Thirteen new COVID-19 cases were confirmed Tuesday by the Hawaii Department of Health, taking the statewide COVID-19 infection count to 517.

The latest documented cases include a dozen Hawaii residents and one non-resident.

Another 18 people were released from isolation, marking more than 333 documented recoveries to date, according to the department.

DOH Director Bruce Anderson said Tuesday that Hawaii’s death rate remains low, at about 1%.

“Out of the 517, nine have died,” he said. “Essentially all others have either recovered or are being cared for.”

If people go at least seven days without symptoms, they qualify to be released from isolation, according to state and federal Centers for Disease Control and Prevention recommendations.

On Tuesday, the health department confirmed a cluster of cases that began at Maui Memorial Medical Center grew to 34 people, including some health care workers. It is the largest documented cluster of cases in Hawaii to date. 

Another cluster of cases — this time linked to a Big Island McDonald’s employee in Kona — has resulted in 14 coronavirus diagnoses, including seven employees and seven of the workers’ relatives.

Anderson confirmed the outbreak at a Senate Special Committee on COVID-19 meeting as well as a Tuesday press conference.

Anderson said it was an example of how “one person can create a significant problem.”

“All are in isolation and being restricted,” he said. The two McDonald’s restaurants located in Kona facilities are closed and have undergone a deep cleaning, he added.

On Tuesday, the COVID-19 death toll remained at nine people.

Honolulu County, which recorded 352 cases on Monday, now has 358.

Hawaii County went from 40 cases to 41. Kauai County reported no new cases and its infection count remained at 21.

Maui County recorded two new cases taking its total to 88, up from 86 on Monday. Four other Hawaii residents have been diagnosed outside of Hawaii. Six Hawaii residents have been diagnosed elsewhere to date.

More than 19,000 COVID-19 tests have been conducted in Hawaii to date. Nearly all samples have been collected by private laboratories.

Anderson said Tuesday the health department has made a request to hire additional people to help in its case investigations.

“We have 30 volunteers on top of our staff, and we’re barely able to keep up,” he told the Senate.

Also on Tuesday, the Healthcare Association of Hawaii made a call out for volunteers to sign up for the Hawaii Medical Reserve Corps, called Na Lima Kako‘o. People with or without medical backgrounds are encouraged to apply online.

“While we have not seen a  large surge of positive patients, we want to continue to prepare for what may occur in the future,” said Hilton Raethel, the association’s president and CEO.