Hawaii’s coronavirus- related mortality toll reached the sad watershed of 500 fatalities Sunday, when the state Department of Health officials reported the death of an Oahu woman in her 50s who was hospitalized and had underlying health conditions.

Health officials also reported 122 new confirmed and probable infections statewide Sunday, bringing the state’s total since the March 2020 start of the pandemic to 36,246 cases, with more than half of the new infections coming from a spike at Hawaii Correction Center in Hilo.

However, despite ongoing coronavirus infections and wrenching losses of life, there were some positive indicators for the islands.

Hawaii’s COVID-19 fatality rate of 35 deaths per 100,000 residents remained the lowest in the nation Sunday, when the total U.S. corona­virus death toll surpassed 594,000, as reported in the daily database compiled by The New York Times.

The states with the next-lowest coronavirus death rates were Vermont, with 41 deaths per 100,000 people, Alaska (48), Maine (61) and Oregon (64).

New Jersey had the highest COVID mortality rate, with 295 deaths per 100,000 residents, followed by New York (271), Massachusetts (259), Rhode Island (256) and Mississippi (245).

Overall, COVID-19 cases and deaths in the United States have dropped to their lowest levels in nearly a year, while the number of people vaccinated continues to grow, the U.S. Centers for Disease Control and Prevention reported Friday on its website.

The CDC said nearly 133 million people in the U.S. are now fully vaccinated, and a 3% national rate of positive COVID-19 tests for the preceding seven days was “one of the lowest rates the United States has seen since widespread testing began.”

Here as well, Hawaii was below national averages for the disease: Health officials counted 4,524 new COVID- 19 test results in Sunday’s tally, for a 2.6% statewide positivity rate, and the state’s seven-day average positivity rate is 1.1%, according to the Hawaii COVID-19 Data dashboard.

The statistics released Sunday reflected the new infection cases reported to the department Friday.

Despite the pandemic, the leading causes of death in Hawaii remain heart disease and cancer, according to the CDC’s National Center for Health Statistics.

The most recent, provisional CDC disease-tracking data shows that for the 12-month period ending with the third quarter of 2020, the Hawaii death rate per 100,000 people was 179 for heart disease and 173 for cancer, numbers that the agency said showed no statistically significant change from the same time period ending in 2019.

However, for influenza and pneumonia the death rate for the same period was 17, lower than the death rate of 30.3 in 2019, the CDC said.

In February the Honolulu Star-Advertiser reported there had been only three flu cases in the islands detected out of 10,000 to 20,000 samples over the previous six months, according to Dr. Edward Desmond, administrator of the Department of Health State Laboratories Division.

Health officials in Hawaii and nationwide have credited mask-wearing, social distancing and other COVID-19 precautions for a drastic reduction in flu cases during the pandemic.

On Sunday there were 577 active COVID-19 cases on Oahu, 79 on Maui, 29 on the Big Island, 17 on Molokai, eight on Kauai and none on Lanai.

There were 63 new infection cases on Hawaii island, 48 on Oahu, six on Maui, two on Kauai and three Hawaii residents diagnosed outside the state.

The seven-day average case count for Oahu was 31, and the seven-day average positivity rate was 1.4%.

Health officials say that more than 50% of the state’s population is now fully vaccinated: As of Thursday, 1,513,894 vaccine doses had been administered.

Last week state health officials began including probable infections, of people who never received a confirmatory test but are believed to have had the virus because of their known exposure, symptoms or a positive antigen test, in its total case counts.

For information on getting vaccinated, go to hawaiicovid19.com/vaccine or OneOahu.org.