Iti Salun-At Yo

Another COVID Surge Hits Our Maui Community

Errol Buntuyan, M.D.

These last few weeks on Maui have been challenging. We are in another surge of COVID positivity due in large part to the ease of pandemic restrictions and the arrival of the Delta variant. Hospital admissions are backed up, clinics are flooded with testing requests and sick patients are seeking care. Below are some of the more frequent questions I have encountered regarding the variants and vaccine hesitancy.

Why should we be concerned about the COVID Variants?

The main role of any virus in this world is to replicate and thrive. A virus needs a host’s DNA to complete their replication cycle. With each viral replication cycle, there are mutations that can occur to benefit each upcoming generation designed to favor its success. Viruses that are successful can replicate faster, evolve to better enter more types of host cells and be more resistant to the host immune system by mutating its appearance. These more successful mutations become the COVID variants of concern.

The Delta variant is the current variant of concern. It originated in India and wreaked havoc in that country causing over 400,000 deaths in a truly short amount of time. We cannot forget the images of their overwhelmed hospitals running out of oxygen and the smoke from the mass cremation rituals darkening the skies of Indian cities.

The Delta variant is here on Maui and is spreading rapidly through our community. It will soon be the dominant strain of COVID. What is worrisome is this variant replicates faster than prior strains. This means the viral load in an infected host increases with each rapid replication as more virus is made. The higher the viral load, the easier it is to spread and the symptoms of infection are more severe. More severe symptoms lead to increased hospitalization and potential to overwhelm our fragile healthcare delivery system.

Why is it important to get vaccinated for COVID?

People who successfully completed the COVID vaccine series have created antibodies to the spike protein on the surface of the COVID virus. These antibodies and T cells attack the virus and render it useless. Vaccinated individuals in essence are already armed with the weaponry and have immune cells prepared to kill the foreign invader once it enters the body.

Those that are unvaccinated do not have these antibodies and T cells to protect them. The unvaccinated must go through the entire process of infection and illness from COVID to make these types of immune cells. COVID attacks and uses lung cells and mucous membranes to replicate and create more virus, causing the host to cough or sneeze. Thus, virus particles and droplets can spread in the air as well as land on surfaces. The unvaccinated have died from COVID because the pneumonia is so severe patients literally drown from the lack of oxygen as the lung cells are overwhelmed with this virus.

Doctor Errol Buntuyan gives a very persuasive talk about the importance of getting the COVID-19 shot. The video can be viewed at:
Screenshots: Alfredo Evangelista

Why are vaccinated people testing positive for COVID and do we still need to wear masks?

The number of vaccinated individuals getting infected with COVID is still relatively small. One theory of why the vaccinated are turning positive is the Delta variant replicates so fast the immune system may not stop all the virus that enters the host in time from replicating shedding particles. COVID swabs detect the presence of shedding virus particles. The amount of virus that is spread from a person who coughs or sneezes and is not wearing a mask is much higher. A person who is not wearing a mask can also breathe in more virus particles. So it is still important to wear masks regardless of your vaccination status.

People who are vaccinated and get infected with COVID do not get as sick as people that are unvaccinated. A very small percentage of vaccinated people get hospitalized or die from a COVID infection because they already have the antibodies and T cells to fight and kill the virus. COVID vaccinated individuals often have no symptoms or have very mild cold/flu symptoms. You may become COVID positive but you will not suffer from the multitude of debilitating symptoms. It is still well worth getting vaccinated to protect yourself from severe illness and hospitalization from COVID.

Are the COVID vaccines safe?

Many people are hesitant to get the vaccine because they feel it had been pushed too fast to production and they have not had enough time to be tested. All the COVID vaccines have undergone a huge number of tests on tens of thousands of volunteers before they received emergency use authorization from the FDA. Prior vaccines have not undergone this amount of testing prior to approval. Because COVID was causing so many horrible deaths in late 2019 and early 2020, the world’s leading scientists were tasked to produce a safe and effective vaccine.

Worldwide 4.1 billion doses of vaccines were administered, in the United States over 344 million doses have been distributed. There are 1.13 billion people worldwide that are completely vaccinated from COVID. The most common post vaccinated symptoms were minor (arm soreness, fatigue, fever and headache) and often lasted no more than 1–3 days. The sheer number of distribution of these COVID vaccines attests to the safety and side effect tolerance of these vaccines.

A recent screenshot of CNN Coronavirus Pandemic report shows the ravaging effects that COVID-19’s Delta variant has had on the U.S.
Screenshot: Alfredo Evangelista

Why should I get the COVID vaccine?

The main reason to get the COVID vaccine is to avoid getting sick from COVID. The unvaccinated make up most of the current infections because they do not have the antibodies and T cells to fight and kill the virus. Because of the rapid replication of this variant, a higher viral load, and better virus efficiency, those who are unvaccinated are experiencing more severe disease symptoms and are being hospitalized.

Another reason to get vaccinated is to protect your loved ones. This variant is spreading rapidly through homes with both vaccinated and unvaccinated individuals. Currently children under twelve cannot get vaccinated and they have the highest risk of exposure. With schools already started in August, the number of tourists on island that we interact with, or if we ourselves are traveling, it is hard to prevent getting exposed to COVID. Because many people are no longer wearing masks, no longer social distancing, attending gatherings, going to bars, watching movies in theaters and eating in restaurants, the spread of COVID is much easier. Getting vaccinated and encouraging others to do so will protect all of us from getting hospitalized and die from COVID.

The percentage of completed COVID vaccinations on Maui are the lowest in the State of Hawai‘i.

We must protect ourselves and loved ones by getting vaccinated and encourage those that are hesitant. The Delta variant is here on Maui. It is more contagious and causes more illness. The antibodies and T cells created from the vaccines provide the weaponry for our bodies to fight and kill COVID. The only way to stop this variant and the evolution of other variants is to have a vaccinated community that makes it an inhospitable environment for this virus to replicate, spread and thrive. Trust the science, I do. I recommend the COVID vaccine to all my patients.

Clearly this pandemic is not over. We must still stay safe through this Delta variant surge. Reduce your risks of exposure, avoid large gatherings and stay home if you can. Wear your masks, use hand sanitizers and stay socially distant. We certainly do not want our island community to get thrown back into a lock down situation, so we must act now to get Maui vaccinated to protect ourselves and our loved ones.

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.