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Health risks from COVID are not over, Hawaii doctor says

Honolulu Star-Advertiser - 5/20/2023

May 20—A recent outbreak at a nursing home in Hilo is a reminder that the threats of COVID-19 are not yet over, according to Dr. Scott Miscovich.

A recent outbreak at a nursing home in Hilo is a reminder that the threats of are not yet over, according to Dr. Scott Miscovich.

With the end of the federal public health emergency for COVID-19 on May 11, there have been major changes to funding for tools such as testing, along with an end in case reporting requirements—and a slide in vaccinations and masking.

But Miscovich, founder of Premier Medical Group, said patients with COVID-19 are still showing up at his urgent care clinics in windward Oahu.

"We're still seeing lot of COVID and we're seeing a lot of clusters, " he said during a conversation on Friday. "I am well aware that right now we have a major cluster going on at a very large nursing home on the Big Island on the Hilo side—37 residents, a lot of staff."

This, he said, highlights the urgency of protecting kupuna in the community.

"So we're getting business clusters, we're getting family clusters, " he said. "Yet you don't hear that any more. The news is over. But it's still happening."

A concerning trend in Hawaii and across the nation, according to Miscovich, is the dropping of masks in health care settings.

Kaiser Permanente Hawaii announced that it is no longer requiring people entering its health facilities to wear a mask covering their nose, mouth, and chin—unless mandated by city or county laws.

If masks are required in a particular facility or area, however, Kaiser said signs will be posted and staff will communicate this.

"It may be necessary to bring back mask-wearing in the future at Kaiser Permanente facilities based on new local laws or guidance from our infection prevention experts, " according to the Kaiser Permanente website.

Hawaii Pacific Health recently for its medical centers and clinics.

Wearing masks is now optional and will no longer be required of patients, visitors and staff in public common areas such as lobbies, elevators, cafeterias, and hallways not within patient care areas.

Masks, however, will still be required in intensive care units, including the pediatric and neonatal ICUs, oncology departments and infusion centers, and all areas serving immunocompromised and oncology patients.

The Queen's Health System's visitor policy still requires all visitors to wear a surgical mask at all times.

Dentists' officers vary, and some still require masks in the waiting room while others do not.

Miscovich said for his own offices and clinics, masks are still 100 % required because he feels health care institutions should be a place of safety.

"So in general, with my offices here and anywhere, we completely have masks and we completely use masks, " he said. "We give masks to everyone if they don't have them. We train them on how to use them, and I do not plan on dropping that."

He encouraged people to continue wearing a well-fitting, N95 mask, saying the data is "crystal-clear " in study after study showing that they work.

The data on COVID-19 deaths show kupuna are still at greater risk, along with the immunocompromised.

There are also risk factors for those younger, he said, including being overweight, a long-term smoker, or having any kind of inflammatory lung disease.

Those who are over 60 or have high-risk factors should still seek Paxlovid from their doctor if they get COVID-19.

On Wednesday, the Hawaii Department of Health reported a seven-day average of 83 COVID-19 cases per day and an average positivity rate of 6.3 %. The weekly average of COVID-19 patients in hospitals was at 50, with an average of four in intensive care.

There were also eight more deaths—all among kupuna ages 60 and older—bringing the state's COVID-19 death toll to 1, 904.

Miscovich expressed concerns about public apathy and the United States "driving blind " as various counties and states drop COVID-19 monitoring altogether, and the Centers for Disease Control and Prevention streamlines its data.

"We are as a country now flying blind, " he said. "That's why I emphasize to you and everyone—they've laid it on our shoulders as individuals. We have to be the ones to protect ourselves and family."

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