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On Wednesday, 13 more cases of coronavirus were confirmed, taking Hawaii’s COVID-19 infections to a total of 530.

Department of Health Director Bruce Anderson said Wednesday that the state is investigating about six clusters of COVID-19 outbreaks, not including the many families that have fallen ill.

“If you count the cases where there are family members involved the number goes way up from there,” he said.

Investigations are ongoing at Wahiawa General Hospital, Maui Memorial Medical Center, and McDonald’s restaurants on the Big Island. Anderson did not divulge details about other groups of cases the state is investigating.

Two of the latest diagnoses are among kupuna and continue to affect an elderly care business called Hale Makua Health Services on Maui. One is a home health care client and the other is a nursing home resident in Kahului.

After an initial April 9 negative test result, a second test on the nursing home patient came back positive on Wednesday for COVID-19, the facility said in a statement. The resident is currently asymptomatic and in isolation.

He or she was also one of the six who were transferred to Hale Makua from Maui Memorial Medical Center, the origin of an outbreak that has caused a string of nearly 40 infections confirmed to date. More than 300 people have been tested in relation to the outbreak,

Employees of Hale Makua who may have interacted with the patients are self-isolating and have been tested for the virus.

The other five patients that could have been exposed while in the hospital are currently asymptomatic, but have been isolated since April 12 and will be re-tested, health department officials said.

All five patients who stayed at Maui Memorial are living in a separate wing at Hale Makua for a two-week quarantine.

The Healthcare Association of Hawaii CEO and President Hilton Raethel said in a statement Wednesday that skilled nursing facilities and assisted living facilities “either limited or eliminated visitation many weeks ago in order to prevent the coronavirus from infecting residents and employees,” and many are conducting temperature checks of all vendors and employees.

Nearly 360 non-hospitalized patients — almost 70% of the 530 cases documented to date — have been “” to date,

Those who qualify to be released from isolation are considered to have recovered if

Approximately 170 active cases remain monitored by the health department.

On Wednesday, one of the cases was confirmed in connection to the 150-unit West Loch Elderly Village in Ewa Beach, a city housing complex for seniors with low incomes. The person infected was not a resident, city officials said, but would not disclose what the person’s connection was to the village.

“The individual is not on property and the Hawaii State Department of Health believes there is no identifiable risk to residents,” the property manager said in a letter distributed to residents, according to the Honolulu mayor’s office. “In an abundance of caution, we have done thorough cleaning of all common areas including the laundry rooms in addition to our regular cleaning and maintenance.”

Oahu continues to report the . Honolulu County recorded 11 new cases on Tuesday for a total of 369 people diagnosed, 271 of whom have been released from isolation. Thirty-seven of the Oahu residents DOH has verified

Hawaii and Kauai counties reported on Wednesday, remaining at 41 on the Big Island and 21 on Kauai. Thirty of the 41 patients diagnosed in Hawaii County have recovered, and none have required hospitalization.

Maui County recorded an for a total of 92 cases, 42 of whom have recovered and seven of whom have required hospitalization.

Six Hawaii residents have been . One other patient’s residence has not yet been determined.

Among the nine who have died due to coronavirus-related complications, three were Maui residents and six were Oahu residents.

The health department told Civil Beat Wednesday that most of those who have died had other medical conditions, including diabetes, cancer, cardiovascular and chronic respiratory conditions.

As of Wednesday, 20,535 people had been