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In a dramatic and unprecedented move reflecting growing alarm over the rapidly spreading coronavirus pandemic, seven Bay Area counties Monday announced sweeping shelter-in-place restrictions effectively confining millions of residents to their homes for three weeks with exceptions for essential work, food or other needs.

The new orders by health officers in Alameda, Contra Costa, Marin, Santa Clara, San Francisco, San Mateo and Santa Cruz counties appear to be the most aggressive public response to coronavirus anywhere in the U.S. so far. The directives are criminally enforceable and go well beyond Monday’s stepped-up calls for increased “social distancing” from the nation’s capital, evoking lockdowns in parts of hard-hit Europe.

“In my life, there’s not even a remote precedent for this sort of thing,” said Robert Siegel, 66, a Stanford University professor of microbiology and immunology. “It’s quite unprecedented for Americans to be experiencing this.”

Across the seven counties, many businesses will be ordered to close, and residents will be allowed to leave their homes only for “essential” reasons from 12:01 a.m. on Tuesday through April 7. Essential reasons include getting health care, shopping for groceries and supplies, caring for family members and exercising outdoors.

“I recognize that this is unprecedented,” Santa Clara County Health Officer Dr. Sara Cody said Monday. “If I had thought last Friday’s announcement (to close schools) was hard, this one is exponentially harder. But we must come together to do this. We know we need to do this, and we know we need a regional approach. We all must do our part.”

And in a sign of how serious the crisis is becoming, Santa Clara County announced two additional deaths due to the coronavirus on Monday — two men, in their 50s and 80s, passed away at hospitals on Sunday — doubling the death count in California’s hardest hit county. Gov. Gavin Newsom said late Monday that the state had reached 392 cases, and said one homeless person had died in the “Santa Clara region,” although it was unclear whether he was referring to one of the two new cases announced by the county.

Some other large urban areas have considered similar restrictions on public movements in recent days, including New York, where the national guard was deployed to help quell an outbreak in the suburb of New Rochelle.

The latest orders go much further than the increasingly restrictive federal, state and local guidances about the virus released in recent days. Santa Clara, San Francisco and San Mateo counties last week ordered schools closed. On Friday, Santa Clara County barred public and private gatherings over 100 people with restrictions in place for assemblies of 35 to 100. Newsom, who last week urged a statewide ban on gatherings of more than 250 people, over the weekend urged bars and nightclubs to close, restaurants to limit service and older residents not to leave home.

Monday’s announcement came in legal orders from the health officers in the seven counties as well as Berkeley, which has an independent health office. Officials said the directives could be extended longer than three weeks or amended to end sooner, as needed.

Businesses allowed to operate during the lockdown include supermarkets, pharmacies, gas stations, convenience stores, health care offices, child care facilities, banks, hardware stores and laundromats. Restaurants will be allowed to operate, but only for delivery and takeout service.

Nonessential gatherings of any number are banned, but public transit will continue operating for essential travel as long as travelers keep 6 feet apart. Nonresidents also will be able to travel to return to their homes outside of the Bay Area.

In addition, governments will continue to provide health, law and order, sanitation and other essential services.

Marin County Health Officer Matt Willis said “essential things we need will be available to us.”

“Grocery stores will remain open,” Willis said. “You can get your medicine from your pharmacy, you can still visit your doctor. We can all expect to experience some cabin fever. You can still walk your dog.”

Health officers acknowledged Monday how difficult the extraordinary measures will be for families already struggling to cope with the rapid upending of their lives, between children told to stay home from school, businesses urging employees to work from home and events canceled. But they said the dire threat of the outbreak makes a regional response necessary.

“We are in a rough place, and we are going to have difficult times ahead of us,” San Mateo County Health Officer Scott Morrow said. “The measures we’re putting in place are temporary, but they will last longer than any of us want. This is the time to unite as a community, come to each other’s aid and dig really deep to find your best inner-self and pull out all the compassion, gratitude and kindness you can.”

The guidance, they said, comes after substantial input from the Centers for Disease Control and Prevention and best practices from other health officials around the world.

Grant Colfax, the director of San Francisco’s Department of Public Health, said health officers from the counties conferred over the weekend and concluded that they needed to put in place the new restrictions as soon as possible.

“Every hour counts,” Colfax said. “The evidence tells us that now is the time to implement this step.”

San Francisco Police Chief William Scott said that violation of the order is “enforceable as a misdemeanor” but added “that is an absolute last resort.”

“We’re looking for voluntary compliance,” he said. “If we do get called to those situations, we’re going to try to educate the public.”

Homeless individuals will not be subject to the order, although officials encouraged them to seek shelter and said they would work with state officials to maximize resources available for the homeless population.

The new orders exclude three Bay Area counties — Sonoma, Napa and Solano. Representatives of those counties did not respond to questions about whether they would follow suit. They have reported some of the fewest cases, with Napa still listing no infections Monday. Santa Cruz County, which is not part of the nine-county Bay Area, made the decision to join the shelter-in-place order Monday after nine confirmed cases.

The restrictions follow new data showing increasing local transmission of coronavirus, the health officers said. The cases confirmed in the Bay Area account for more than half of California’s total — and experts believe there are likely many others in the region that haven’t been discovered yet due to a lack of testing.

The pandemic has sickened more than 167,000 people in more than 151 countries, half of them in China, and killed more than 6,600. The Bay Area has been at the center of the viral outbreak in the state and is one of the nation’s hot spots for infections, with the first case reported Jan. 31 and a cruise ship stricken with infections departing Oakland on Monday.

Of the region’s counties ordering shelter in place, by Monday Santa Clara County had 138 confirmed cases, San Mateo 42, San Francisco 40, Contra Costa 34, Alameda 18, and Marin and Santa Cruz nine each.

Also on Monday, Newsom issued a new executive order to help prevent evictions during the pandemic. The order gives local governments the authority to halt evictions for renters and homeowners, aims to slow foreclosures and helps keep utilities running for residents affected by COVID-19.

The governor also recommended that restaurants statewide stop serving meals other than takeout and delivery, and that all gatherings be cancelled regardless of how many people they include — extending those portions of the Bay Area orders statewide.

In addition, the state legislature passed a $1.1 billion coronavirus spending package, fulfilling an emergency request from Newsom. The money will go to efforts like opening new hospitals, cleaning schools and child care facilities, purchasing health care equipment, and housing homeless people in hotels.

Monday also marked the start of widespread school closures affecting about half of districts around the state, including Santa Clara, San Mateo and Santa Cruz counties, with many attempting to teach students online. New York City and Los Angeles — the nation’s two largest districts — also are closing.

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“If everybody was successfully quarantined for two weeks, that would put a substantial dent in the transmission of the virus,” Siegel said. “It’s valid reasoning, but we don’t know the extent to which that will work.”

Barring a turnaround in the numbers of new cases and deaths, the Bay Area and other hard-hit areas could face even stricter measures going forward, Siegel predicted.

“You can look at the trajectory of policy in other countries,” he said, “and it’s my expectation that it’s going to become more restrictive.”

Staff writer Robert Salonga contributed reporting.