A third and fourth patient from Hale Nani Rehabilitation and Nursing Center was diagnosed with COVID-19, facility administrators reported Wednesday.

A total of five COVID-19 cases have been diagnosed and verified by state health officials within the span of six days.

What appears to be a growing cluster of infections began Friday, when a nurse who worked with patients was diagnosed with COVID-19 after first showing symptoms on June 10. On Monday, the first patient was diagnosed with COVID-19 upon transfer to an Oahu hospital. On Tuesday, a second patient was reportedly confirmed to have COVID-19 and was put into isolation.

By Wednesday, two more patients tested positive.

“The three COVID-19 positive residents are being cared for at the building in an isolation setting,” Hale Nani officials wrote in an online post.

Initial tests conducted among the colleagues and patients of the first staff member who tested positive were negative. It was only when a resident was diagnosed at a nearby hospital that additional rounds of testing began early this week. The Department of Health is currently conducting testing throughout the facility.

In an email to Civil Beat, Hale Nani administrators said nearly 200 residents and another 120 staff were swabbed on Tuesday. Tests will continue until all 700 staff and residents are tested.

“All of those results are pending at this time,” said Allison Griffiths, vice president of legal affairs for Avalon Health Care Management, which owns Hale Nani. “Currently, all positive residents resided on the same unit. Care staff are assigned to a specific unit and do not typically float between units.”

Approximately 20 residents live in the affected unit, they said.

The skilled nursing facility is the largest in the state, with 288 beds and eight nursing units spread throughout three buildings.