Hawaii’s COVID-19 cases are climbing, just not as quickly as in most of the U.S.

The 14-day change in Hawaii cases was up 36% through Saturday. For the nation as a whole, that number was up 80%.

Hawaii went from a seven-day average of 66 new cases on Nov. 1 to a seven-day average of 99 new cases Saturday. Nationwide, the seven-day average on Saturday was 159,121, according to The New York Times.

The growth in coronavirus cases here may not be as rapid, but it is still concerning and, if left unchecked, will likely lead to prolonged restrictions on activities and businesses.

“There are a lot of big things on the near horizon that could cause spread. The only thing that will stop coronavirus is mask wearing and social distancing,” said Lt. Gov. Josh Green.

The miniature spike in Hawaii’s coronavirus cases came on the heels of Halloween and a general election. Now officials are worried that if Hawaii residents don’t adhere to social gathering limits for Thanksgiving and Christmas, the spread of COVID-19 could lead to additional hospitalizations and deaths, strain Hawaii’s health care capabilities and disrupt economic recovery.

“We’re in an enviable position for now. But we saw how bad it could get,” Green said. “July and August were terrible. It was very rough, and I don’t want us to tip that way again. Going backwards would mean more delays in schools, more delays in economic recovery, of course God forbid more loss of life.”

Green said he’s more concerned about Thanksgiving than he was about Halloween.

“Thanksgiving is a very gathering-rich holiday. Everyone builds their Thanksgiving specifically around having the 10 to 15 closest people coming over from a long meal, which means they won’t be masked, they will be from multiple different bubbles and there will be spread,” he said. “We need to stay strong on our gathering numbers, and we need to have mask compliance way up. Otherwise, it’s going to be a really tough December.”

Most of Hawaii’s new cases are in Honolulu and on Hawaii island.

The state has had 6.9 daily new cases per 100,000 over the last week, according to data from COVIDActNow.org, and it has the lowest COVID-19 rate per 100,000 of all the states.

Hawaii also has the nation’s fourth-lowest effective reproduction rate, according to rt.live. On Sunday rt.live reported Hawaii’s reproduction number as 1.05, meaning people who test positive for the novel coronavirus in the state will infect an average of 1.05 other people.

The reproduction rate of 1.05 is well below most other states, but it still is above 1.0, meaning that the virus could spread quickly. A rate below 1.0 means the virus will eventually stop spreading.

Hawaii is doing better than other states, where the Centers for Disease Control and Prevention reported that COVID-19 infections rose to 155,708 Saturday.

But that’s kind of a dubious distinction since virtually all states have COVID-19 spreading problems. Only two states, Mississippi and Alabama, on Sunday had effective reproduction rates below 1.0.

The nation’s worst effective reproduction rates on Sunday were in Vermont, which had an effective reproduction rate of 1.43, and Maine, which was at 1.40.

Back in August, Hawaii was at the top of the nation’s effective reproduction rates, giving it “super spreader” status. Officials speculated that a previous surge was due in part to an increase in local gatherings after Memorial Day, especially Fourth of July holiday celebrations.

Hawaii health officials Saturday reported 108 new coronavirus infections statewide, bringing the total since the start of the pandemic to 16,519 cases. The official state Department of Health coronavirus-­related death toll remained unchanged at 222.

New numbers weren’t available for Hawaii on Sunday because the state Department of Health changed the timing of its reports over the weekend. The data that would have been reported Sunday at 3 p.m. is slated to be reported today at noon.

Dr. Jill Hoggard Green, president and CEO of The Queen’s Health Systems, said during the first of three town hall COVID Pau events that Queen’s is predicting a fall surge in Hawaii’s coronavirus cases.

“However, and this is most important, we have the tools to prevent it. If we are following those protective rules for public health, if we are wearing our masks, keeping social distance, there are dramatic impacts in terms of the rate of slowing down any spread of disease,” Hoggard Green said. “So when you talk about a surge and what can we see if we don’t do that, it will be a larger surge than what we just experienced.”

Some in the community, who have been quick to blame tourism or other forms of economic reopening on higher rates of infection, might worry about the state’s decision to expand its pre-arrival testing program. Starting Nov. 17 there’ll be 11 more trusted partners covering domestic travelers, including those arriving from Samoa and Guam. They’ll add to the state’s previously announced testing partners, including 17 domestic partners and 22 from Japan.

On the flip side, other critics say government hasn’t done enough to reopen Hawaii’s economy, contributing to high unemployment, increases in social service needs, and mental health woes that also have hurt the community.

Ray Vara, president and CEO of Hawaii Pacific Health, said during the COVID Pau town hall that he believes Hawaii’s pre-arrival testing program has been effective.

The program, which launched Oct. 15 for U.S. trans-Pacific travelers and Nov. 6 for travelers from Japan, has provided a pathway to begin recovering Hawaii tourism, which dropped about 72% through the first nine months of the year, which saw only 2.2 million visitors as compared with 7.8 million last year.

“The fact that we have a test and then the fact that the far majority of those tests have come back negative tells us that the prevalence rate of those coming into our state continues to be extremely low — in fact, exposing very little risk to the residents,” Vara said.

Peter Ho, chairman, president and CEO of Bank of Hawaii, who spoke at the COVID Pau town hall, said infection rates take more of a toll on Hawaii’s economy than policy actions.

“The reality is what really impacts the community is infection rates in our community. As those peak up, we do see economic drop-off. And it’s not so much the policy action that’s driving economic impact; it’s just the rate of infection,” he said.

Ho said the “real issue is how can we get better.”

“Because as we get better, as we control the virus better and better, that allows people’s livelihoods to begin to be repaired,” he said. “That allows small businesses to go on and prosper, and it allows us to keep each other that much healthier. I think that’s the big issue — not so much how well are we doing relative to other places.”