Dr. Norm Estin is the medical director of Doctors On Call Urgent Care and Testing Centers in Kaanapali and Wailea.

WEST MAUI — Dr. Norm Estin is the medical director of Doctors On Call Urgent Care and Testing Centers in Kaanapali and Wailea. He has been a physician for the West Maui community since 1987 and is recognized as Maui’s founder of Urgent Care.

Dr. Estin worked extensively with Dr. Lorrin Pang and the state Department of Health to test and vaccinate community members during the Coronavirus pandemic.

We caught up with him last week.

Lahaina News: Let’s start with Covid; what’s going on right now? Dr. Estin: It’s all pretty good news. Covid isn’t over, but even the most cautious of us are moving on. It’s still out there, but in smaller numbers, and people aren’t generally as sick.

For example, over the last three years, Covid was the third-leading cause of death in this country behind heart disease and cancer. That number is absolutely staggering! This year it will drop to number four, so it’s still important, especially to the elderly. But on the average, in the whole State of Hawaii, we now have only about 70 positive cases a day (we run 5-6 per day in our own offices) and only very rarely does someone have to go to the hospital.

Overall, about 10 percent of all people tested will be positive, but again, most of these are not very sick. However, because it is still so very spreadable and serious for older folks and kupuna, there is state guidance on exposure, isolation, etc. The most important part is if someone tests positive, they still have to isolate for five days and are supposed to wear a mask for ten days in public. The full state guidance can be found at https://health.hawaii.gov/coronavirusdisease2019/files/2022/08/Home-Isolation-and-Exposure-Guidance.pdf.

Lahaina News: What about the nasal swab tests these days?

Dr. Estin: Tests and testing are no longer free, but most medical offices have access, and we at Doctors On Call always have the rapid tests, which insurance will cover. The Paxlovid treatment still works well for those positive folks who need it, and the new flu shot this fall will also have a Covid booster in with it — highly recommended!

You can catch this virus more than once, despite vaccination. The average person will get it 3-5 times. The vaccination wasn’t designed to stop you from getting it; rather, it was designed to stop you from dying or winding up on a respirator, which it did pretty well.

Lahaina News: Is this virus ever going totally away?

Dr. Estin: Unfortunately, no. Remember, this still is a NEW virus, even though it is becoming widespread or “endemic.” Some 40,000 to 50,000 people in this country will still die from it this year (close to the number from auto accidents, suicides or firearms). And then there are a lot more people who will have chronic symptoms or “long Covid.”

Lahaina News: What is the take-away for us then?

Dr. Estin: For those of us who work with the public, those pesky fiberglass shields are gone (they didn’t really do much anyway). But, we still need to be vigilant and use common sense around people who are sneezing or coughing, wash our hands, use masks if desired and take care of ourselves when sick. There’s no real down-side to using a mask in public or in crowds, as anyone who has travelled to Asia knows.

Lahaina News: Thanks for the update, Doc. What can you tell us about this weight-loss shot that’s often in the news?

Dr. Estin: You’re talking about Ozempic and Wegovy, which are brand names for a medicine called semaglutide. This drug mimics the effect of GLP-1, a naturally-occurring hormone that stimulates insulin secretion and thereby lowers blood sugar. It also slows stomach emptying, lowers the appetite and can stop food cravings.

These medicines are designed to be used, along with diet and exercise, to help treat Diabetes or obesity with co-existing medical problems. They will reduce your blood sugar and your body weight. They will help prevent the long-term complications of being overweight, like heart problems, strokes, joint problems and full-on Diabetes.

We really have gone from a Covid pandemic to an overweight epidemic. We all know people who are way over their healthy weight. These medicines work wonders. The pounds can melt off. They are safe and are given in an easy, once-weekly injection. Before starting, it is necessary to have an evaluation by a physician that will include baseline blood tests.

Lahaina News: We’ve heard they are expensive.

Dr. Estin: They are not cheap, with the brand names costing $1,200 to $1,400 per month. Yes, per month. Insurance may cover the cost of the medicines depending on the company and the specific medical diagnosis, but often do not. There is an effective generic version available made specifically by state-licensed compounding pharmacies that costs considerably less, about $200. We are working with the compounding pharmacy to be able to provide this.

Anybody who knows someone who might be interested should ask them to contact us at Doctors On Call. An evaluation can be arranged easily at the Times Market location, which itself is usually covered by insurance.