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Since Monday, three more individuals in Alaska have tested positive for COVID-19, bringing the state’s total to six confirmed cases, state officials said Tuesday.

The state of Alaska is also prohibiting public dine-in service at all restaurants, bars, breweries, cafes and similar establishments, and closing all entertainment facilities, “including theaters, gyms and fitness centers, bowling alleys and bingo halls,” according to the state’s health mandate. The prohibition takes effect at 5 p.m. Wednesday and ends at 5 p.m. April 1. Under the dine-in restrictions, salad bars and buffets are also closed to self-service.

“No on-site consumption is permitted,” Dr. Anne Zink, Alaska’s chief medical officer, said at a press briefing Tuesday.

The mandate doesn’t close restaurants entirely. And it does not include health care, child care or residential facilities; shelters or soup kitchens; employee cafeterias; restaurants inside secure airport zones; or places that provide food for off-site consumption, like grocery stores, convenience stores or drugstores.

“Carry-out, drive-thru and delivery services are still permitted but should be conducted in an environment where patrons and staff maintain social distancing, practice good hand hygiene whenever possible," Zink said. Under the mandate, up to five members of the public are allowed in an establishment at one time to pick up their orders, so long as they have 6 feet of space between them.

The new cases involve individuals in Anchorage, Ketchikan and Fairbanks, Zink said. Officials in Ketchikan announced the positive test result there on Tuesday afternoon. All three new cases are considered travel-related cases, Zink said, and one of the individuals who had contracted the illness was in their 20s while the other two were older.

All three were doing well and did not need hospitalization, Zink said.

“We’ve been talking about this for some time, we’ve been preparing for this, and it is starting to escalate,” Zink said of COVID-19, the upper respiratory disease caused by the new coronavirus.

The announcement of the statewide restrictions comes a day after Anchorage Mayor Ethan Berkowitz signed an emergency order that temporarily prohibits dine-in services at bars and restaurants, closes entertainment facilities like theaters and gyms, and prohibits gatherings of 50 people or more in the state’s largest city.

Similar steps have been taken in communities around the world to limit person-to-person contact and curb the spread of the new coronavirus. Public health officials say social distancing is one of the most effective ways to slow the outbreak and prevent the overburdening of health care facilities.

“This is an incredibly hard time. It’s hard for health care providers, it’s hard for business owners, it’s hard for families, it’s hard for loved ones,” Zink said Tuesday. “This is the time to be kind, to work with each other, but also remember that the small actions that you do can save a life for someone else.”

Though young people may experience only mild symptoms, they can still spread the illness to others, Zink said.

“You may not be thinking that you're hurting anyone else,” Zink said. “You may not know that you're spreading it.”

There’s more data showing the early stage of the illness is when someone might have the “highest likelihood of transferring it other people," Zink said.

Prior confirmed COVID-19 cases in Alaska involved a cargo pilot passing through Ted Stevens Anchorage International Airport and two older men in Fairbanks who had recently traveled to areas of the Lower 48 where the new coronavirus was being transmitted in the community. As of Tuesday evening, there are three confirmed cases in Fairbanks; two in Anchorage; and one in Ketchikan.

The individual in Ketchikan who tested positive “has a history of travel to the lower 48,” the Ketchikan Emergency Operations Center said in a statement released Tuesday.

“Upon experiencing symptoms of illness, the individual self-isolated and sought testing through a Ketchikan clinic,” the statement said. “The individual is an employee of the Ketchikan Gateway Borough.”

Borough employees who came in direct contact with the individual will self-quarantine for at least 14 days, officials said. Public health officials in Ketchikan will investigate the extent of the individual’s contacts and ask others to isolate themselves as needed, according to the joint statement from the Ketchikan Gateway Borough, City of Ketchikan and City of Saxman.

The White Cliff Building, which houses Ketchikan borough offices, is closed until further notice and will receive “a thorough commercial disinfectant service” for the building, said officials, who urged people to wash their hands and practice social distancing.

A statement from the Fairbanks Memorial Hospital on Tuesday indicated that the individual who most recently tested positive for COVID-19 is a woman who self-isolated after recent travel.

Precautions after travel

The state also issued a health mandate stipulating that people who traveled to countries listed by the federal Centers for Disease Control and Prevention as “Level 3” — including several countries in Europe, as well as China, South Korea and Iran — must home-quarantine. That means staying at home and avoiding contact with other members of the household, and not going to school or work for 14 days.

"Minimize contact with people as much as possible, self-monitor and practice social distancing” for two weeks, Zink said.

Zink also said that anyone coming from anywhere else Outside should “self-quarantine to a degree as well.” According to the mandate, that involves possibly not going to school or work, and avoiding crowded places and limiting public activities.

“That means that you need to stay 6 feet away from others,” Zink said. “That also means that you need to not be near people who are vulnerable.”

State officials continue to urge hand-washing and social distancing as ways to stem the spread of the illness in Alaska.

Regardless of whether you have COVID-19 or not, Zink said, “if you had any symptoms of fever, chills, cough, shortness of breath, you need to stay away from others.”

Gov. Mike Dunleavy said during the call with reporters that former Alaska Gov. Sean Parnell and former U.S. Sen. Mark Begich, along with other officials, would be part of an “economic stabilization working group."