C-19 positivity does not drastically change unless herd immunity or vaccine gets developed.
Not sure exactly what you mean there, but it does change with such simple steps as social distancing, wearing face protection, hand washing, sanitizers, avoiding poorly ventilated indoor areas, and temperature screenings. None of these are particularly burdensome, and collectively they have a huge impact on contagion/spread. The danger to Hawaii (or any place) hospitals is not a sick person, it is a sick person spreading it to many others. In technical terms, if R0 (or Rt) is near 0, Hawaii can handle a lot of infected people. If it is 2, it will be overwhelmed quickly by exponential growth.
Here is an interesting site:
https://rt.live/ It shows R values by state in almost real time. For context, if R is < 1, the number of cases will go down. If R is > 1, the number will go up. If R = 2, you have exponential growth.
Hawaii is current 0.91. However, because of its small numbers, it has a wide area of uncertainty.
p.s. They note that their model assumes contagion begins with symptoms, but that actual contagion likely is before that, and they have not taken that into consideration. So actual Rt may be higher.