Hawaii is ready to treat Covid-19 like other diseases, Gov. David Ige said Wednesday, despite rebounding positivity rates and increased hospitalizations across the state.

Under a new plan quietly published by the Hawaii Department of Health last week, the state’s pandemic response will progress from emergency response into disease management. Highlighting this shift in strategy, Ige made the announcement in his first in-person press conference since the start of the pandemic.

Changes to expect include less emphasis on mass testing and infection control and a greater focus on improving access to approved Covid-19 treatments and monitoring of future variants of the coronavirus.

“As part of the transition, Covid will be handled more like other diseases, something health care providers diagnose and treat,” Ige said, wearing a mask.

With this transition, the state is scaling down its Covid lab testing programs, DOH director Libby Char said, as federal pandemic relief funds run out and at-home tests become widespread.

Results from at-home tests are not included in official case counts, meaning the state’s most recent infection numbers are almost certainly an undercount, state epidemiologist Sarah Kemble acknowledged.

“That is why we have to shift the metrics that we’re paying attention to. We also really have to pay attention to how much critical illness are we seeing, what are the ultimate counts in deaths.”

Hawaii reported a weekly average of 362 cases per day on Wednesday, a near fourfold increase since daily averages dipped to 89 in mid-March, according to the state’s most recent numbers. The positivity rate rose to 9.1% statewide even as the number of lab-processed tests remained stagnant.

The number of people hospitalized with Covid, which can lag infection numbers by weeks, has risen to 51 from a March low of 11. In the past week, the state recorded 11 new Covid deaths.

The availability of effective Covid treatments, such as monoclonal antibody injections and antiviral pills, and greater levels of immunity imparted by vaccines and previous infections mean the state can afford to lighten its infection control measures without too much risk that hospitals will be overwhelmed, Char said.

“I don’t know how many people will end up in the hospital,” Char said. “If we can get therapeutics to people in a timely fashion when they get a Covid infection, it can help to keep them out of the hospital.”

Wastewater monitoring and other surveillance measures will play an important role in disease management, Char said, especially as the state prepares for increasingly infectious variants. Omicron subvariant BA.2 and its lineage account for nearly 97% of current infections nationwide as of Tuesday, according to estimates from the Centers for Disease Control and Prevention.

Ige cautioned that the pandemic hasn’t ended, reflecting confusion at the highest levels as to how the United States should respond to Covid.

White House chief medical advisor Anthony Fauci made headlines Tuesday when he said that America had exited Covid’s “pandemic phase” in an interview on PBS NewsHour. The next day, Fauci was quoted in multiple outlets as saying his words had been misconstrued.

Kemble estimated that health authorities would need at least another year to determine whether the period of global, uncontrolled spread that defines a pandemic has officially ended.

“Let’s say we get through another winter respiratory disease season, and we don’t see a major hit on the hospitals, we don’t see a rise, a dramatic rise in deaths,” Kemble said. “That is that transition into endemicity. I wish I had a magic answer to say exactly when that happens.”