UPDATE 9:23 p.m.

The Hawaii Department of Health tonight announced that an Oahu adult is the state’s first death from the new coronavirus, COVID-19.

The person died Friday and suffered from multiple underlying health conditions, according to a news release from the state’s COVID-19 Joint Information Center.

“The available history for this person suggests they had a potential indirect travel-related exposure,” the release said.

The person had been tested at a clinical commercial laboratory and the results were indeterminate, officials said. Follow-up testing today, by the State Laboratories Division, confirmed COVID-19, according to the COVID-19 Joint Information Center.

“All of Hawaii expresses condolences to the family of the person who died and shares in grieving their loss,” officials said.

No further details on the person were immediately released.

After tonight’s announcement, Honolulu Mayor Kirk Caldwell tweeted, “It breaks my heart to hear of the first death on Oahu due to Covid-19. We must continue to act with immediacy to keep this virus at bay and flatten the curve. We are all in this together. Please take care of yourselves and your families. We will get through this.”

The announcement came after the Health Department said today that the statewide tally of confirmed coronavirus cases rose to 77.

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Hawaii returned today to double-digit increases in the number of coronavirus cases, which now stands at 77, as state officials grapple with how to avoid overwhelming the fragile health care system.

The state Department of Health officials reported 21 new cases overnight — a 37.5% increase from Sunday’s total — with 12 new presumptive and confirmed positive tests on Oahu and another two each on Maui and Hawaii island. Kauai reported no new cases today. On Sunday, the state reported eight new cases.

In addition, state health officials said today’s total of 77 cases includes five “pending” cases and that one individual had been admitted to a hospital for treatment, bringing the total number of people hospitalized with COVID-19 in Hawaii to four.

There have been no deaths in Hawaii reported in conjunction with the coronavirus pandemic.

According to the DOH’s Disease Outbreak Control Division:

“As COVID-19 spreads globally and nationally, we are detecting cases introduced into our state by both visitors and residents alike, although >80% of our cases are among returning residents from mainland as well as international locations.

At least one of the newly identified cases has no known travel or contact with travelers. This is the first indication of community spread of COVID-19 in Hawaii and highlights the importance of social distancing (i.e., maintaining at least 6 ft distance or 2 arm’s length, whichever is longer, from others).

Social distancing can reduce the spread of disease and protect those who are most vulnerable in our community. If you get sick, please stay home, get rest, drink plenty of fluids and get better. If you are older or have an underlying medical condition and become ill, call your doctor.”

At a news conference Sunday, Honolulu Mayor Kirk Caldwell warned that in a worst-case scenario Hawaii could see 40,000 to 45,000 cases by the end of April if drastic action isn’t taken. With fewer than 300 intensive care units in the state, projections indicate that Hawaii could exceed its capacity of ICU beds by April 25.

Honolulu’s emergency medical services is already being strained with dozens of COVID-19-related calls daily that most of the time are not life threatening, said spokeswoman Shayne Enright. There were roughly 300 suspected coronavirus calls to EMS since Thursday, averaging about 70 a day, she said.

“We wanted to alert people that the system could get overwhelmed. We need people to utilize other services instead of EMS. Every time we go on one of these calls we have to put on PPEs,” personal protective equipment that is in short supply, Enright said. “A lot of these are turning out to be non-life-threatening medical emergencies, where we could have avoided using these PPEs.”

The majority of the 911 calls can be avoided if people utilize other non-emergency resources that include calling their doctors, hospital hotlines or 211, as well as going to drive-through clinics, Enright added.

“EMS is for medical emergencies, so with flu-like symptoms your life is not at risk if you’re experiencing a fever,” she said. “Stay home for us so we can be there for you.”

Honolulu Mayor Kirk Caldwell issued an emergency order Sunday requiring everyone except essential workers to shelter in place from Monday at 4:30 p.m. through at least April 30 in a move to fight the spread of the coronavirus. Maui County Mayor Mike Victorino issued a similar “stay at home and work at home” order for his four-island county, while Kauai Mayor Derek Kawakami indicated he will do the same today.

Caldwell’s emergency order comes one day after Gov. David Ige, who has suggested a similar plan is in the works for the entire state, ordered visitors and residents returning to the islands to undergo a 14-day quarantine starting Thursday.