The U.S. Centers for Disease Control and Prevention has bumped Kauai County back up to a high-level community for COVID-19 impacts.

Kauai joins Honolulu and Maui counties, which are also categorized as high-level communities, based on metrics that measure COVID hospital admission rates, percent of inpatient beds occupied by COVID patients, and new COVID cases per 100,000 over the past seven days.

Under CDC guidelines, those living in high-level communities should wear a well-fitting mask indoors in public and on public transportation, regardless of vaccination status.

People should also stay up to date with their COVID-19 vaccines and get tested if they have symptoms, and those who are immunocompromised or at high risk for severe disease should also consider avoiding non-essential indoor activities in public where they could be exposed.

Kauai has moved back and forth between medium and high, having been the first county in Hawaii to be moved up to the orange, high-level category back in mid-May, followed by Honolulu and Maui counties. Kauai was then moved down to a yellow, medium-risk community in late May, while Honolulu and Maui remained high.

CDC bumped Kauai County back up to high on Thursday, listing the case rate per 100,000 at 601.7, new COVID hospital admissions per 100,000 at 15.2, and staffed inpatient beds used by patients with COVID at 6.9%. The greatest increase in metrics were in new hospital admissions per 100,000, which increased from 8.3 to 15.2, bringing it back up to high.

On Wednesday, the Hawaii Department of Health reported Kauai County’s seven-day average of new cases dropped to 65, down from 71 reported on June 1. The average positivity rate for the county, however, increased to 26.5% from 24.7% reported on June 1.