An older Oahu man recently hospitalized with multiple medical issues became Hawaii’s first fatality linked to the new coronavirus as cases in the islands climbed to 224.

“One of our own, a Hawaii resident, passed away last night due to COVID-19 virus. This is a difficult time for everyone in Hawaii, and I know you join me in mourning the passing of one of our neighbors to a virus that is threatening our community, other communities all around the world,” Gov. David Ige said Tuesday at his daily coronavirus briefing. “It is all of our responsibility to help flatten the curve and stop the spread of COVID-19 in Hawaii. Please continue to practice proper hygiene and social distancing. Stay at home and self-isolate, especially if you are sick. You need to remain vigilant.”

While the exact cause of death is still unclear, health officials said the man did test positive for COVID-19 and that the disease possibly contributed to his death.

In announcing the fatality, state Health Director Bruce Anderson said the state double-checked to make sure it wasn’t a “clerical error,” which is what caused last week’s erroneous report of a coronavirus death in Hawaii.

In addition, Anderson said the state’s random COVID-19 surveillance program that included testing 380 negative flu samples March 1-24 for the virus, has found its first positive result, “which reinforces that there is limited and localized spread of the virus, at least on Oahu.”

The coronavirus has been found on all the major islands, with the exceptions of Molokai and Lanai, which still has no confirmed cases. But state officials are expecting a surge in cases, at least on Oahu, over the next few weeks as the virus spreads in the community.

“Social distancing is critical and important to consider at this time,” and as the governor has reiterated, “we should behave as if we have COVID-19 and everyone around us has COVID-19,” Anderson said, adding that over the past week the trend has been moving away from travel-related cases to individuals who don’t have any history of travel or exposure to tourists.

The Department of Health has released maps of each island where residents have tested positive, but it does not necessarily mean there’s community spread in those areas, he said.

Many of the cases on Oahu were reported earlier when most were travel-related and are in residents in higher socioeconomic areas from Kapahulu to Kaimuki and Kahala and down to Kaneohe, according to the DOH map.

“There’s no additional risks if you are in those census tracks. It’s very likely and in fact probable that the person who’s living in those areas was exposed somewhere else. It’s probably at work or in other public places,” Anderson said. “No one should assume that because they don’t live in a census track where there’s not been a case that they’re not possibly going to be exposed. They should act as though they are indeed at risk.”

There were 20 new cases from Monday, including 19 adult residents mostly on Oahu, including a second firefighter and the first employee at The Queen’s Medical Center. The Honolulu Fire Department temporarily shut down the Kalihi Uka fire station for cleaning and disinfecting and will reopen it at 8 a.m. today. Queen’s, which has closed its hospitals to most visitors due to the pandemic, said the positive test was for one of its caregivers, who is self-isolating at home. No new cases were reported on the Big Island, Maui or Kauai. Of all the confirmed cases in Hawaii since the start of the outbreak, 13 have required hospitalizations while 58 have recovered.

Hawaii has now tested more than 9,000 people, mostly by private laboratories.

Ige on Tuesday signed an emergency proclamation effective today requiring all interisland travelers to self-quarantine for 14 days, with the exception of essential workers and those seeking medical care, matching the policy for domestic and international arrivals. Ige had announced the interisland travel quarantine Monday.

The government also has imposed statewide restrictions on Hawaii residents in an attempt to slow the spread of the disease, and had earlier asked tourists to stay away.