Hawaii’s largest coronavirus outbreak at Maui Memorial Medical Center in Kahului is now considered over.

The state Department of Health has cleared the island’s only acute care medical facility for Maui County, Lanai and Molokai since the last active case there was nearly three weeks ago.

“The outbreak is considered closed because two incubation periods (28 days) have passed with no COVID-19 symptoms associated with any person that could have been connected with the original outbreak,” said Tracy Dallarda, spokeswoman for hospital operator Maui Health, an affiliate of Kaiser Permanente. The last onset of illness was April 21.

Final numbers from the outbreak totaled 52 people — 38 health care workers and 14 patients, she said. Among the patients infected was 95-year-old Lillian Seiser, who recently beat the disease that kept her hospitalized for at least 69 days. The Maui resident contracted COVID-19 while hospitalized for a urinary tract infection and developed viral pneumonia, a complication of the disease. A another staff member who contracted the virus was not attributed to the outbreak, but was counted as a household contact by the DOH, she said.

Hospital workers had earlier told the Honolulu Star-Advertiser that they initially were prohibited from wearing their own personal protective gear and weren’t given proper PPE from the hospital, causing the spread of the infections.

The hospital said it has since implemented a number of changes to prevent future outbreaks, including establishing an Emergency Operations Center that meets daily. Maui Memorial has only one positive COVID-19 patient who is expected to test negative for the virus soon, Dallarda said.

Maui Health is requiring “universal masking for all patients, employees and providers” and universal screening for anyone entering the facility, which includes fever and symptom screening. The hospital also has ongoing training on PPE, bi-weekly virtual town hall meetings for employees and medical staff and a daily digest with the latest stats, updates and answers to questions, she said. It has a designated isolation unit for coronavirus cases and ongoing planning in case of a future surge. Maui Memorial has also established a contact tracing team and program for screening and testing in high-risk contact areas.

“Maui Health is prepared for whatever should come next,” she said.

Hawaii’s tally of coronavirus cases rose by two cases — one each on Oahu and the Big Island — to a total of 643. Of all the confirmed Hawaii cases since the start of the outbreak, 82 have required hospitalizations, according to the DOH.

As of today, 48 infections were active with a total of 578 patients classified as “released from isolation” since the start of the outbreak — more than 90% of those infected. The state’s coronavirus death toll was unchanged at 17. State and clinical laboratories have now conducted more than 42,024 COVID-19 tests with just 1.5% positive.

State health officials announced Monday that for the third time in less than two weeks Hawaii had no new confirmed coronavirus cases. The Health Department’s daily count of new infections has not been in the double digits since April 18 when 22 new cases were reported.

Hawaii’s low number of infections — and lowest-in-the-nation mortality rate — has led to the easing of certain state and county emergency restrictions, but has left lawmakers scrambling to deal with the devastating fallout and with how to safely reopen the local economy and tourism industry with thousands of businesses shuttered and tens of thousands of residents unemployed.