A married Japanese couple in their 60s tested positive for the coronavirus after returning home from a Hawaiian vacation, health officials said Saturday, according to the New York Times.

The couple had returned to Nagoya, Japan’s fourth-largest city, on Feb. 7, and a day later he visited a hospital with a fever but was turned away. He was back after two days when he learned he had pneumonia, but he was then released. On Thursday, the man went by ambulance to a hospital.

His wife checked into the hospital Friday with a fever. Both now have the virus.

The disclosure of the post-visit infection has caused concern among Hawaii health officials, the Times reported. “All of the state agencies have been preparing for…