State and county officials are considering bringing back COVID-19 testing for vaccinated domestic travelers, as well as implementing other requirements aimed at halting the spread of the coronavirus.

Lt. Gov. Josh Green said officials are closely watching the surge in COVID-19 cases, and if conditions worsen could take action.

Sunday was a record day for cases, which soared to a one-day high of 893. However, Green said any change would come with at least a two-week warning.

While increased testing is under consideration, Green said, “Travel pre-testing may be challenged legally because we are the only ones to have successfully done it, and vaccination status is the standard the CDC has been promoting.”

He said other interventions are more likely, such as having people show vaccination cards to get into gyms, restaurants and other public places, as well as implementing curfews to reduce activities that could further strain health care facilities.

Green said 392 COVID-19 patients were in hospitals Sunday.

“We peaked at 318 last year,” he said. “I’ve cautioned the governor and the mayors that if our numbers go much higher, we are going to lose some citizens to COVID that should be able to get care.”

Further tightening of Safe Travels requirements could make travel to Hawaii safer. But it could negatively affect Hawaii tourism at a time when seasonal fall slowdowns are expected, and the nationwide rise in COVID-19 cases could curb travel demand.

Green said that from its Oct. 15 start, Hawaii Safe Travels has provided a way to safely reopen tourism.

A vaccination exemption has been in place since June 15 for vaccinated travelers who received at least one shot in Hawaii. It was offered July 8 to domestic trans- Pacific travelers.

The vaccine exemption has been credited with helping Hawaii’s domestic tourism rise above the peak 2019 level. It also has been criticized by some for increasing tourism demand for Hawaii, potentially contributing to coronavirus tolls.

President Joe Biden’s administration has announced that most Americans vaccinated for COVID-19 should get a booster after eight months. Some immunocompromised individuals in Hawaii already have gotten the extra shot.

Green said most of Hawaii’s COVID-19 cases continue to be from community spread. According to state Department of Health data, travel-related COVID-19 cases in July made up about 14% of cases, with only 1% attributed to nonresident travelers.

However, Tutu Man Kawaikapu Hewett — a founding member of Hawaii Quarantine Kapu Breakers, an entertainer and a former Hawaii Tourism Authority board member — said he’s skeptical of Hawaii’s travel- related COVID-19 statistics, especially given the daily arrivals to Hawaii.

On Saturday, 31,054 travelers arrived in Hawaii, according to Hawaii Safe Travels data. Some 26,682 of them were visitors.

“We have about 900,000 visitors coming in a month, and we are to blame for everything,” said Hewett. “You will never convince me that those numbers are right. It’s like saying the moon is made of green cheese.”

Hewett said he supports toughening Safe Travels entry requirements immediately as well as instituting short-term lockdowns and curfews. He also wants officials to beef up enforcement of Hawaii’s coronavirus restrictions.

“I’m a great-grandfather, a grandfather, a father. I want to make sure that everyone survives this. I’m going to support anything and everything that makes us safer,” Hewett said.

Hawaii is the strictest U.S. state for COVID-19-related travel entry requirements.

Gary H. Yamashiroya, special assistant to state Attorney General Clare Connors, said there have been challenges to Hawaii’s COVID-19 restrictions.

“However, as a general matter we don’t believe these cases have any merit or will impact our COVID response programs,” he said.

Travel requirements and other restrictions aimed at stopping the spread of COVID-19 are gaining traction again in the U.S. and elsewhere.

New Zealand recently locked down over just one case. New York, Virginia, the District of Columbia and Louisiana have tightened emergency restrictions.

That’s led to calls from some Hawaii residents for more stringent travel entry requirements, as well as instituting lockdowns and curfews to curb community spread. Some even favor closing bars and nightclubs again, possibly even schools and gyms.

Hawaii Safe Travels was expected to end around September when 70% of the state’s population was expected to be vaccinated for COVID-19. Now, Green said, the program is likely to stay in place through at least the end of the year.

Darci Evans, Charley’s Taxi vice president, said she worries that further crackdowns on tourism or community lockdowns will have a devastating impact on Hawaii’s tourism-dependent economy.

“Please don’t hurt the tourist industry anymore. It’s already been severely impacted, and it’s not the tourists who are bringing COVID in,” Evans said. “Further lockdowns would severely cripple Hawaii’s economy.”

Evans said it’s already been a huge struggle for Charley’s Taxi and other businesses to survive.

“We are the oldest transportation company in the state, and this has been the hardest time for us, including WWII and 9/11,” she said. “We had to take out massive SBA loans, which is certainly not anything that we would have wanted to have done.”

Evans said she doesn’t think curfews are the answer, either.

“It worked against Europe,” she said. “Everybody was going out when they got off of work, so there was more of a rush and more people congregating.”

Hawaii businesses and residents could face additional restrictions if COVID- 19 infections continue to rise. Although, decision makers haven’t reached consensus.

Hawaii island Mayor Mitch Roth asked Gov. David Ige on Wednesday to reinstate a pre-testing program for all visitors and residents flying into the state, regardless of vaccination status.

“The consistent rise of COVID-19 cases within the state of Hawaii and across the country has reached record heights and has put an unbearable strain on our health systems and communities at-large,” Roth wrote in a letter to Ige on Wednesday. “On Hawaii Island alone, our hospitals are at capacity and are unable to in-take any more critical care patients.”

Kauai Mayor Derek Kawa­kami said while Kauai is seeing higher case counts, the island is not experiencing the same capacity concerns at its health care facilities that other islands are facing.

“The Department of Health has been in close contact with the CEOs of both of our local hospitals, and we continue to be in a manageable position,” Kawakami said. “However, we are one state. I recognize that any patient on Kauai who requires medical transport will be draining an already taxed health care system on Oahu. In that sense, I am open to support any uniform preventative measures that (Ige) deems fit for all four counties.”

Travel industry expert John E. DiScala, aka Johnny Jet, who writes a popular travel newsletter, used his Sunday Round-up to urge travelers to check hospitalization numbers before heading to destinations.

“I’m not sure it’s a good thing that so many people are traveling especially to places where hospitals are being stretched to their limit like in Hawaii,” he said.

Mufi Hannemann, president and CEO of the Hawaii Lodging and Tourism Association, said Hawaii’s tourism industry cannot continue rebounding if the destination isn’t safe and travelers aren’t confident.

Hannemann said domestic travel demand for Hawaii was strong over the summer, but booking reports show slowing after Labor Day.

“It’s hard to tell whether the slowdown is the result of the slow season or the fact that people are getting leery about traveling given the virus count,” Hannemann said. “There’s a real possibility of further restrictions, and I really can’t blame the government from having to consider going down that route.”

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The Associated Press contributed to this story.