Iti Salun-At Yo

Surviving the Delta Surge on Maui

Errol Buntuyan, M.D.

The rate of delta surge infections started to plateau at the end of September and COVID infection rates are continuing to go down on Maui. This last surge did cause a wave of suffering, illness and death from COVID illness in our community. The good news is we did see some important changes in our community helping to flatten this surge.

Our completed vaccination rates on Maui increased to 60 percent. Though we still have many Mauians who need to complete their vaccinations, this rising rate of vaccination is great news. Our people are getting protected by vaccine immunity, preventing infection and further spread. The vaccination requirements for restaurants and workplaces will also continue to provide this level of protection. Third shot vaccinations started early in September for the immunocompromised and Pfizer boosters also began in the last week of September for people over 65 years old and those with at risk health conditions.

Monoclonal antibody treatment (REGN-COV2) given early in COVID infection have also made an impact by preventing the developments of worsening symptoms, hospitalizations and deaths. We have FEMA teams on Maui giving these antibody injections in September and October.

People have also started to be more mindful of limiting their gatherings and opting for safer outdoor activities. Of course, the continued Hawai‘i state protocols for travel requirements, indoor masking and social distancing reminders have been the mainstays of COVID prevention from the very start.

We have seen an increased amount of COVID infections of people who have been vaccinated with this delta surge. This waning immunity from the two shot vaccination series has spurred the recent approval of COVID booster shots. These boosters will help in increasing the immune response to provide protection. We have seen that those who have had the COVID vaccine have had much milder symptoms and recover much quicker from illness than those who have not been vaccinated.

There are still people in our Maui Filipino community that insist on listening to radio personalities spreading false information about the vaccine. They still choose to not get vaccinated while seeing loved ones around them suffer and die from COVID. This is an unfortunate and sad situation, as these lives could have been saved if they had received the COVID vaccine. The COVID virus will continue to spread amongst the unvaccinated because they have no immune defense to stop it from infecting their bodies.

As we move along in the coming weeks and months out of this surge, we expect to see continued COVID infections. It will be, however, at a much lower rate. Because this latest delta variant is so prevalent and contagious, we will all eventually be exposed. Those who have been vaccinated are protected with antibodies. Those who are unvaccinated and have contracted then survived COVID infection have natural immunity. Breakthrough COVID infections amongst the immune will continue because this virus at this point is everywhere and easy to catch. Because of natural and vaccine immunity, breakthrough infections will render less suffering, manifest with only mild symptoms of this disease and have less chance of spread.

For now, we continue to watch for other COVID variants of concern. Thus far, the lambda and mu variants have not been as infectious as the delta variant. We do not know if this status will change in the future. Continued encouragement of COVID vaccination is still the best protective way to avoid suffering and death from severe symptoms of COVID. For those unvaccinated that have survived a COVID infection with natural immunity, vaccination is still recommended to further enhance the immune response and give protection. For those who choose to remain unvaccinated, the risk of severe illness, suffering, and death are very high. Please get vaccinated.

This transition phase of this pandemic will certainly be a challenge. There will be much more information and more recommendations from the FDA, CDC and the State of Hawai‘i Department of Health to come. Boosters for Moderna and J&J are likely to be approved soon. Pfizer will hopefully expand to be able to vaccinate children 5-years-old and up. Monoclonal antibody will expand eligibility criteria to help protect more people from going to the hospital when they are infected with COVID.

We will eventually move to an endemic status of COVID, where it is regularly found among particular people or in a certain area. Infections will be happening but the illness will be mild. When this happens, we hope some semblance of normalcy will return because the risks of hospitalizations and death will be low.

In the meantime, we still must continue to be mindful of the risks of exposure when we choose our activities, we need to get our immunization shots and boosters when approved and always follow the safety practices (masking, distancing, hand washing) that have been imprinted in our daily lives.

Errol Buntuyan, M.D. is a Family Medicine Practitioner and the Physician in Charge of Maui Primary Care at Kaiser Permanente. Born in Quezon City and raised in Southern California, he has been practicing medicine on Maui since 2007. Dr. Buntuyan promotes whole food, plant based nutrition, regular physical activity, stress mindfulness and sleep hygiene as keys to optimum health and wellness. He enjoys cooking, playing tennis and travel.