COVID cases likely three times more than reported

The number of COVID-19 cases in Hawaii are likely much higher than currently reported by the state Department of Health.

“Thousands of people have taken advantage of the opportunity to get free home test kits, and many more have purchased at-home tests,” said DOH spokesman Brooks Baehr. “Results from those tests are not reported to the Department of Health, so they are not included in our data.”


During a livestream on Friday with the Honolulu Star-Advertiser, infectious disease expert and Senior Fellow in the Research Program at East-West Center on Oahu Dr. Tim Brown speculated cases could be underreported “by about a factor of three.”

When combining the average of 8,000 tests completed in early March with the current positivity rate of roughly 5%, Brown estimates new cases could be “over 450 cases a day right now,” as opposed to the 164 recorded over the last week by the DOH on Wednesday.

“We are sure there are a lot more COVID cases in the community than our data suggests,” Baehr said. “We just don’t know how much.”

The recent positivity rate increase could be attributed to the waning protection of current COVID vaccines.

“If you are six or more months out from your second dose, you have virtually no protection against infection from your vaccine,” said Brown. “In fact, your protection against hospitalization, in the latest U.S. study, is down about 60%.”

To combat the waning efficacy, vaccine manufacturers are looking into multivalent vaccines to protect against multiple variants.

In May 2021, one of the first-in-human trials of a multivariant, second-generation COVID-19 vaccine was tested by OSE Immunotherapeutics. By September, the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, awarded approximately $36.3 million to three academic institutions to conduct research on the development of vaccines to protect against multiple variants.

Moderna, BioNTech and Novovax have all started testing combination shots this year to validate decisions on the best vaccine strategy.

“I expect, probably by the fall, they will come up with some vaccines that combine different variants,” Brown said. “The National Institutes of Health has a study where they’re looking at different combinations, like a delta-omicron variant, as opposed to a fourth booster with the old vaccines.”

Brown still recommends the current boosters for better protection against infection.

“It’s important to realize that if you didn’t get boosted, your protection against hospitalization is down,” said Brown. “You really should be thinking about getting that booster.”

While the state of Hawaii is high in vaccination rates, with 78% fully vaccinated, the state is behind in boosters, with only about 55% of the eligible population having received an additional dose.

“People have kind of forgotten about COVID, and they’re acting like living with COVID means acting like COVID is not out there,” Brown said. “But the reality is, it’s still spreading in the community.”

Email Grant Phillips at

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