Iti Salun-At Yo

Stay Ahead of COVID in 2022

Errol Buntuyan, M.D., FAAFP

We ring in the New Year of 2022 amidst another surge. Omicron emerged in the United States last month and made its way to the Hawaiian shores by the December holidays. The daily number of positive cases once again rose to record numbers. The omicron variant has a large number of mutations in its surface making it more contagious. Both immunized and unvaccinated people are turning positive. The good news is omicron has caused less overall severe illness, hospitalizations and deaths. The unvaccinated population is the least protected and have suffered the most illness with this variant. The unvaccinated still account for almost all those who are hospitalized and dying from COVID.

There is some good news in that the boosters of the mRNA vaccines from Moderna and Pfizer are highly effective against omicron in preventing severe illness, hospitalization and death. Those who received the J&J vaccine are advised to get an mRNA booster to benefit from this protection. Though the vaccinated are turning positive, the symptoms start quickly after exposure (1–2 days), are very mild (scratchy throat, cough and congestion) and do not last for more than a few days. The spread of omicron happens via aerosols when a person has symptoms, thus when someone is asymptomatic, the chance of spread is very low.

Because of this, the CDC and the Hawai‘i DOH have reduced the isolation guidelines down to just five days (when asymptomatic or with resolving symptoms). Omicron seems to move through rather quickly in those that are infected. The exposure and quarantine recommendations were also updated. See CDC guidance in the table below.

The effectiveness of getting a COVID booster is still the best way to protect ourselves from omicron infection. Getting boosted against COVID is now the definition of ‘fully vaccinated’ in Maui County. Also, the FDA has recently authorized children twelve and up to get the Pfizer booster. If you are eligible for a booster and you have not received one yet, please get it done.

The mild symptoms of the omicron variant is a good indication we are moving towards the endemic state. The COVID virus seems to be heading towards a more survivable infection as it continues to circulate in our population. Still, we are a long way from being able to categorize this as an endemic. COVID continues to maintain a death toll mostly in the unvaccinated and has killed a total of more than 823,000 people in the US and 5.43 million people worldwide. We have seen more deaths due to COVID in 2021 (almost 500,000) than we saw in 2020 (385,000). COVID will be endemic when we get enough immune protection from vaccination or infection that we start to see less infections and less death rates. We can only hope that future variants will continue to cause milder symptoms and less death in those that are infected.

Volunteers at the registration table assist Maggie Evangelista during a recent Bakuna at Binhi at Ani Filipino Community Center. Photo: Alfredo G. Evangelista
Volunteers from University of Hawaii Maui College listen to instructions at a recent vaccination clinic held at Binhi at Ani Filipino Community Center. Photo: Alfredo G. Evangelista

Many of us are already exhausted and tired as we approach the second-year anniversary of this pandemic. Unfortunately, news headlines of this latest omicron surge dominate the start of 2022 with infections forcing many people to isolate—impacting staffing shortages in almost every industry. Our daily lives are once again affected. The ebb and flow of surges will most likely continue in the years to come. We must stay as resilient as we can.

A volunteer at a recent Bakuna at Binhi at Filipino Community Center. Photo Alfredo G Evangelista

What can we do to protect ourselves, get ahead of COVID and stay resilient?

Get vaccinated. Maintain any boosting recommendations as these variants arise. Encourage friends and loved ones not yet immunized to get vaccinated. COVID has caused much worse symptoms, suffering and disease in the unvaccinated than the vaccinated. Mahalo to the many volunteers who continue to commit their time and energy to promote and give vaccinations in our community.

Wear a mask. The latest expert recommendations are to use N95 or KN95 masks for the best protection against Omicron. A surgical or level 2 mask can also be used. The good news is that these are now readily available and in good supply online and at many retail stores throughout the island. There is overwhelming evidence that cloth masks are not good and are ineffective against this latest variant.

Stay healthy. Commit to eating lots of fruits and vegetables, limit processed foods and meats, do not smoke and limit your alcohol and soda intake. Obesity is a major risk factor in getting COVID disease. Get regular physical activity and eat so you can maintain a normal body weight with a BMI less than 25. You can calculate your BMI with this site from the CDC: Adult BMI Calculator | Healthy Weight, Nutrition, and Physical Activity | CDC.

Boost your immune system. Get plenty of restful sleep each night and reduce your stress. Try to get seven to nine hours of sleep each night. Identify your stressors and actively work to reduce them. Getting into a daily routine, exercising, avoiding “junk” food, meditating, maintaining connection with others and talking to a professional in mental health are some strategies that can reduce your stress levels.

Volunteers from Philippine Nurses Association of America Maui Chapter pose with State Representatives Kyle Yamashita and Sylvia Luke. Photo Alfredo G Evangelista

The transition to this new normal will not be easy. A surge in COVID omicron infections during the 2021 December Holiday Season was difficult for us and caused missed gatherings, cancelled flights and absent workdays. 2022 may yield a few more COVID variants and surges and we must stay vigilant and prepared.

A common New Year’s resolution is the pledge to ‘lose weight’ by eating healthy and exercising. Hopefully we can all strive to live healthier lifestyles by also reducing stress and getting adequate rest. The commitment and resolution to be healthy in 2022 will build our resilience and ensure our success in this ongoing fight against COVID.

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.