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Officials in San Antonio and Bexar County took their most drastic steps to date Monday to slow the spread of the novel coronavirus after the disease claimed its first local victim over the weekend.

Effective at 11:59 p.m. Tuesday, residents in San Antonio and the county’s suburban cities must stay home except to make essential trips, such as picking up groceries and medicine, getting gas or seeking health care.

Here's what stay-at-home means Most residents can leave homes only to exercise, get gas or groceries, pick up food at restaurants or get health care for family and pets No gatherings except for household members Non-essential businesses must close — owners and employees can work from home Essential businesses keep operating: health, safety, education, transportation, construction, internet

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Mayor Ron Nirenberg and Bexar County Judge Nelson Wolff handed down the stay-at-home order — dubbed the “Stay Home, Work Safe Order” — after the county had its first death caused by COVID-19.

It also comes the day after Gov. Greg Abbott declined to declare a statewide mandatory stay-at-home order similar to those enacted in California and New York.

Instead, Abbott left that decision to cities and counties.

The aim of the order is to prevent a surge of COVID-19 cases from overwhelming area hospitals, officials said.

“These are painful steps, we know,” Nirenberg said at a news conference Monday evening. “But they are necessary to protect life and safety.”

READ: The declaration of public health emergency by the mayor's office

Nirenberg and Wolff issued their parallel orders hours after Metro Health officials announced that the number of confirmed local COVID-19 cases grew to 57, including 16 that were the result of community transmission, meaning infection contracted locally from an unknown source.

Nirenberg and Wolff met for several hours Sunday and Monday to discuss enacting the stay-at-home order, the two men said. Attorneys for San Antonio and Bexar County banged out the specifics Monday afternoon.

READ: The excutive order by County Judge Nelson Wolff

Residents can go outside to walk, run or otherwise exercise but only if they keep their distance from others. And they can’t gather in any group; the exception is family and household members at home.

Houses of worship including churches, synagogues and mosques had been exempt from previous orders issued by Nirenberg and Wolff. Now they have been directed to provide religious and worship services only by video, teleconference or other remote measures.

Under the order, most businesses must close to the public. But there are a number of exceptions.

Businesses providing “essential services” such as grocery stores, gas stations and pharmacies will remain open. So will information technology firms that provide internet and telecommunications services.

Also allowed to continue is infrastructure building, including housing construction and road work; public and private transportation such as buses, ride share drivers and taxis; and businesses that support airport operations.

Restaurants and other food and beverage providers can provide takeout, delivery or drive-through service. Bars remain closed.

On ExpressNews.com: Get the latest update on coronavirus and a tracking map of U.S. cases

Activities to protect health and safety are allowed, including businesses and government agencies that provide these services. Essential government functions including solid waste collection and utility operations will continue. Businesses that provide food, shelter and social services for the economically disadvantaged or other vulnerable populations can stay open.

The order also exempts child care providers, along with educators and other school support staff for the purposes of facilitating distance learning. School districts will need to keep their campuses closed as long as the order is in effect but teachers and students will continue working from their respective homes.

The order carves out news media, financial institutions such as banks, and funerals.

Those who violate the order could face fines of up to $1,000 and six months of jail time. But Wolff said he hopes they don’t have to resort to those measures.

“We don’t want to have to do any of that,” Wolff said.

Nirenberg concurred.

“I don’t think we have to interrogate somebody who’s out on the streets as long as they’re going home,” Nirenberg said.

On ExpressNews.com: ‘We’re at war’: What to expect as coronavirus continues to spread in San Antonio

More cases coming

The San Antonio Metropolitan Health District updated the number of confirmed cases in the later afternoon, adding 12 more cases to Sunday’s count to total 57.

Twenty-eight cases stem from travel outside Bexar County. Six are still under investigation by the health district. The count also includes the city’s first death, a woman in her 80s who died Saturday in hospice care after receiving treatment at Brooke Army Medical Center.

With hopes of containing the virus all but gone, local officials expect the number of cases to continue to rise for some time before leveling off.

The health department has already shifted its priorities to slowing the local rate of infection, so that hospitals do not become overburdened with patients. Much of that will be accomplished by keeping members of the public apart to reduce transmission, hence the city and county leaders’ decision to issue the shelter-at-home orders.

“This is not complicated, people: stay home, save lives,” Nirenberg said. “That’s all we want.”

Now that the virus is spreading locally, Metro Health is also no longer recommending self-quarantine for residents who have been exposed to the coronavirus if they are not exhibiting symptoms. People who become mildly ill should stay home for at least a week after they become sick, and until they have been symptom- and fever-free for three days.

Because testing remains limited, Metro Health will not test the close contacts of people who have been confirmed to have the virus. Instead, it will reserve testing for those at a high-risk of developing complications and those who are hospitalized.

As of Monday afternoon, Metro Health’s lab had processed 400 coronavirus tests, 42 of which came back positive. Testing is also being conducted through commercial laboratories and some hospitals.

Reports of exposure

In the past few days, there has been an uptick in potential exposures to the virus in the San Antonio area.

A health care worker at Haven for Hope’s clinic was exposed to it by an infected family member. CentroMed, which operates the shelter’s Sarah E. Davidson Clinic, learned of it Friday and ordered the person to undergo a two-week self-quarantine at home.

The clinic was shut down, along with another location with which it shares staff, La Paloma de Paz Shelter Clinic. Both clinics are being sanitized, and staff from both locations have been sent home, CentroMed said. Metro Health is reaching out to patients who had contact with the worker.

Residents of Guadalupe County were alerted Sunday of another coronavirus exposure that occurred earlier this month, at an H-E-B Plus in Schertz, near the corner of Interstate 35 and F.M. 3009. It was related to the second confirmed case of COVID-19 in Guadalupe County, officials there said.

The exposure occurred on March 16 between the hours of 11 a.m. and 2 p.m. While officials there said the risk to shoppers was low, they advised residents who had visited the store during that time frame to monitor themselves for symptoms of COVID-19, including fever, coughing and shortness of breath. If they see those signs and don’t require urgent medical attention, they should contact their health care provider for medical advice, officials said.

Additional cases have been reported in surrounding counties.

On Monday, Comal County announced its fourth case, in a person who had recently traveled. The person is hospitalized outside the county, officials there said.

Cases have also been confirmed in Kendall, Hays and Wilson counties.

Local authority

In opting not to issue a statewide shelter-at-home order, Abbott left local officials to fend for themselves and bear the brunt of any political blowback resulting from restrictive measures taken to slow the spread of the disease.

Hours after Abbott bowed out, Dallas County Judge Clay Jenkins handed down a shelter-in place order for its 2.6 million residents. Harris County Judge Lina Hidalgo said Monday county officials there are looking at implementing their own for the Houston area.

Rather than allow a patchwork of differing regulations to crop up across Texas, San Antonio and Bexar County officials said they’ve been coordinating with officials in those major cities and counties as well as Fort Worth and Austin to come up with something relatively uniform.

Abbott, often flanked by Republican leaders, has clashed with elected officials in Texas cities and counties over the years — often looking to nullify local leaders’ power to enact policies seen as more progressive than those passed by conservative lawmakers at the state level.

It’s an irony not lost on Wolff.

“It’s interesting to see the governor say, ‘Well, it’s up to you guys locally,’” Wolff said. “Personally, I like it. I’d rather take responsibility along with the mayor to do what’s right here than to turn it over to the governor of the state of Texas.”

Joshua Fechter is a staff writer covering San Antonio city government and politics. Read him on our free site, mySA.com, and on our subscriber site, ExpressNews.com. | jfechter@express-news.net | Twitter: @JFreports