SEATTLE—At a regular Tuesday night pickup hockey game in this city’s Shoreline suburb, so many tech workers arrived wearing telecommuting sweatpants instead of their slightly more formal work clothes that the players jokingly called their new look, “COVID Casual.”

Businesses such as Amazon, Microsoft, Facebook, and Salesforce have told many of their employees to work from home. Downtown crowds have dwindled. The region’s notorious rush hours have become minutes. Local officials have demonstrated how to do elbow bump greetings instead of hugs or handshakes. And shoppers have cleared store shelves of toilet paper in anticipation of hunkering down at home.

Welcome to the strange new world of social distancing in Seattle, national epicenter of the 2019 novel coronavirus outbreak that causes the infectious disease known as COVID-19.

Washington State health officials confirmed a tenth death Wednesday—accounting for all but one in the U.S. so far. By Thursday morning, the case count had ballooned to 70 statewide. Of those, 51 cases and eight deaths have been in King County, with another 18 cases and one death in Snohomish County just to the north and a single case in Grant County in the central part of the state. Employees at both Amazon and Facebook have tested positive for the virus, adding to the anxiety and exodus from Seattle-area office towers.

The national tally appeared to eclipse 200 cases by Thursday afternoon , according to numbers from Johns Hopkins University and the latest from Washington, with nearly 98,000 cases and more than 3,300 deaths tallied from China and more than 80 other countries.

In all, Washington State health officials have now placed at least 231 people under public health supervision due to their potential exposure to the virus. In King County, the Kirkland, Wash., long-term care facility Life Care has been especially hard hit by the virus, and linked to the majority of deaths.

But as of Wednesday officials had yet to identify a transmission link for several other cases, including a man in his 30s who hasn’t required hospitalization and three other recent cases involving two men in their 20s and another in his 50s, all of whom had been hospitalized. “It is definitely concerning,” Jeff Duchin, health officer for Seattle and King County Public Health, said at a press briefing.

The growing case count and increasing signs of local person-to-person transmission prompted Duchin and other health officials to announce new guidelines for social distancing and other precautions. Thursday morning, Gov. Jay Inslee further escalated the guidelines, recommending that all non-essential meetings of more than 10 people be postponed.

Suffice to say, locals were interpreting the directives in their own unique ways.

The Can Can Culinary Cabaret, a popular burlesque and modern dance theater in the Seattle’s Pike Place Market, sent out an email Wednesday night advising patrons that its shows were continuing as scheduled but that it was consulting with a sanitization specialist and working to ensure that “all areas of the venue are sterilized on a continual basis.”

Emerald City Comic Con, a major comic book and pop culture convention, was still a go for this weekend as of Wednesday, despite widespread criticism, cancellations by major vendors, and organizers’ offer to refund tickets for fans who are unable or unwilling to attend.

At the nonprofit Goodwill Seattle thrift store southeast of downtown, employees and shoppers went about their business, though with a few extra touches. One employee in the collectables section used food handlers’ gloves to gingerly hand an antique sword to a potential buyer during the store’s discount promotion for veterans and seniors. Other store employees improvised with winter gloves, and about a third wore face masks ( health officials have pleaded with the public to reserve face masks for healthcare providers and the truly ill).

Spokesperson Katherine Boury said the 24 Goodwill stores in western Washington haven’t yet implemented added precautions beyond general advice issued by authorities, though a task force was slated to meet Thursday to chart out how to proceed.

The county’s official advice has consisted mainly of encouraging people to work from home, recommending that big gatherings be canceled or postponed, and urging high-risk people to “stay home and away from large groups of people as much as possible.” In particular, that last advisory covers people 60 and older; those with underlying health conditions such as heart disease, lung disease, or diabetes; people with a weakened immune system; and anyone who is pregnant.

Officials stopped short of recommending school closures, an action taken by China, Japan, South Korea, Italy and other countries—as well as some local schools at their own discretion. But the stepped-up social distancing guidelines reflected a growing sense of urgency that more dramatic measures were needed to slow the spread of a virus that may have been circulating in the Seattle region since mid-January.

“We know that this disease is not able to be put back in the box. It’s out there in the world, it’s with us,” Duchin said. The new measures, though, might help reduce the risk for some of the most vulnerable populations. “The main message is, if you don’t have to be in close contact with others at this time, please don’t be,” he said.

Angela Rasmussen, a virologist at Columbia University in New York, said she thought the precautionary steps and behavioral changes could be very effective for those at higher risk. Locking down the city or restricting movement, she added, was not as likely to be successful in containing the virus, especially given the growing number of cases tied to community transmission elsewhere around the country.

“I just don’t think that’s practical,” she said.

Research suggests that the coronavirus is spread mainly when an infected individual coughs or sneezes and distributes virus-containing mucus or saliva droplets within a roughly six-foot radius. The CDC has recommended staying six feet away from visibly ill people, one form of social distancing.

In many ways, the public health messaging has already taken hold. Seattle’s famous Pike Place Market has been eerily quiet, local papers have listed a growing roster of canceled events, and Rasmussen said her Tuesday night flight from Newark to Seattle, where her husband lives, was only about one-third full. “I’ve never seen that flight that empty,” she said.

The legendary Seattle Freeze, a term portraying many Seattleites as polite but standoffish, even received a shout-out as a potential boon for residents in their time of need. A Reddit post called “Seattle Freeze vs COVID-19” showed an altered picture of a man and woman ignoring each other in an elevator, with the words, “CDC: Social distancing is an effective way of preventing the spread of Coronavirus. Seattllites [sic]: We got this.”

Other preparations drew a more mixed reaction. To help house and isolate homeless patients and others recovering from COVID-19, King County announced that it is buying the 85-room EconoLodge in the Seattle suburb of Kent for $4 million. The purchase, still in the works but reportedly set to close Friday, was aimed at giving more mildly affected patients a place to recover without taking up precious hospital beds.

Rasmussen called the move a “step in the right direction,” especially given the limited surge capacity in many of the nation’s hospitals and the vulnerability of Seattle’s homeless, housing insecure, and uninsured populations.

Kent officials have protested the plan, however, complaining that they were not consulted and telling The Seattle Times that they were “very concerned about the public health and safety implications this has for our community.”

Separately, the county has disclosed plans to set up a 32-room modular housing cluster in Seattle’s White Center neighborhood to house homeless people with COVID-19. In combination with two other locations in other parts of the city, the housing could accommodate up to 170 people.

A hastily arranged media tour of the slightly battered two-story beige and brick EconoLodge on Wednesday led to the spectacle of a gaggle of reporters peering into a fairly Spartan room while other motel guests wandered by. The room was equipped with a bathroom, two beds, a small refrigerator, microwave, TV and small desk and chair against a turquoise wall. Multiple travel sites were advertising rates as low as $69 per night for a weekend stay, though many recent reviews haven’t been kind.

King County spokespersons couldn’t say whether the facility would include onsite security or medical personnel, and whether the isolation would be voluntary or enforced as a quarantine. A fact sheet suggested that public health personnel would monitor patients on a daily basis, though media reports have suggested that people housed at the facility would be free to leave. At press time, a county spokesperson couldn’t immediately verify which option was under consideration.

On Thursday morning, Washington State Secretary of Health John Wiesman said health officials must start with voluntary compliance, by state law. But he added that the state has the authority to order isolation or quarantine if need be. As for objections to some of the sites under consideration, “We can’t ship Washingtonians to Mars,” Gov. Inslee said. “We need to care for them.”

Across busy Central Avenue at 32-lane Kent Bowl, co-owner and manager Dennis Zaborac confirmed that someone from the county health department had advised him of the motel’s pending sale early Wednesday afternoon. Zaborac said he had likewise received conflicting information about whether the COVID-19 isolation would be enforced or voluntary, however. If the former, he said he had no problems with it. “If it’s a lock-in quarantine, I’m personally not worried about it at all,” he said.

If the latter, he would be considerably more wary, especially given his concerns that voluntary isolation wouldn’t do much to control the virus. As for business at his bowling alley and its travel-themed Passports Pub, Zaborac said he hadn’t seen any slowdown and expected to be full that evening. “We’re solid every day,” he said.

Even so, he expected that virus fears would eventually hit the bowling alley and bar as well.

“To me, the first sign that it’s affecting business will be when someone walks in with a face mask,” he said.