A COVID-19 variant associated with several outbreaks in California has infected one person on Oahu who had traveled to the mainland and a second person on Maui who had not, state health officials said.

The two cases do not appear to be related, according to Dr. Sarah Kemble, the Hawaii acting epidemiologist. That could mean the variant, known as L452R, has been circulating in the islands for some time.

Viruses naturally evolve to include mutations, leading to new variants. This particular variant, like others, has been on scientists’ radar not because it causes more severe illness or death, but because it could be more transmissible than other strains.

“It could mean that the virus has been here longer than we realize,” Kemble said during a press call Monday afternoon. “I think given our ties to California and the West Coast, that wouldn’t be entirely surprising.”

Now, state health officials are contacting other people who may be in the patients’ circle and “trying to understand how recently it may have been introduced,” she said.

The greater a virus’s transmissibility, the more likely hospitals are to be overwhelmed and deaths to spike, the national Centers for Disease Control and Prevention warned last week.

The Hawaii State Laboratories Division conducts extra analysis of about 75 samples a week from people who have tested positive across the islands. Hawaii scientists were able to recognize three mutations to the virus’ spike protein — which it uses to enter human cells — characteristic of the variant detected in California. It takes the state laboratory technicians six to eight working days to complete a thorough analysis of a specimen’s genetic material.

More research is needed to measure exactly how transmissible the variant is, Kemble and Hawaii State Laboratories Division Administrator Edward Desmond said.

“L452R has not yet been shown to be associated with increased transmissibility, although further research might show that,” Desmond told Civil Beat. “What is known is that the prevalence of viral strains with this mutation have greatly increased in California around the same time that case rates in that state have also greatly increased.”

New variants are surfacing as vaccination efforts get underway. A second mass vaccination clinic operated by The Queen’s Health Systems opened Monday to patients 75 and older. Various hospitals, health clinics, and pharmacies across Hawaii are involved in vaccine administration. Eligible patients must make appointments in advance. Hawaii is currently in phase 1b of its COVID-19 vaccine rollout. Eligibility and scheduling information is available online at hawaiicovid19.com.

Hawaii, like other states, has struggled to get sufficient supply of vaccine and some local hospitals have had to turn away patients and cancel their appointments. 

Kemble said the state has recorded several COVID-19 infections among people after they got their first of two vaccine doses.

“You get your shot and feel invincible, but do remember it takes time for your body to mount its full immune response,” she said. Those who have received both doses of the vaccine should have immunity approximately two weeks after their second dose, she said. The vaccines currently being distributed are believed to still be effective in preventing illness, even against the newer strains.

Hawaii has recorded 1,656 new infections during the past two weeks.

Officials announced Monday they had uncovered 60 COVID-19 deaths that date back to August 2020 after an analysis of death records. Those deaths were missed either because the patients were no longer under health department monitoring or because doctors did not report them to the department.

The Department of Health is working to automate its electronic death certificate surveillance to identify possible COVID-19 related deaths sooner, Kemble said.