FREDERICTON -- New Brunswick is at a "tipping point" as health officials try to control the spread of COVID-19, chief medical officer of health Dr. Jennifer Russell said Thursday.

Officials are giving time to see if present health orders are working, she said, adding that they won't hesitate to move the province into another tight lockdown if necessary.

"We know that once the doubling time shortens to the point where you're doubling every day, that's exponential growth and we definitely don't want to see that," Russell said. "We definitely are at a tipping point."

Russell said the number of new infections in the Moncton, Saint John and Fredericton zones appear stable after officials moved those regions to the red pandemic-alert level. The Campbellton, Bathurst and Miramichi zones will remain at the orange level, she said, adding that her biggest concern is the Edmundston region, which shares a border with Quebec.

"The situation in (Edmundston) remains gravely concerning," Russell said. "The outbreak has spread into workplaces and adult residential facilities, which is deeply worrying."

Health officials reported 32 new cases Thursday, bringing the province's active reported case count to 324. Of the new cases, 19 were identified in the Edmundston area. New Brunswick's case rate is about 132 cases per 100,000 people.

Premier Blaine Higgs said the Moncton, Saint John and Fredericton zones could move back to the orange level sooner rather than later. "If we continue to focus on protecting each other, we could move these zones to orange in a mater of days, not weeks or months," he said.

University of Toronto professor Dr. David Fisman said New Brunswick's current situation is similar to where Manitoba was last fall, right before cases rose sharply after months of relatively few infections.

"I have been suggesting to people that New Brunswick is on a knife edge right now and can go either way," Fisman said in an email Thursday.

Manitoba, which once had some of the lowest infection rates in the country, quickly became a cautionary tale as cases rose by several hundred each day by mid-November.

Fisman said certain factors have preceded big waves in places that previously had a low case count, including the spread of COVID-19 in schools, meat-packing facilities, long-term care homes and among highly mobile young people.

Dalhousie University immunology professor David Kelvin said reducing viral transmission among the young is key to controlling the virus, because cases in youth are often asymptomatic. Kelvin said in an email Thursday that strategies such as pop-up rapid testing may help identify hot spots among young people.

He added, however, that more research may be needed to see what lies behind the New Brunswick case increases in order to project where trend is headed.

"It could be New Brunswick is in the early stages and will continue on the exponential increase in cases," he said, though there is also the possibility the numbers have plateaued as social events from the holiday season have subsided, he added.

Fisman said he found the province's interventions "lagging," adding that shifting between various pandemic-alert levels isn't ideal when faced with a sharp increase in cases.

"I think when you are hanging on to de facto COVID-free status, it is worth pulling out the stops and having a short, hard lockdown … the whole enchilada," Fisman said. "It is significant short-term pain, but as Manitoba showed, the cost of allowing things to spiral is far more painful."

This report by The Canadian Press was first published Jan. 21, 2021.