Molokai has been experiencing a surge in cases over the past few weeks, putting the island’s population of about 6,275 on alert.

As of Saturday, the island had experienced 31 cases over the past 14 days and a positivity rate of 4.4%, according to the state Department of Health.

“I think we kind of had a perfect storm,” said Helen Kekalia Wescoatt, chief executive officer of the Molokai Community Health Center. “Relaxed restrictions combined with the delta variant’s emergence into the population, just when people were getting relaxed and really looking forward to the new norm after the vaccines.”

In addition, she said vaccination rates on Molokai were “not quite there yet” to protect everyone, as people were traveling over the summer followed by the start of the school year.

“That’s where we really saw the transmission rates get sky high,” she said.

The health center is offering free antigen tests for COVID-19 by appointment on weekdays, along with the Pfizer and Moderna vaccines. The center in late August also announced the availability of monoclonal antibody therapy, which is free to patients and community members to prevent severe disease and hospitalization from the coronavirus.

Molokai is one of the most vulnerable areas in the state, she said, with limited resources, so it was important to have this available on the island.

Demand for testing has gone up significantly in recent weeks, according to Wescoatt, along with an uptick in COVID-19 vaccinations, possibly due to employer mandates and county policies.

On Wednesday, Maui County’s Safer Outside rules went into effect, requiring proof of vaccination for entry into bars, restaurants and gyms. Employees of these establishments also must show proof of vaccination or take weekly COVID- 19 tests.

Currently, about 65% of Molokai’s population is fully vaccinated against COVID- 19, while 70% have received at least one shot.

Over the past week, daily cases have ranged from two to five per day. Molokai also recorded its first coronavirus- related death in late August — a woman in her 70s who was hospitalized with underlying conditions.

The Molokai Dispatch newspaper ran a community notice memorializing the death of Dianna Solatorio of Halawa Valley, who was known for her warmth, generosity, love of family and cooking, the Dispatch said.

State Sen. Lynn DeCoite said Solatorio was a well-loved member of the community who touched many people’s hearts.

The reality of one death and the growing number of cases on Molokai is having a big impact on the small community, where people had gotten more relaxed over the summer and were gathering for parties and to put their loved ones to rest, she said. Also, many kupuna, like her own dad, wanted to travel to Las Vegas.

“I think it’s starting to hit home,” DeCoite said. “I’ve seen a change here. I think people are starting to understand it can kill us. I’ve seen a change in attitude for those who were not masking up before are masking up.”

More residents are asking questions about the delta variant, now the dominant strain statewide, and are now open to getting vaccinated.

“Of course there have been many that have been skeptical of taking the vaccine shots,” DeCoite said. “I think for many it has hit home. After their families contracted COVID, some have decided to take the COVID vaccine.”

Statewide, daily coronavirus case numbers have trended down over the past week, and the seven-day average of daily new cases on Saturday was at 526, with a positivity rate of 6.1%.

The positivity rate for Molokai has also come down slightly, to 4.5% from 5.3% at the end of August.

But Molokai residents still need to be cautious, according to DeCoite, because of the potentially damaging impacts of an outbreak on an isle with only one hospital and just three main grocery stores.

At a news conference with Maui County Mayor Mike Victorino, the lawmaker shared that when one store has to close down, lines grow long at the other stores.

The first known case of coronavirus on Molokai was confirmed by Maui County officials in April 2020 in a male resident who had traveled to Las Vegas. He reportedly was an employee of the island’s main grocery store, which temporarily closed.

With only one airline — Mokulele Airlines — that offers flights to Maui, an outbreak affecting its workers would have an impact on the whole community.

And since Molokai has just one hospital, residents are aware that if they require a ventilator or oxygen, they will need to transfer to The Queen’s Medical Center on Oahu. Residents are also aware that hospitals on Oahu have been at capacity.

Coronavirus testing options are available on island, DeCoite said, including free tests at Molokai Drugs, which was recently announced by the Health Department.

But some residents are hesitant to get tested because of the “coconut wireless.” People should not be ashamed if they contract COVID-19, DeCoite said, and “the respect needs to be there for people who do have it” because it may be through no fault of their own.

DeCoite said everybody needs to do their part by masking, distancing and notifying others if they are infected.

“It’s really up to the people,” she said.

As of Friday, there were no COVID-19 patients at the 15-bed Molokai General Hospital, which is run by The Queen’s Health Systems.

“We are here for the community and are doing everything we can to ensure our patients are given the care they need,” said Jan Kalanihuia, president of Molokai General Hospital, in a statement. “We recognize the capacity issues at Oahu’s hospitals, and we have done all we can to prepare for the possibility that it may become difficult for us to send any patient — COVID positive or not — to Oahu because of the growing number of COVID patients in all the hospitals in Hawaii.”