Jillian Evans, head of health intelligence at NHS Grampian, said it would be “wrong” to relax restrictions in Moray at this point.
Latest figures show Covid rates of 93 per 100,000 in Moray significantly higher than the rate in the rest of the country, with cases expected to rise in the coming days as the impact of the previous easing of restrictions is felt.
NHS Grampian has introduced extra testing measures, and has ramped up its vaccination programme in Moray, now offering a first dose to everyone over 18.
Dr Evans said the health board is pleased with the uptake of these measures, and hopes the situation will improve in around ten days to two weeks.
"It may be that we don't need to wait for the next levels review before Moray can then come back into level two,” she said.
The localised outbreak has been attributed partly to very low levels of Covid in Moray throughout the past year, leading to low immunity, and people not following Covid-19 rules because of a perception that the virus is no longer a significant risk.
Remaining in level three will have “huge implications” for local people, Dr Evans said.
“It will be a difficult one to manage,” she said.
"It's not just a case of carrying on as we are because the rest of the country will have eased restrictions, so it effectively makes a border of Moray. I think it'll be a difficult one to take.”
But she added the situation could be turned around “very quickly” if people follow the rules, pointing to the local restrictions in Aberdeen last summer which were lifted after case numbers dropped.
NHS Grampian deputy director of public health Chris Littlejohn said the impact of being left in level two could be “quite significant”.
"It will be painful and understandably it will be upsetting for many, but with the extra vaccinations, testing and people sticking by the guidelines Moray will very soon be heading in the right direction and I’d thank each and every person who is playing their part in protecting Moray,” he said.
First Minister Nicola Sturgeon is set to review coronavirus restrictions across Scotland on Tuesday and will set out the final decisions for the next easing of restrictions scheduled for May 17.
It comes as the Covid-19 alert level in the UK has been downgraded from level four to level three after a “consistent” fall in cases, hospital admissions and deaths.
Deputy first minister John Swinney said the situation in Moray presented a “particular problem”.
He told BBC Good Morning Scotland on Monday: “We have a particular problem in Moray where there has been an outbreak.
“We are concerned about the degree of spread of that outbreak and I think there is a warning in there for all of us that we need to maintain our vigilance at all times to make sure that any particular incidents don’t become too significant.”