Hawaii health officials are investigating half a dozen COVID-19 clusters throughout the islands as the number of cases continues to creep up.

The investigations include three employees at Wahiawa Health who tested positive, more than 30 cases at Maui Memorial Medical Center and a dozen cases connected to two McDonald’s locations in Kailua-Kona on the Big Island. Seven infected crew members were also found on the Pride of America cruise ship docked in Honolulu.

Health director Bruce Anderson did not provide details on the other groups of cases under investigation.

The state’s tally of coronavirus cases climbed by 13 to 530 on Wednesday, with new cases reported at West Loch Elderly Village in Ewa Beach and at Hale Makua Health Services on Maui, which was related to the Maui Memorial Medical Center cases. Both facilities serve the elderly population, most vulnerable to the disease.

A Hale Makua home health patient tested positive for COVID-19 after being discharged from the Maui hospital, according to the state Department of Health. In addition, one of six Hale Makua nursing home residents suspected to have been exposed while at Maui Memorial has also contracted the virus. The nursing home resident, who is asymptomatic, initially tested negative on April 9, but was retested on April 13 and found to be positive, the DOH said.

Meanwhile, city officials reported a case of COVID-19 at the 150-unit West Loch Elderly Village in Ewa Beach for low-income seniors. Residents were informed by the property manager Wednesday that an individual who does not live there has contracted the virus.

“If you count all the cases with families involved, the numbers go way up from there,” Anderson said, adding that the DOH is following up on thousands of leads. “We are pursuing contacts, investigations go on for sometimes weeks. We’re lucky to have only a handful of large clusters here in the state that have involved multiple people.”

Of the 13 new cases, six had travel-related exposure and six were likely related to community spread.

“The disease is widely spread throughout much of the U.S. That continues to be a concern for Hawaii, particularly as we look at potentially opening up our borders and inviting residents and visitors back,” Anderson said.

The state and private laboratories have now conducted 20,535 tests, 2.6% of which were positive, which suggests the “disease is not widespread here,” he said, adding that several people linked to Kualoa Ranch have all tested negative after an employee got sick from the virus. “Nevertheless we’re seeing some evidence of limited community spread and a number of clusters, which is concerning.”

In addition, an isolation quarantine facility for the homeless in downtown Honolulu, the Kaaahi Street Clinic, has nine individuals in quarantine awaiting test results, he said.

Visitors keep coming

Meanwhile, 512 trans-­Pacific passengers came to Hawaii on Tuesday — including some visitors. The Hawaii Tourism Authority reported the arrivals included 119 visitors and 174 residents, 136 airline crew members and 34 transit passengers who are catching other flights and 43 intended new residents for Oahu and six for Kona.

Visitor counts have greatly decreased since March 26, when Gov. David Ige instituted a 14-day mandatory self-quarantine for all arriving trans-Pacific passengers to cut travel demand and protect Hawaii’s resources due to COVID-19. He expanded the quarantine to interisland flights on April 1.

At this time last year, more than 30,000 passengers were arriving in Hawaii daily. In the 20 days since the quarantine began, some 2,657 visitors have arrived — an average of nearly 133 visitors a day.

Critical time

The Hawaii National Guard is activating 1,200 Guardsmen to help with the COVID-19 response. That includes 400 soldiers and airmen activated last week and 800 more who will be brought on today.

President Donald Trump said Wednesday that states with the lowest numbers of cases would likely be the first to reopen in the coming weeks.

Gov. David Ige said he is leaning on the mayors and emergency managers to create the framework for reopening the state.

“We will be looking at the policies across the board and making science-based decisions about what appropriate relaxing of the stay-at-home orders and other restrictions would make the best sense for our community,” he said, adding that the state must first ensure it has a robust testing program and is able to follow up on positive cases in the community and help with cleaning and sanitation when necessary.

The next few weeks through the end of April is a “very critical time for us to maintain the actions and mandates we’ve put in place,” Ige said.

“Please do not let your guard down. The worst thing we can do now is to become complacent and overconfident,” Ige said. “We have not won the battle yet. We have a long way to go so continue to do your part to protect your families, your friends and our community.”