peak of about 3,700 cases on Oct. 8

But Monique Chyba, a member of the volunteer HiPAM collaborative who helped develop the modeling tool, said that number is already obsolete and likely will not go that high. 

Even a small change in some factors like vaccination rates and restrictions on public gatherings would be enough to drive the numbers down, she said.

“Modeling a pandemic is very difficult right now,” said Chyba, a mathematics professor at the University of Hawaii Manoa. “The model is extremely volatile and I think people get frustrated about that because every week we have to adjust the model and then the predictions for the situation, they can fluctuate quite a lot.”

People wait in line outside a Covid-19 vaccination site located at Windward Mall on August 24, 2021.
Dozens of people waited in line Tuesday outside a Covid-19 vaccination site at the Windward Mall. Even a small increase in the rate of vaccinations now will bring down the number of future cases, experts say. Cory Lum/Civil Beat/2021

HiPAM’s graph aims to track how an ever-changing array of state and county public policy initiatives, such as travel restrictions and mask-wearing mandates, might result in various scenarios for Covid infection counts, hospitalizations and fatalities.  

Developed over the course of a year and published in June, the model was built in an effort to better inform coronavirus-related public policy decisions made by local politicians and health care officials.

It’s designed specifically for Hawaii, taking into account factors including geography, demographics, contact tracing capabilities and risk of infection from incoming travelers. Age, for example, plays a large role in how well people recover after falling ill.

Even small, incremental changes to the variables, such as the approximately 20,000 coronavirus vaccine doses that the state has been putting into arms in recent weeks, can bring about a big shift in the model, which HiPAM updates every five to six days. 

So on Monday, when Honolulu announced a four-week suspension of all large gatherings, triggering a wave of cancelations for planned conferences, concerts and other big events, many of the longer term predictions generated by the model instantly became irrelevant, Chyba said.

The model has not yet been updated to reflect Honolulu’s sweeping policy change, which goes into effect Wednesday and restricts events to 25 people outdoors and 10 indoors. The policy will be taken into account in a calculation that accounts for Honolulu’s virus transmission rate, and Chyba said an updated model should be publicly available at the end of this week.

Although the model peers into the coming months, the tool is most accurate when used to predict the Covid climate in Hawaii within a more limited two-week time frame, Chyba said.

“Predictions three months in the future are extremely difficult and those numbers should be read with lots of caution,” Chyba said. 

“People can relate to the fact that we do not predict weather three months into the future but we can analyze some qualitative behavior and predict a cold or hot winter, for instance,” she said.

A major takeaway from last week’s update to the model that hasn’t lost relevance, however, is the prediction that daily Covid infections statewide will not decrease in the next two weeks, which means the number of patients hospitalized with Covid is likely to continue to increase into at least early September, according to Chyba.

The highly contagious delta variant now makes up 93% of recent Covid cases in the islands, according to the new variant report released last week. Health officials say community transmission is responsible for the latest surge.

On Tuesday, 403 coronavirus patients were hospitalized in Hawaii, slightly lower than the peak of 412 hospitalized Covid patients last Monday. The HiPAM model predicts the number of hospitalized Covid patients could climb to 611 by Labor Day.

Actions the public takes now, however, could thwart the trajectory of Hawaii’s Covid-fueled hospital squeeze.

Dr. Sarah Kemble, acting state epidemiologist, says Hawaii is at a “critical juncture” in the pandemic. Eleni Avendaño/Civil Beat

Hawaii health care leaders said this week that they hoped federal regulators’ full approval of the Pfizer-BioNTech coronavirus vaccine would push more people to overcome vaccine hesitancy and drive a boost in inoculation rates amid the surge that is overwhelming some local hospitals. 

The approval replaces the emergency use authorization granted by the U.S. Food and Drug Administration last December, raising the U.S. government’s endorsement of the Pfizer vaccine to the same level as common vaccines for illnesses such as the flu or chickenpox. 

All told, 62% of the state’s population is fully vaccinated while 70% of residents have initiated vaccination, according to data from the Hawaii Department of Health.

“This is the most studied, scrutinized, tracked vaccine in the history of mankind,” said health department Director Dr. Libby Char, noting that there has been a slight uptick in the number of people initiating vaccination in Hawaii over the last two weeks. 

The Queen’s Health Systems also confirmed a slight rise in the number of people agreeing to get vaccinated at its clinics in recent weeks, according to Queen’s spokesman Sean Ibara.

What’s prompting more people in Hawaii to initiate vaccination is unclear. But with a growing number of employers choosing to institute policies that require workers to get vaccinated or get tested weekly, experts point to the growing list of disincentives associated with rejecting the shot. 

Even a modest increase in the state’s vaccination rate of 5% or so could ultimately make a big difference in slowing down the spread of disease, according to Chyba.

Three in 10 unvaccinated adults said they would be more likely to get the jab if one of the vaccines received full approval from the FDA, according to a national survey conducted in June by the Kaiser Family Foundation. 

However, the survey suggests that FDA approval could be a proxy for general safety concerns since two-thirds of adults, including a majority of unvaccinated adults, either believe the vaccines available in the U.S. already have full approval from the FDA or are unsure of their approval status. 

A million-dollar lottery could motivate about a quarter of the unvaccinated to get a shot, according to the survey, while mobile vaccine clinics motivate about one in six people to get vaccinated.

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