Is This the New Normal
Errol Buntuyan, M.D., FAAFP
We have started to feel comfortable in this current state of life. Wearing masks, using hand sanitizers, washing hands, being mindful of high-risk gathering situations, getting vaccinated, getting tested and staying home if feeling sick have all been the mainstays of COVID management for over 21 months. Filipinos in the State of Hawai‘i make up the largest ethnic group that have died from COVID. We have suffered and endured. We are stressed, frustrated and tired of living this way but yet we have managed to work around these adaptations to carry out a work and social life balance that has incorporated these safety precautions.
We must learn to live with COVID for the years to come because the virus will be regularly found in our population. This is the definition of an endemic state. Many have chosen to refuse vaccination from COVID, thus the eradication of COVID will be literally impossible. Many parts of the world do not have access to an adequate supply of vaccines and we may never get to a satisfactory immunization rate that prevents infection and spread. We have moved from overwhelming fear of a novel virus to a realm of vigilance and management.
For us on Maui, vaccine boosters are now available for those over age 18. Vaccines for those 12 to 17 years old have not yet been approved but will be soon. For those who have received the mRNA vaccines (Pfizer/Moderna), a period of six months since the second shot is required to be eligible. For Johnson and Johnson, only two months are needed after the single dose to receive a booster. The COVID vaccines are also “mix and match” and you may receive whatever booster vaccination you desire. It is best to stick with the same brand of vaccine if you received the mRNA vaccines Pfizer or Moderna. Many people who have received J&J are opting for an mRNA vaccine for their booster dose. Either way, all three vaccines essentially provide the same level of excellent protection from severe COVD illness, hospitalization and death. The booster dose only takes a few days to raise the antibody levels against COVID and thus provides quick protection from infection, illness and spread.
Keiki ages 5 through 11 years old are now eligible to receive the Pfizer vaccine series. Now we can protect our children from becoming ill or transmitting the disease to others. Vaccine clinics, pharmacies and community events are up and running busily distributing first time Pfizer immunizations to keiki as well as giving boosters to adults. All the efforts to get our population vaccinated comes along in perfect timing to provide further protection through this Holiday season.
Living in an endemic state means restrictions will continue to ease, more large events and gatherings will take place and restaurants will be operating at full capacity now that the State of Hawai‘i has eased the rules. Many people will be more comfortable visiting friends and family on the mainland for the Holidays. Tourists will be coming to enjoy the warmth and weather of our islands. Many are taking extra precautions by only going to events requiring vaccinations, avoiding large gatherings or are doing rapid antigen home self-testing to see if they are infected and potentially spreading the contagious virus particles at planned events.
In the last few weeks, we have seen a rise in the number of COVID cases on the mainland in about half the States as well as parts of Europe. More activities in those parts of the world are held indoors due to less daylight hours and colder weather. Here in Hawai‘i, we’ve seen some positive clusters again, however the percentage of infection is still really low. The good news is on Maui we are at 66% completed vaccinations with 79% with at least one dose. This really helps in limiting the spread of COVID infectivity.
More recently, news of a South African variant has emerged. The Omicron variant of COVID has more mutations on its spike protein which may render it more contagious than Delta, more deadly and also be more resistant to current vaccines and natural immunity. It may take weeks for researchers to find out if this is true and if we should be more concerned about this new strain. The swift action was for certain countries to immediately restrict travel to the southern parts of Africa until more information about this variant is known. This watchful vigil for arising strains is part of the new normal of life in an endemic as we live with COVID in our world.
Should there be yet another COVID variant that arrives, Maui would hopefully be in a better position than we were in the past year to survive it. Being the tried-and-true warriors of this pandemic, we have survived previous surges. This constant vigilance of COVID infection variants along with continued practice of safety precautions (getting vaccinated, testing, masking and physical distancing) are the new standards of normal we must abide by.
Our lives changed drastically twenty-one months ago and we have adapted to this new pandemic to an endemic lifestyle. Hopefully we can find peace and joy again in this new normal. We need to remain grateful for the blessings we do have in our lives, for it is the only way we can continue to persevere amidst our struggles. Have a safe, Happy Holiday Season full of joy, merriment and restoration.
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.