Signs outside a restaurant state their mask policy in Old Orchard Beach on Tuesday. Credit: Troy R. Bennett / BDN

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There’s no evidence that Maine is currently on track to see a surge of coronavirus cases like those now being recorded in many other states in the South and West. But those new flare-ups have shown just how quickly the pandemic can spiral back out of control even in areas that seemed to have tamed it.

Like other northeastern states, Maine’s efforts to combat the virus over the last few months have generally brought results. Most counties are reporting fewer than 10 active cases, and the state’s moving average of new confirmed cases has mostly been dropping from a peak in late May even as testing for the virus has increased.

But the danger of reopening the economy too quickly or without enough safeguards has become apparent in larger states such as Florida, Texas and Arizona, which have seen enormous jumps in cases and hospitalizations after loosening restrictions on businesses and large gatherings in recent weeks.

For Maine, a more cautionary example may be California, even though it’s larger and more populated, according to Dr. Robert Horsburgh Jr., a professor of epidemiology at Boston University. While California seemed to be bringing the virus under control last spring, it is now contending with its own large spike in cases after reopening portions of its economy.

The Pine Tree State did see an uptick in new confirmed coronavirus cases in late June, which Nirav Shah, director of the Maine Center for Disease Control and Prevention, attributed to wider testing and increased spread among younger people venturing back out into public.

But new daily cases have resumed dropping since then, according to a moving average of new cases over the previous seven days. The average jumped from 23 on June 22 to 39.6 on July 1 before falling back down to 26.7 by Tuesday.

“When you have small numbers, a little bit of up and down is not something to be worried about,” Horsburgh said. “But you definitely don’t want to see the trends going up over time.”

Even with Maine’s relative success at blunting the virus, though, Shah said on Monday that the state is still at risk of another surge like those in the South and West.

“There is not a single region or state that’s immune, as it were, from a recurrence of COVID-19,” he said.

One of Shah’s top concerns, he said, is that the virus could spread enough in the community that it sparks a new round of outbreaks in facilities such as nursing homes, where the virus can spread quickly among a large numbers of residents who are at a greater risk of severe complications and death than younger, healthier people. Nursing home residents accounted for more than half of Maine’s coronavirus deaths in the early months of the pandemic and a sizable portion of the state’s total cases.

However, nursing home outbreaks have been rarer in recent weeks, and the Maine CDC no longer considers most of the nursing homes that had outbreaks early on to have active outbreaks, as those infected have either recovered or died.

At the same time, the state did see an increase in the total number of active outbreaks between the start and end of June, from 42 to 52, according to the Maine CDC. But the more recent outbreaks have generally been smaller and in workplaces or group homes.

Health experts have said the surging cases outside the northeastern U.S. highlight the need for states in this region to be cautious about loosening restrictions on businesses and large gatherings. They should also be able to widely test for the virus and trace the contacts of people confirmed to have it so that they can be quarantined and prevented from spreading the virus, according to Horsburgh.

He said that states and communities should not open everything back up at once, but make gradual changes — such as reopening restaurants for indoor service — then wait at least two weeks to see if that change is followed by a spike in new cases. If it is, he said, they should consider reimposing the restrictions or even putting more stringent ones into place.

Maine should also be careful about loosening requirements for people to wear face coverings and masks, given a growing body of evidence that they are effective at preventing the spread of the virus, which can be contagious even when people aren’t exhibiting symptoms, according to Dr. R. Gibson Parrish, a physician and epidemiologist based in southern Maine who used to work for the U.S. Centers for Disease Control and Prevention.

While Maine is a small state, Gibbs said that it should follow the example of a state such as New York, which has been reopening much more deliberately than the places that are now seeing surges.

“The virus is still out there,” he said. “If one relaxes the rules in terms of trying to reduce spread, reduce transmission, the virus will begin to spread again. It’s a process where you have to keep your eyes on the numbers and respond to them. You can’t just ignore things.”