With coronavirus cases surging in the region, and deaths on the rise, a survey from the University of Maryland Medical System finds that 4 in 10 Marylanders were unwilling to change their in-person Thanksgiving plans because of the coronavirus.

Elected leaders and public health officials from throughout the region and across the country have tightened restrictions in recent days and implored residents not to celebrate the holiday with anyone outside their immediate household.

But the online survey, conducted Nov. 16-23 among 525 residents in central and Southern Maryland and on the Eastern Shore, found that 44 percent said they were not altering Thanksgiving or other holiday plans.

David Marcozzi, a physician who led the project, said the results dismayed him.

“It’s disappointing, the lack of recognition that this virus will not take a holiday, it’s silently waiting for an opportunity to spread between us,” he said. “We’re setting ourselves up for a perfect storm. . . . You have the potential for multiple small superspreader events.”

The survey, which has a margin of error of 4.9 percent, did not include Montgomery County, which is Maryland’s most populous jurisdiction, or the western panhandle of the state. But it did include Prince George’s County in the Washington region, as well as Baltimore.

Respondents in more rural areas were less likely to say they have canceled in-person holiday plans than those in central Maryland. Women, older adults and those with higher education levels were more likely to have changed holiday plans.

In Montgomery, officials on Wednesday pleaded with residents to avoid large gatherings over the holiday and warned that authorities would be ramping up enforcement of physical distancing rules. The county reported 383 new coronavirus infections, bringing its seven-day average to triple what it was a month ago.

“We have broken records time and time again in the past week,” Health Officer Travis Gayles said at a briefing. “If I’m sounding bleak or sounding concerned, it’s because we certainly are.”

Earl Stoddard, head of emergency management, said county police will join state police in patrolling high-density areas such as Silver Spring and Bethesda to ensure that businesses and individuals comply with health orders.

Since the start of the pandemic, the county has levied $500 fines on businesses 30 times for violating physical distancing or mask-wearing requirements, Stoddard said. Officials have also closed or suspended seven businesses for a time.

Gayles said community transmission of the virus has become so widespread in the county that it is increasingly difficult to conduct contact tracing. Officials said they are seeing a growing number of cases associated with family gatherings, youth sports, indoor dining and houses of worship.

“It would be easier if there was one type of activity we could isolate,” Gayles said, “but there’s lots of different possibilities now.”

In the District, acting D.C. city administrator Kevin Donahue told members of the D.C. Council on a weekly phone call: “We are in the middle of a national wave that’s going to continue to get worse.”

A total of 5,522 new infections were reported Wednesday in the greater Washington region: 2,697 in Maryland, 2,718 in Virginia and 107 in the District. The rolling seven-day average of new cases shows Maryland with 2,334, Virginia with 2,495 and D.C. with 150.

So far this year, the region’s total case count is just short of 435,000.

Deaths reported in the District from covid-19, the disease caused by the novel coronavirus, increased by four Wednesday to 677. In Maryland, 37 additional deaths were reported, bringing to cumulative total to 4,518. In Virginia, the death toll rose 29, to 4,008.

More than 34,000 patients have been hospitalized with covid-19 since the pandemic came to the region. About 3,000 remain in hospitals in Virginia, Maryland or D.C.

Maryland continues to lead the region in the number of cases per 100,000 residents. Its seven-day average of cases is 38. D.C. reports 21 cases per 100,000 and Virginia reports an average 29 cases per 100,000 over a seven-day period.

While it’s easy to get lost in the statistics, people who watch the numbers closely warn that the data over the next few days may vary greatly.

Numbers will probably flatten or drop for several days around Thanksgiving as people put off testing, wrote Erin Kissane at the Covid Tracking Project. Then, next week, testing, case reports and deaths will rise, “which will look like a confirmation that Thanksgiving is causing outbreaks to worsen.”

“But neither of these expected movements in the data will necessarily mean anything about the state of the pandemic itself,” Kissane wrote. “Holidays, like weekends, cause testing and reporting to go down and then, a few days later, to ‘catch up.’ ”

Any infections resulting from Thanksgiving exposures probably won’t start showing up in the data until the second week of December, Kissane said. Succeeding waves of infections from holiday gatherings are likely to roll in for weeks. And that has implications for the future.

“This will not dissipate by Christmas, or any of the holidays at the end of December,” Marcozzi said. “I don’t think there’s a recognition that we’re all a risk to each other. We are our brothers’ keepers.”

Erin Cox and Fenit Nirappil contributed to this report.