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Maryland, Virginia and the District on Monday barred residents from leaving home unless it’s absolutely necessary, joining a handful of other states that have issued such orders in hopes of controlling the fast-spreading novel coronavirus.

While all three jurisdictions had already banned most gatherings, closed businesses and schools, and urged people to stay home as much as possible, the orders made clear that compliance is no longer optional — and added fines and potential jail time for some violations.

“We are no longer asking or suggesting Marylanders to stay home,” Gov. Larry Hogan said during a news conference in Annapolis. “We are directing them.”

Nearly 3,000 residents of the Washington region have tested positive for the coronavirus, and 53 people have died. Without new action, Hogan (R) warned, the national capital region could soon resemble the New York metropolitan area, which reported 253 deaths Monday and has become a global epicenter for the pandemic.

“A major outbreak among our critical federal workforce could be catastrophic,” Hogan said, noting that more than 440,000 people work for the federal government in the District, Maryland and Virginia.

The National Institutes of Health and the Food and Drug Administration, which have been working on a coronavirus vaccine, are headquartered in Maryland.

D.C. Mayor Muriel E. Bowser (D) initially refrained from announcing an order like those issued by Hogan and Virginia Gov. Ralph Northam on Monday. But she soon released guidance summing up earlier orders geared toward social distancing and outlining penalties for those who did not take heed.

Together, the directives from Bowser, Hogan and Northam affect about 15.2 million people, according to census estimates.

Officials said residents may still go outside for food, medication and essentials, and to exercise or walk pets, but should avoid shopping for other things and contact with people not from their households.

The orders — which already exist in California, Illinois and a handful of other states — came as the FDA gave emergency approval to a Trump administration plan to distribute to hospitals anti-malarial drugs whose effectiveness on the coronavirus is unproven.

The World Health Organization said it was cautiously optimistic about initial studies showing certain drug cocktails may lessen coronavirus symptoms, but stressed large-scale research is needed and there still is no cure.

Italy, which has been hit hard, said an additional 812 people have died in the pandemic, bringing the country’s total number of deaths linked to the outbreak to 11,591. The country said the number of people recovering from the virus was also increasing; a strict lockdown that has been in place since early March was extended at least through Easter, on April 12.

The U.S. House of Representatives followed the Senate in announcing a recess until April 20. Macy’s, one of the country’s largest retail chains, said it will furlough 125,000 workers. The Marine Corps temporarily suspended sending recruits to boot camp training at Parris Island, S.C., after two recruits tested positive for the coronavirus last week.

Both Hogan and Northam (D) chided Washington-area residents who continue to gather in groups, even as health officials predict that the peak period of infections in the region is still weeks away.

Maryland’s stay-home order went into effect at 8 p.m. Monday, with violators subject to one year in jail or a fine of as much as $5,000, or both. There was no end date given.

The governor said no Maryland resident should be traveling outside of the state unless it is “absolutely necessary” and asked Marylanders who have recently been outside the state to self-quarantine for 14 days.

Those who commute from Maryland to the District or Virginia for essential work or to care for family members are exempted.

Hogan emphasized that residents can still step outside if they maintain social distancing. “People are not locked in their homes,” he said. But authorities announced the arrest of a Carroll County man accused of serving alcohol to a group of teens at a party, emphasizing the importance of stopping such gatherings to keep the virus from further spreading.

Northam’s stay-at-home order took effect Monday and will last through June 10.

Under it, Virginians cannot go out except for food, supplies, work or medical care, or to get fresh air or exercise, Northam said. The order closes beaches to any use but exercise or fishing, bans reservations of less than 14 nights at campgrounds, and bans colleges and universities from holding in-person classes.

Violations of any of those restrictions — or of the ban on gatherings of more than 10 people — can result in a fine of up to $2,500 and or jail time of up to a year. Northam did not put the same criminal penalties on his order to stay at home, saying he was not eager to have police making arrests. He had been hesitant to take a harder line on social distancing measures, which are already hurting the state’s economy, but said he was moved to act after a warm weekend drew people to pack the state’s beaches.

The beachgoers “are completely ignoring what we’re doing,” Northam said, sounding uncharacteristically angry. “You are being very, very selfish because you’re putting all of us — especially our health-care providers — at risk. To date, this has been a suggestion to Virginians. Today it’s an order.”

Bowser’s order is effective Wednesday through April 24 and “reinforces the Mayor’s direction to residents to stay at home except to perform essential activities,” her office said. Residents who willfully violate the ban face criminal penalties, including up to 90 days in jail and fines up to $5,000. D.C. government employees who break the rules face suspension without pay or termination.

“We have to enforce orders, or they are worthless,” the mayor told D.C. Council members before she announced the order, according to people on the call.

Bowser’s order also mandates that apartments shut down common areas, including rooftops and party rooms. It permits residents to leave their homes to visit a religious institution and to care for others. Residents can continue to garden and exercise outdoors, as long as they are avoiding contact with those outside their household.

Those more aggressive steps came as the number of cases in the region again spiked.

Maryland reported 174 new infections, pushing the state’s total to 1,414 confirmed cases, with 17 deaths. Health officials said 13,316 tests in the state have come back negative. The Pleasant View Nursing Home in Carroll County, which announced an outbreak of 66 coronavirus cases over the weekend, said it has 11 more known cases and a second fatality, a man in his 80s.

The nursing home is experiencing a staff shortage, and county officials have put out a call for skilled volunteers.

Virginia announced 130 additional cases, bringing its total number of infections to 1,021, with 27 deaths as of Monday afternoon. Six people died in Virginia over the weekend.

The District reported 94 new cases Monday evening, its highest single-day increase, which brought its total number of known infections to 499, with nine deaths

District officials Monday urged residents who experience symptoms of covid-19 to seek medical care, saying some people appear not to be doing that. One official said three of the five D.C. residents who died over the weekend had not been hospitalized.

She encouraged all residents to see a doctor and get a test if advised to do so, including those who are undocumented immigrants. A bilingual call center has been set up at Mary’s Center, a community clinic in Adams Morgan, for residents who are experiencing symptoms but don’t have a primary care doctor, officials said. The number is 1-844-796-2797.

“If you’re not feeling well, if you have symptoms of covid-19, fever, cough or shortness of breath, we need you to call a doctor or health-care provider, and we need you to stay home,” Bowser said.

The mayor said the District is opening its own testing site for police officers, firefighters and Department of Corrections officers, who have become infected in increasing numbers. Bowser said a drive-through and walk-up testing site at United Medical Center, the District’s only public hospital, will be up and running by the end of the week, and open to D.C. residents whose doctors have ordered a test.

Maryland opened three virus testing sites at vehicle emission testing locations, for people considered to be at high-risk from the virus. The state opened a fourth virus testing site in the parking lot of FedEx Field in Prince George’s County.

The sites are reserved for health-care workers, first responders, the elderly, residents in group homes and those who are deemed “medically unstable” by their doctor, said Fran Phillips, Maryland’s deputy secretary of public health.

“This is for at-risk people with symptoms of the disease who will not be tested in emergency rooms or crowded physicians’ offices,” Phillips said.

Hogan said the lack of resources to fight the virus will be felt most acutely inside area hospitals, where doctors and nurses attending to a growing tide of new patients need more respirator masks and other protective gear.

“They are in danger,” Hogan said, calling the shortfall “the greatest tragedy of this crisis.”

“We’re pushing to get supplies everywhere we can get them,” he said. “There simply is not enough of all of these things.”

Correction: An earlier version of this story misstated when the District’s “stay-at-home” order begins. It takes effect on Wednesday.

Rebecca Tan, Laura Vozzella, Fenit Nirappil, Darran Simon, Dana Hedgpeth and Peter Hermann contributed to this report.