The number of confirmed coronavirus cases in Massachusetts jumped by 986 Thursday — the highest count of new cases in nearly five months — as more than 20 percent of the state’s cities and towns were designated high-risk for the virus.
Thursday’s new confirmed cases, which reached the highest daily mark since May 24, brought the statewide total to 143,927, while the death toll rose by 30 to 9,589, the state Department of Public Health reported.
In recent days, the state has seen an increase in cases after appearing to get the virus under control this summer. Governor Charlie Baker has recently acknowledged cases are rising but has said the state is prepared for it.
“It’s the trend that we’ve been worried about,” Dr. Nahid R. Bhadelia, medical director of the Special Pathogens Unit at Boston Medical Center, said of the growing number of cases.
Bhadelia said the increase in infections was likely caused by a combination of factors, including the state’s gradual reopening, the return of students to some college campuses, cooler weather driving people inside, and pandemic fatigue from months of sacrifices.
“These numbers signal that we need to consider whether we need to roll back some parts of reopening, including things like indoor dining and other aspects that we know carry greater risks,” she said. “Because there’s going to be a trade-off between those types of activities versus continuing schools.”
Boston is one of 77 cities and towns designated high-risk in this week’s data, meaning they have had more than 8 cases per 100,000 residents in the past 14 days, the Department of Public Health reported. There were 63 communities, including Boston, in the red zone in last week’s report, up from 40 the week before. The statewide average remained in the red zone, as well.
Boston’s average daily rate of infection per 100,000 residents was at 12.0, up from 11.1 last week, the department said. The statewide average daily rate was at 9.2, up from 8.7 last week.
The other 76 communities considered high risk include 13 that have been designated high risk for three straight weeks: Acushnet, Brockton, Chelmsford, Holyoke, Hudson, Kingston, Leicester, Malden, Plymouth, Randolph, Waltham, Webster, and Woburn.
Starting Monday, the 13 communities must roll back to step one of the state’s reopening plan, meaning indoor venues like skating rinks and trampoline parks must close, and gyms and libraries must reduce capacity from 50 to 40 percent, according to state health officials. Outdoor gatherings must also be limited to 50 people.
The Department of Public Health on Thursday night ordered indoor ice rinks in Massachusetts closed for two weeks after a rise in COVID-19 cases connected to hockey practices and games, officials said.
The closure order, which lasts from 5 p.m. Friday to Nov. 7, does not include college and professional hockey programs, the department said in a statement.
By far, the community with the highest daily average is Middleton, with 61.6 cases per 100,000 residents, according to the state. In early September, an outbreak at the Middleton Jail and House of Correction infected at least 137 inmates, but only 15 remained ill last week, according to the Essex County sheriff’s office.
Second highest was Lawrence, with an average of 45.9 cases per 100,000 residents, up from 41.9 the previous week. Lawrence has been one of the hardest-hit communities throughout the pandemic, and earlier this month Mayor Daniel Rivera unveiled a new mobile health unit to offer free testing for the virus. Rivera also implored residents then not to have parties, not to travel without quarantining or being tested, and to wear face masks.
Bhadelia said she is worried about the situation across the country, and especially in the Northeast, which will be one of the first regions hit by the fall cold and flu season.
“The trend is worrisome. I hope it doesn’t continue down this road,” she said. “Our hospitalizations have gone up, but New York has already seen deaths go up — and we always seem to be behind New York by a week or two. . . . This is the time to act decisively, because we shouldn’t wait until we get to a point where we only have extreme choices left.”
In another disturbing sign, tests of wastewater at the Massachusetts Water Resources Authority plant at Deer Island found increasing traces of the virus. The pilot program is meant to be an early warning system for possible new surges.
Trend lines for both the northern and southern sections of the MWRA system took a sharp turn upward as of tests taken Monday.
“It strongly suggests a marked increase in cases throughout the region, north and south. I would caution against overinterpreting it, just as I would caution against interpreting a drop in the next sample as a reason to relax. However it suggests transmission increasing at a rate not seen since the spring,” said William Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health.
Hanage noted the state’s move earlier this month to allow lower-risk communities to advance to the second step of Phase 3 of the reopening plan.
"If cases are on the increase we know that providing the virus more opportunities to transmit will make things worse, quicker. We also know that the people who are going to be in hospital (or worse) in a few weeks don’t know they are infected yet. It is time to start talking about the most effective ways to slow this down,” he said in an e-mail.
Boston leaders announced Wednesday that the school district would be returning to all-remote learning, affecting about 2,600 high-needs students who have been attending school part time since earlier this month. Students with high needs include those with severe disabilities, English learners, and those facing homelessness.
The news came as Boston’s virus positivity rate — another key metric watched by health specialists — jumped to 5.7 percent for the week ending Oct. 17, up from 4.4 percent the week prior.
On Thursday, Baker would not explicitly say that he disagreed with Boston school officials' decision to return to all-remote learning, but he emphasized that districts across the state are not seeing the virus spread within school buildings.
“One of the things we’ve tried to do over the course of this pandemic is to learn from the real-life experience and the research of others, and the real-life experience and the research with respect to schools is overwhelming at this point that schools are not spreaders, that kids in schools are not spreaders of COVID,” Baker said.
State officials in their daily report said that 17,966 more people had been tested for the virus, bringing the total to more than 2.58 million. The number of administered tests climbed to more than 5.44 million. The state also reported that new antibody tests had been completed for 284 people, bringing that total to 125,118.
The seven-day average of positive tests per total tests administered was at 1.4 percent. The lowest observed figure for that metric — a number watched closely by state officials — is 0.8 percent.
The state also offers on its dashboard a different measure of test positivity: daily positive tests per people tested. That number was at 5 percent. Some experts have suggested that positive tests per people tested is a better measure of the pandemic.
Meanwhile, the three-day average of hospitalized coronavirus patients grew slightly from 512 to 519. The lowest that metric has been is 302.
The number of hospitals using surge capacity was 4 and the three-day average of deaths from confirmed cases was 16; the lowest that number has been is nine.
Martin finucane can be reached at firstname.lastname@example.org.