If COVID-19 restrictions ease and case counts surge again, Gov. David Ige warned Monday that a new round of restrictions could be even more severe.

New restrictions were announced by Ige and Honolulu Mayor Rick Blangiardi in July, “and the case counts continued to increase for six weeks,” Ige told the Honolulu Star-Advertiser’s “Spotlight Hawaii” livestream program Monday. “Until right before Labor Day we averaged 900 to 1,000 cases per day. I guess I’m a very conservative guy. I do know that if we relax the restrictions too much and we see a surge in cases, then the next restrictive period or the next time where we’re going to limit interactions will even be longer and probably be even more restrictive than right now.”

While the seven-day average of new cases has fallen to 350 from 1,000, Ige said they are “still clearly at that level that could surge again.”

Ige is no longer using a benchmark of a 70% vaccination rate to remove restrictions, which include limits on indoor and outdoor crowd sizes, vaccination and testing mandates for Oahu businesses and a ban on fans at University of Hawaii sports.

The original idea in June was to reach a target of a 60% vaccination rate by July 8 that would increase the size of gatherings — then eliminate all restrictions when eventually reaching a 70% vaccination rate. As of Monday the state’s fully vaccinated rate was 67.7%.

“We anticipate that on or about July 8, Hawai‘i will have achieved a 60% vaccination rate,” Ige said in a statement June 24. “Our residents have sacrificed and worked hard to get to this point, but we still have more to do. Please get vaccinated to protect yourselves and your loved ones. We are close to achieving a 70% vaccination rate, at which point all restrictions will end and we can return to the lives we remember.”

But the delta variant changed everything, and Ige no longer uses vaccination rates as a benchmark, his office told the Star-Advertiser.

On Monday, Ige declined to specify what conditions could lead him to ease some restrictions, but repeatedly suggested that reducing the pressure on Hawaii’s health care system likely would be a key indicator — specifically, the removal of hospital outdoor tents used to treat some patients and the departures of more than 650 traveling nurses and other out-of-state health care workers.

“Without them our health care system would definitely be on the brink of collapse,” Ige said. “We are still very, very close to capacity, and we need to remain vigilant.”

Unlike the mainland, Ige said, Hawaii’s isolation makes it difficult to find alternative health care if the number of COVID-19 patients overruns the capability to treat them and other patients, especially in intensive care units.

“We don’t have the luxury of flying someone or driving someone to another hospital if our system gets overwhelmed,” he said. “It’s 2,500 miles away to the nearest assistance, and clearly, once our hospitals are overwhelmed, then the whole notion of crisis standards of care and how we will ration care would become front and center. … We haven’t had to ration care, and we don’t want to.”

Also on Monday, state health officials reported 255 new confirmed and probable coronavirus infections, bringing the state’s total caseload since the start of the pandemic to 78,404.

The new confirmed and probable infection count included 162 on Oahu, 17 on Maui, 32 on Hawaii island, 33 on Kauai, four on Molokai and seven Hawaii residents diagnosed outside the state.

No new virus-related fatalities were reported, leaving the statewide COVID-19 death toll at 757: 573 fatalities on Oahu, 84 on Maui, 86 on Hawaii island, eight on Kauai, one on Molokai and five Hawaii residents who died outside the state.

Ige has probably reached the maximum number of people who will heed his call to get vaccinated, he said, and continues to reach out to people, including state legislators, who might appeal to anti-vaccination holdouts.

He thanked everyone who has gotten vaccinated and continues to follow restrictions, and urged patience and understanding.

“Please be patient another two, four, six weeks, because we are making progress,” Ige said. “We still have too many cases, at more than 300 for the seven-day average, but it is trending in the right direction.”

Ige is optimistic that UH sports could see a return of limited numbers of fans “this season” and the return of vaccinated visitors “hopefully before Halloween.”

“I am hopeful that we will release more restrictions and be able to invite those who are vaccinated back to the islands,” he said, “because we do know that it’s important to our economy and important to getting everybody back to work.”

Ige called himself “a big fan of UH athletics” who is “definitely hurting” because he cannot attend men’s and women’s sports.

To get limited numbers of fans back in the stands, Ige said, there will be a learning curve and adjustments and many details that need to be worked out, such as whether food and drinks will be available and how to control the flow of fans getting into and out of events.

“How do you avoid those mash-ups where people just get released?” Ige asked. “It certainly is an opportunity for people to get infected if somebody is infected in that audience.”

But, Ige said, “I really do think that we will get to a point this season where we will begin to invite fans back. It will be tiered. We would definitely want to start with fewer people rather than just allowing all fans to attend.”

Asked about travelers who have been arrested with bogus vaccination cards and others who refuse to follow restrictions, Ige said that his next emergency proclamation will make it clear that each county has the authority to subject violators to fines, petty misdemeanor and even full misdemeanor penalties that could end in “some jail time if it’s egregious enough.”

“We need to make an increased effort to enforce for those who violate the fines or the prosecution, because otherwise it’s not meaningful,” Ige said.

His administration continues to work with Hawaii County Mayor Mitch Roth on Roth’s desire to publish the names of visitors who refuse to get vaccinated or tested and choose instead to be quarantined for 10 days.

Ige and Roth are trying to figure out how to publish the names without violating “protected health information,” Ige said.