St. Louis County, Mo. (AP) — Missouri’s largest county is warning its 1 million residents that 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 Monday that with cases rising again and hospitals filling quickly, more drastic measures could be announced next week unless things turn around.

St. Louis Mayor Lyda Krewson also has said that a new shutdown remains a possibility. Missouri has seen a big spike in cases over the past several weeks.