MIAMI — COVID-19 refuses to go away.

As of Wednesday, there had been five additional confirmed positive cases since Sunday — bumping the total for Ottawa County to 42, according to the Oklahoma State Department of Health.

The OSDH daily report Wednesday showed 8,904 confirmed cases statewide with 364 deaths. There have been 6,898 recoveries.

The number of cases spiked on April 28, flattened May 2, had a blip in mid-May, flattened again until June 9, when there was a bit of as bump.

Of the Ottawa County count, the OSDH numbers by town report shows 24 cases in Miami, 13 in Afton, three each in Commerce and North Miami and two in Fairland.

There have been 17 recoveries in Miami, 12 in Afton and each reported case in Commerce, North Miami and Fairland are shown as recovered.

“As Oklahoma continues open back up, seeing an increase in cases is somewhat expected,” said Jonas Rabel, president of Integris Miami and Grove hospitals. “We have also noticed many people are relaxing their COVID precaution efforts. We certainly understand people are fatigued after months of COVID precautions.

“Our hospitals and physicians have resumed seeing a full slate of patients. We have taken an abundance of caution to make visiting our physician offices and hospitals very safe.”

The OSDH report showed 22.2% of the cases in Ottawa County have been associated with and none of the deaths have been associated with a long-term facility or nursing home.

Both of the deaths have been individuals in the 65 and older age group.

Those numbers actually are the result of activities over the Memorial Day weekend, Dr. David Chansolme, the medical director of infection prevention at Integris Health said in a video. Conversely he said there will be more cases pop up.

“COVID-19 cases definitely are on the rise right now, and as such, we have to continue the hyper-vigilance we’ve been preaching for the last four months: social distancing, hand hygiene and community masking, also,” Chansolme said. “It is still recommended that you wear masks in public, not only to protect yourself, but if you also happen to be an asymptomatic spreader, it’s protecting those people around you.

“We need to be hyper vigilant for those people who are at a higher risk of developing problems, particularly the elderly and those with underlying health issues. Even though the weather is nice and people want to be outside, we still have to be aware that it can be transmitted, even in these hot climates.

Chansolme said there have been big outbreak in Mexico; Texas is dealing with numerous cases as well and Florida and Arizona — locales that have weather hotter than Oklahoma.

“Just because its summertime, that doesn’t mean we can take our foot off the gas. We have to continue to do the things we can to try to mitigate the spread of coronavirus,” he said.

The Jasper County Health Department in Carthage, Missouri, reported 230 total cases as of Wednesday, with 181 current cases in isolation, several hospitalizations and 686 cases placed on quarantine.

The report said most of the cases were clustered around the Carthage area.

The Joplin Health Department said that there had been five additional COVID-19 cases as of Wednesday, with 29 cases within the city of Joplin.

Two adults reside in Joplin within Newton County and the other three reside in Joplin within Jasper County.

Health officials have warned of a spike in coronavirus cases in the Tulsa are that can be linked to indoor events and urged people attending such gatherings to take precautions. The warning came ahead of President Donald Trump's scheduled campaign rally in the city on Saturday.

Tulsa Health Department spokesperson Leanne Stephens said an undetermined number of the latest coronavirus cases were linked to two recent indoor gatherings, but declined to name them.

Stephens said the department has not had contact with the Trump campaign and the warning is unrelated to the planned rally.

THD director Bruce Dart has said publically that he wishes the president would postpone the rallies because of the spike in the number of COVID-19 cases.

Projections show there could be more than 200,000 deaths by Oct. 1.

For most people, the coronavirus causes mild or moderate symptoms that clear up within weeks. But for others, especially older adults and people with existing health problems, the highly contagious virus can cause severe symptoms and be fatal.

The actual number of people who have contracted a virus is likely higher because many people have not been tested, and studies suggest people can be infected and not feel sick.

Local test sites include the Ottawa County Health Department, 1930 North Elm (918-540-2481), Delaware County Health Department, S. 9th Street, Jay (918-253-4511) and Craig County Health Department, 115 East Delaware in Vinita (918-256-7531).

To learn more about COVID-19, call the COVID-19 call center at 877-215-8336 or 2-1-1 or visit https://coronavirus.health.ok.gov/

— The Associated Press contributed information to this report.