Hawaii’s number of daily new coronavirus cases spiked to a record high of 655 Thursday, this time with no lag time from lab glitches to blame for the surge.

That’s an 89.3% jump from Wednesday’s case count of 346, with the new ones Thursday bringing the state’s total since the start of the pandemic to 44,617. The last record, single-day high was from July 30, when the state Department of Health reported 622 cases that reflected a lag from previous days due to a lab reporting system interruption.

Health officials say it is due to the highly transmissible delta variant, which now makes up 81% of all variants circulating in the state. Delta has been present in all four major counties since at least mid-July.

Lt. Gov. Josh Green, who first posted the case count on Instagram, said COVID-19 cases are increasing “largely due to the highly, highly infectious delta variant.”

“The delta variant is rolling through the 250,000 individuals that are unvaccinated,” he said. “They’re taking a very serious risk for their health and also for the health of those around them.”

He urged the quarter- million who are eligible and still unvaccinated to do so as soon as possible.

“Those are the people catching COVID, spreading COVID and putting others at risk,” he said, “so they need to take personal inventory on this matter.”

The seven-day average of daily new cases Thursday was 436, and the average positivity rate at 6.9%, the highest it’s been in a year, according to the Health Department. Green said there were 4,391 active cases Thursday, seven times more than about 600 just a month ago.

Although these case counts are concerning, he said, what is more worrisome is the growing numbers of COVID-19 patients in hospitals.

Green reported 166 COVID-19 patients were in hospitals Thursday, up from 150 Monday. The COVID-19 dashboard listed 164 COVID-19 patients in hospitals, with 30 in intensive care and 18 on ventilators.

One child with COVID-19 was in the hospital this week, said Green in a follow-up Instagram post later in the afternoon.

“As the hospital numbers go up, it limits our ability to care for everyone,” he said, adding that elective procedures such as orthopedic surgeries would be postponed. “I think you will definitely see restrictions on gathering sizes coming again.”

Green said Gov. David Ige and county mayors will likely make announcements about gathering restrictions in the next few days.

Ige announced Thursday afternoon that all state and county workers will be required to show proof of vaccination by Aug. 16 or undergo weekly testing.

Hilton Raethel, president and CEO of the Healthcare Association of Hawaii, said the state’s hospital resources are “stretched thin.”

During a briefing for the state Senate COVID-19 Committee on Thursday, Raethel said there were about 2,250 patients in hospitals beds, with about 3,000 total available. Of those patients, 164 are COVID-19 patients, and approximately 95% of them are unvaccinated.

While hospitals are not yet at full capacity and ventilator levels are fine, he said hospital staff are stressed and many are burned out, having battled the pandemic for a year and a half now. Also, hospitals this year are full of other patients in addition to COVID-19 patients, whereas last year they were mostly full of the latter.

The association is working on a request to bring more than 500 additional staff, mostly emergency room and critical care nurses, to care for COVID-19 patients at about 20 acute-care hospitals in Hawaii, using Federal Emergency Management Agency funds.

This is three times more than during the height of the pandemic last summer, when about 140 mainland medical personnel assisted hospitals in Hawaii.

Raethel said he was concerned about hospital capacity if the situation continues to escalate, with no indication that the peak of the surge has been reached yet and no sign that positivity or infection rates are coming down.

Many new COVID-19 cases are resulting primarily from social gatherings, he told senators, particularly in confined spaces or instances where people are eating or drinking indoors, without masks, for several hours at a time. Smaller gatherings lower the risk of transmission, he said.

Raethel also told senators he expected an announcement about gathering-size limits from top officials soon.

A cluster report released Thursday by DOH highlighted two clusters over the summer resulting from volleyball tournaments that took place at indoor stadiums with thousands of attendees in Las Vegas and Kansas City, Mo.

Hawaii residents who traveled and participated in these events tested positive for COVID-19 upon their return home, including a few who were fully vaccinated.

Health officials are investigating 38 clusters involving more than 600 cases across all four major counties, including ones that broke out at educational settings, workplaces and social gatherings.

A total of 1,767,912 COVID-19 vaccine doses had been administered statewide as of Thursday, roughly 3,400 more than the previous day; 60.4% of Hawaii’s population completed vaccinations; and 67.4% received at least one dose.