COVID-19 cases and hospitalizations in Hawaii are trending upward, indicating a possible late-summer wave.

The state Department of Health on Wednesday reported a seven-day daily average of 115 new cases, reaching triple digits for the first time since mid-May. The average positivity rate was about 12% statewide, roughly double what it was in mid-May.

Week after week there has been an uptick in the number of COVID-19 patients landing in hospitals, with a seven-day average of 76 per day reported Wednesday, up from 67 the previous week and 56 in mid-July.

The increase in hospitalizations is in line with national trends, which also indicate a rise in recent weeks.

More than 8,000 COVID-19 patients were admitted to hospitals in the U.S. the week ending July 22, a 12% increase over the previous week, according to the U.S. Centers for Disease Control and Prevention.

It was the second straight week of increases after seven months of steady declines.

The CDC said numerous other COVID-19 indicators, including levels in wastewater, test positivity and emergency department visits are also increasing nationally.

Hospitalizations, however, are still considered to be at low levels, and are far below levels recorded at the same time in 2022. Weekly deaths are at their lowest levels since the start of the pandemic.

CDC guidance for actions around COVID-19 are tied to hospital admission levels, and there are no changes to its recommendations at this time.

The federal public health emergency related to COVID-19 ended May 11.

In Hawaii some county positivity rates have jumped significantly beyond the 5% threshold, with 15% reported for Honolulu County and 19.5% for Maui County as of Wednesday.

Tim Brown, an infectious disease expert with the East-West Center in Manoa, said cases in Maui County have more than doubled in the past few weeks.

“And the trend in positivity is unmistakable — it’s skyrocketing,” he said in an email.

This rise on Maui began in mid-June and does not appear to have slowed, based on the latest data available, according to Brown. It is now at 80% of the peak positivity during the initial omicron outbreak last winter, which was 23.9%.

Wastewater trends from the CDC also show the start of a rise in SARS-CoV-2 concentrations for two sewer sheds on Maui, also starting about mid-June.

Katelyn Jetelina, a nationally known epidemiologist at the University of Texas, wrote in her weekly newsletter Tuesday that “a COVID-19 wave is here.”

“Thanks to our immunity wall, 2023 looks very different,” she said, “but we can still use tools to help minimize disruption. To me, it’s still worth it.”

Jetelina recommends repeat testing to rule out false negatives, indoor masking, and for those over age 65 to get the Paxlovid antiviral treatment if they test positive for COVID-19.

The coronavirus, meanwhile, continues to evolve. A growing mix of omicron variants descended from the XBB family are currently competing with one another for dominance in the U.S.

In Hawaii, mostly XBB.2.3 and XBB.1.5 were circulating in test specimens collected during the two-week period ending July 15, according to DOH’s latest variant report.

DOH has through genome sequencing detected new offshoots that epidemiologists are watching, including the new omicron subvariant EG.5 — a descendant of XBB.1.9.2 with one extra spike mutation — which has growing prevalence in the U.S. and worldwide.

The World Health Organization has added EG.5 to its list of variants under monitoring but said there is no evidence so far that it is fueling rises in cases or deaths or resulting in more severe infections.

Federal authorities are expected to roll out an updated COVID-19 vaccine this fall targeting the XBB strains.

“Keep in mind, still lots of COVID out there,” said Brown in his weekly update. “Every other day I talk to someone who has a close friend or family member who just caught COVID (often … again). So take your precautions if you’re at higher risk or around those who are and be careful out there.”

Also Wednesday, the Health Department reported five more COVID-19-related deaths, bringing Hawaii’s death toll from the disease to 1,970.