Dozens of COVID-19 patients have been hospitalized following numerous coronavirus outbreaks, including one in Kalihi among Pacific islanders living in large multigenerational households.

“We’ve seen dozens of people get sick. We’re only one order of magnitude away from losing complete control. If cases go from 500 to 5,000 in 14 days, it’ll be over,” Lt. Gov. Josh Green told the Honolulu Star-Advertiser, urging residents to remain vigilant about safety precautions to prevent the spread of the coronavirus. “There’s just more clusters all over the place. If the numbers don’t start decreasing, then we’re going back to very strict restrictions on gatherings in public places. Let’s hope we don’t have to get there.”

One such cluster includes at least 36 people who were infected at funeral events in the Pacific Islander community.

Health officials reported 47 new coronavirus cases Tuesday, bringing the statewide number of infections since the start of the outbreak to 1,757. The numbers may be artificially low since state laboratories didn’t conduct all of their COVID-19 tests Sunday due to the threat of Hurricane Douglas. Over the past 30 days there have been 839 new cases, compared with about the same amount in the previous five months combined, said Green, who is also an emergency room physician on the Big Island.

Of significant concern is reaching out to Pacific islanders, who have disproportionately high numbers of COVID-19 infections.

“There’s some cultural barriers. One is that testing is not traditional in the Pacific islander community,” Green said. “Routine testing and swabs can sometimes be viewed as a risk.”

Dr. Scott Gallacher, medical director of the intensive care unit at The Queen’s Medical Center, said hospitals across the state have seen a substantial increase in COVID-19 cases over the past several days — some of them in smaller ethnic group clusters that need more education on how to prevent infections.

Ethnic minority groups, including those in the Micronesian community, living in small quarters with nearly a dozen or more people “can’t help but be in contact with folks.”

“They have challenges. Some of these are disadvantaged folks. When one gets sick, everyone will get sick. They don’t stand a chance,” he said, calling for partnerships between the hospital and community liaisons who can help spread the public-health message of prevention. “General health literacy in some of these local communities, it’s not very good. We need to have closer partnerships to get them through this.”

The latest cases included 46 on Oahu and one in Maui County. As a result of updated information, officials removed one case from Hawaii island. The statewide coronavirus case total includes 1,419 on Oahu, 154 in Maui County, 116 on Hawaii island, 45 in Kauai County and 23 Hawaii residents diagnosed out of state.

The state’s coronavirus-related death toll remains at 26: 19 on Oahu, six on Maui and one Kauai resident who died outside Hawaii.

Costco confirmed Tuesday that three workers — two in Hawaii Kai and one in Iwilei — had contracted the virus, while Foodland said two employees — one at its School Street location and one at Foodland Farms Pearl City — also tested positive. The recent spike in coronavirus cases has prompted officials to consider reinstating the 14-day interisland travel quarantine, which was lifted June 16. Honolulu Mayor Kirk Caldwell is also calling for the closure of Oahu bars for three weeks; a mask-wearing mandate for both indoors and outdoors; and the limiting of social gatherings to 10 people or less.

Gallacher said the most recent surge has been the “perfect storm.”

“I wouldn’t describe it as an unanticipated surge. There’s been a number of community exposures. About two to almost three weeks after an event locally — whether it’s bars and restaurants opening up (or) … July 4th — we always see kind of a natural increase in cases,” he said. “We’re still at an OK place, but we can’t take our eye off the ball. This isn’t something that’s going to go away. We’re going to have to learn to live with this.”

There are 526 active infections in Hawaii, and 1,205 patients are considered recovered, or more than 68% of those infected. Of all the confirmed Hawaii cases since the start of the outbreak, 167 have required hospitalization, including 47 people currently hospitalized, 15 patients in the ICU and six patients on ventilators, Green said. Of the 117,559 coronavirus tests conducted so far by state and clinical laboratories, 1.5% now have been positive.

“We cannot allow mass spread to occur; that would be a calamity. That would result in over 4,000 deaths in Hawaii,” Green said, referring to previous fatality estimates for the state. “We’re at a risky crossroads where we can either get better and return to low risk or get significantly worse and be like Florida, Texas and California and have lots of fatalities.”