Malta announced its first death from COVID-19 on Wednesday, a 92-year-old woman with severe underlying medical problems.

The tiny Mediterranean island reported its first case of the disease a month ago and since then 299 people have tested positive, with four patients receiving intensive care hospital treatment.

“I confirm the woman’s passing with a heavy heart,” Health Minister Chris Fearne told a news conference.

Malta confirmed six new cases on Wednesday after a spike of 52 infections announced on Tuesday.