Cook Islands has announced its first death from Covid-19 on Sunday, over two years since the pandemic began.
The country had long been free from the virus, but it opened to quarantine-free travel with New Zealand in January, and an outbreak of Omicron followed in Rarotonga in February.
The person who died with Covid-19 was a 63-year-old woman from Aitutaki.
“It is with great sadness that I announce that we have recorded our first in-country death attributed to Covid-19,” Prime Minister Mark Brown said.
She had been sick for three days at home and refused medical treatment, a statement from the Cook Islands health ministry read.
"The family made an emergency call to Aitutaki hospital just before midnight last night. The woman stopped breathing in the ambulance en route to the hospital and was unable to be revived."
The woman was triple-vaccinated and had serious underlying health problems.
“It is tragic, but not unexpected that we might lose someone to Covid. I, together with Te Marae Ora [health ministry], am sending our condolences to the family who have just lost a loved one, our thoughts and prayers are with them at this time and the people of Aitutaki," the prime minister said.
One hundred and sixteen cases were reported in Rarotonga and Aitutaki in the past day, bringing the nationwide total to 4727 since the outbreak began.
Prime Minister Mark Brown said on Saturday the situation is improving in the two main islands, and some restrictions on inter-island travel and gathering limits are being loosened.
Cook Islands is open to anyone via New Zealand if they meet border requirements, and pre-departure tests won't be needed from May 1.
Direct flights from Sydney and Los Angeles are yet to be announced.
It's expected isolation rules for positive cases will be eased in the coming weeks.
There are more than 700 active cases in Cook Islands and 98% of its population aged 12 and over has had two doses of a vaccine, 75% of those eligible have had a third dose.