O’FALLON, Mo. — Missouri’s largest county offered a dire warning to its 1 million residents on Monday: New restrictions will be necessary unless the coronavirus surge is brought under control.

St. Louis County already requires face coverings and has imposed other restrictions, but Democratic Executive Sam Page said at a news conference that with cases rising again and hospitals filling quickly, more drastic measures could be announced next week.

“No one wants to shut down our economy and no one wants more restrictions,” Page said. “We understand how harmful that will be. But we can’t stand by as this virus continues to rage in our community.”

Missouri is among dozens of states seeing a big increase in COVID-19 cases and hospitalizations. After reaching new records in cases several times last week, culminating with a high of 4,559 on Saturday, the state health department reported better numbers Monday — 3,244 new cases and no new deaths.

It’s too early to tell if that was a one-day blip or the start of a trend.

State data showed Missouri’s positivity rate at 19.5% — nearly four times the benchmark suggested by the World Health Organization. Missouri has now reported 212,441 confirmed cases and 3,153 deaths since the start of the pandemic.

On Sunday, Dr. Alex Garza of the St. Louis Metropolitan Pandemic Task Force cited a “frightening” amount of virus in the St. Louis area, and he warned that hospitals are increasingly overwhelmed. Average daily hospitalizations and admissions have more than doubled over the past month at St. Louis-area hospitals.