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Although there have been encouraging signs that the outbreak is beginning to level off in some places, the threat of the virus is continuing to grow in some states and regions.

Even in areas where the number of new cases is beginning to flatten, it is doing so at a very high level: New York, which reported its fewest new cases in a month and its lowest one-day death toll in more than two weeks, still reported 4,726 new cases and 478 new deaths on Monday. And the country has added more than 25,000 new cases a day for the past week.

But in some regions, there are signs that things are getting worse, not better.

Massachusetts has been particularly hard-hit in recent days. It reported 1,705 new cases on Sunday, bringing its total to 38,077, and 146 new deaths, which brought the death toll to 1,706. “We’re right in the middle of the surge now,” Gov. Charlie Baker, a Republican, said Sunday on “Face the Nation” on CBS.

Los Angeles County reported 81 deaths on Saturday, its highest one-day death toll.

“In this last week, we have doubled the number of deaths that occurred among L.A. County residents,” Barbara Ferrer, the county’s director of public health, said in a statement on Saturday. Fewer deaths were reported Sunday — 24 — but county officials noted that nearly 1,000 new cases had been identified in the previous 48 hours.

There have been significant workplace-based clusters in Iowa, Kansas, Minnesota, North Dakota, South Dakota, Tennessee and other states, suggesting that the pandemic is just beginning to sink into some communities.

Nursing homes and prisons also continue to be hot spots.

The outbreak’s collateral damage includes people whose other illnesses go untreated.