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Four new coronavirus cases were confirmed among adults in Hawaii and Maui counties on Monday, taking the state’s total infection count to 584.

Many people continue to recover — 423 people have been “released from isolation” by the Department of Health, about 72% of confirmed cases to date. More than 24,500 people have been tested for the virus in Hawaii to date.

On the surface, Monday’s four new cases seem to mark a decline in cases, since 27 cases were confirmed over the weekend. But daily case counts reported by the health department fluctuate because the count is closely tied to the number of tests conducted. The results come at a lag, depending on when specimens were collected and where they were processed.

The median delay time between a patient’s swab sample and the test result report date is three days, a spokesperson with the State of Hawaii COVID-19 Joint Information Center (JIC) told Civil Beat.

“DOH strongly recommends against inferring anything about the pace of testing based on the cumulative number of tests over the past several days,” JIC spokeswoman Myra Ching-Lee said in an emailed statement. “We may see some change in testing volume, depending on what happens with the community screening drives.”

The department may be alerted about confirmed diagnoses days after symptoms begin, DOH Director Bruce Anderson said Monday at a

In other words, illnesses that began within the past week or so may have not yet been reported, since DOH is notified by providers about positive case after diagnosis.

County Cases

There’s been a “clear shift” in the number of patients who have a travel history to those who have not, Anderson said Monday, indicating a growing proportion of patients have caught the virus in the community.

Oahu, which has seen the bulk of infections, reported no new cases on Monday for the first time. The remained at 385. Approximately 47 Oahu residents have been hospitalized and six have died. The majority, 312, have been

Maui County reported 108 COVID-19 patients,

Maui County is still dealing with an outbreak that appears to have originated at the Maui Memorial Medical Center. DOH reports only seven Maui residents have been hospitalized. Four of the state’s 10 COVID-19 related deaths have been among Maui residents, the

Hawaii County reported , bringing its new total to 64 patients infected, 38 of whom have recovered.

A cluster of infections that health department officials believe began with a Kona McDonald’s employee who worked while ill continues to grow. As of Monday, 30 COVID-19 cases were confirmed by DOH in connection to the McDonald’s infection web, including 18 employees and 12 household members of the original employee. All involved are in isolation and quarantine.

“So far we have not found any customers to be impacted,” Anderson said. “It’s probably unfair to attribute all of this to one individual.”

Kauai County infections have remained steady at 21, and 16 people have qualified to be released from isolation. One Kauai resident has been hospitalized.

The health department reports 55 of the confirmed The state’s coronavirus .

Quarantine Assistance

Family clusters of infection are the most common form of cases the state has found in its investigations, Anderson said Monday.

A recent case investigation into a Kona household with six or seven people made it clear social distancing was “impossible,” he said.

In those situations, DOH offers alternate accommodations, including hotel rooms for people to stay in without exposing others. Anderson said the state has identified facilities in all counties for quarantine or isolation, but did not specify which facilities or who would qualify for such subsidized accommodation.

He also did not specify how many cases have required such accommodation. All Anderson said was that space will be available if needed.

“These are typically agreements in most cases with hotels,” he said. “We provide the rooms and wraparound services for those who need isolation or quarantine. Fortunately we haven’t needed a large facility for the small number of individuals who fit this category, but it has happened.”

For those who do not have permanent housing, a Kaaahi Street facility is currently housing six or seven people and has the capacity to shelter as many as 20 people at once, according to Anderson.

“That protects the community from infection but also provides an opportunity for us to engage with those individuals,” Anderson said.

Hawaii’s statewide stay-at-home order began March 25. Arriving travelers must comply with a mandatory 14-day self-quarantine or risk jail time and a fine. Visitors must cover the costs of quarantine themselves.