Hawaii’s daily COVID-19 count hit a record high Sunday, spurring officials to plead with the 225,000 or so Hawaii residents who have not gotten the coronavirus shot to get vaccinated.

State Department of Health officials reported one death and 893 new confirmed and probable COVID-19 infections Sunday, bringing the state’s total since the start of the pandemic to 56,099 cases. The death was a woman on Maui in her 30s with underlying conditions who died in a hospital, DOH said. The statewide COVID- 19 death toll is now 564. As many as 9,244 cases are considered active in Hawaii.

Lt. Gov. Josh Green said Sunday the active number of cases is a serious concern and will mean over 300 hospitalizations in the coming two to three weeks. Green said a lot is riding on whether more Hawaii residents choose to get vaccinated.

Full approval from the U.S. Food and Drug Administration for the Pfizer vaccine could happen as early as today — a move that is expected to increase confidence in the various shots, which have been under emergency use authorization.

“Full FDA approval of the vaccination should mean 40-60% of the remaining 225,000 Hawaii residents who are eligible for the vaccination will get it,” Green said. “They would then be protected from severe disease, and our hospital numbers will subsequently drop. If people choose not to get vaccinated, then we will see continued high daily case numbers and full hospitals through the fall.”

The latest Hawaii COVID-19 vaccine summary says 1,820,538 vaccine doses had been administered through state and federal distribution programs as of Friday, up 4,737 from a day earlier. Health officials say 61% of the state’s population is now fully vaccinated, and 69% has received at least one dose.

Green said, “The delta variant is too contagious to contain among those who aren’t vaccinated; 83% of the population who is eligible for the shot and got it done are safe.”

When children ages 5-11 can be vaccinated, he said, he expects about half will get vaccinated, which also will help prevent spread.

“But this won’t be as impactful as adults getting vaccinated, because very few COVID-positive children have required hospital care,” Green said.

In the meantime, he said, officials will be expanding the number of COVID-19 beds at the hospitals, staffing them with 550 contract travel nurses, and likely establishing triage tents to deliver extra care for people with mild disease all across the state.

“This is how we get through this,” Green said.

His remarks came as the U.S. coronavirus- related death toll Sunday was over 628,000 and the nationwide infection tally was nearly 38 million. They also came in advance of the upcoming Labor Day holiday. Historically, COVID-19 infections in Hawaii have surged after every holiday since they tend to lead to more social gatherings.

Sunday’s new confirmed and probable infection count by island included 596 new cases on Oahu, 83 on Maui, 158 on Hawaii island, 37 on Kauai, 11 on Molokai and eight Hawaii residents diagnosed outside the state.

Dr. Jill Hoggard Green, president and CEO of The Queen’s Health Systems, said in a video on covidpau.org that the delta variant is in the community and is “impacting far too many people.”

Hoggard Green urged those who are not vaccinated to get the shot. She also encouraged people to continue social distancing and to wear masks in inside and outside settings regardless of their vaccination status.

The Queen’s Health Systems declared an “internal state of emergency” Friday as an influx of COVID-19 patients at its West Oahu hospital outstripped available beds and the ability of staff to care for them.

According to the latest information from the Health Department’s Hawaii COVID-19 Data dashboard, 362 patients with the virus were in Hawaii hospitals as of Friday, with 65 in intensive care units and 53 on ventilators.

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Star-Advertiser reporter Sophie Cocke contributed to this story.