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At the beginning of summer, Hawaii appeared to be well on its way to a full recovery after more than a year of COVID-19-related restrictions and economic pain. More than 50% of Hawaiian residents were fully vaccinated by early June, and 90% of residents 65 and over, who had suffered the brunt of the pandemic, had received at least one vaccination.
But then the highly contagious Delta variant struck and caused the number of cases to rise to the highest levels since the beginning of the pandemic. In the past three months, there have been 239 deaths from COVID-19, according to the Department of Health, making up a third of all deaths from the virus during the entire pandemic.
The data includes residents of Hawaii who have died from the virus both in and out of the state, as well as visitors who have died in Hawaii. The total death toll from the pandemic stood at 757 on Tuesday.
Local epidemiologists say the sharp rise in deaths in a population that was significantly vaccinated against the virus is evidence of the dangers of the Delta variant. While it’s not clear whether the variant is actually more deadly, it is spreading like wildfire through the pockets of the unvaccinated population.
While someone infected with the original strain of the virus usually infects two to three other people, someone infected with the Delta variant transmits it to six to seven people on average, said Jacob Schäfer, an epidemiologist and director for infection control and employee health for the Waianae Coast Comprehensive Health Center.
That rate “actually makes it one of the most transmissible respiratory pathogens we know,” he said. “And this development happened in less than a year.”
About half of all COVID-19 cases reported in Hawaii have occurred since the beginning of July, when the delta variant, which now accounts for almost all cases, began to take hold. It’s not clear how many of these cases are breakthrough infections in vaccinated people, but it is largely the unvaccinated who get seriously ill and die. The state has seen only eight deaths among fully vaccinated people since vaccines began rolling out in December through late August.
“Those who are not vaccinated are still most at risk,” said Schäfer. “Because it’s so much more transmissible and so many people have COVID, it has found these people, which is why we see so many high deaths in this group.”
Scientists have also found that the Delta variant appears to produce a higher viral load earlier during infection, meaning people can be more contagious before they even realize they’ve caught the virus.
When it comes to whether the Delta variant causes more severe illness, scientists warn that there aren’t any good studies on it, but some health care workers have reported that patients with the Delta variant appear to get sicker and get worse faster.
Ironically, the state’s success in keeping case numbers down during the first year and a half of the pandemic could also pose a higher risk if the Delta variant occurs. While the state’s vaccination rates were among the highest in the country, Hawaii didn’t face the types of large outbreaks like other parts of the country, resulting in lower natural immunity in the population.
Studies aimed at shedding light on the percentage of the population infected with the virus have not been very reliable, but state epidemiologist Sarah Kemble said during a media briefing earlier this month that they suggested a low infection rate.
“We have had very low seropositive rates in this state experiencing this spike, and that is part of our vulnerability here,” she said.
The recent surge in COVID-19 cases has been on the decline, but experts say the high death toll is likely to continue for a while due to the delay between infection and people’s death. On Tuesday, the state reported 240 new coronavirus cases and a 4% case positivity rate. According to the state, 259 people were hospitalized with COVID-19, up from a high of 473 on Sept. 7. The number of COVID-19 patients in intensive care units and on ventilators has also continued to decline.
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