After days of promising tighter restrictions because of an unprecedented surge in COVID-19 cases, Los Angeles County health officials announced a modified health order today that will ban almost all gatherings, further restrict most businesses and close some sectors altogether.

The order, which goes into effect Monday, will keep most retailers and other businesses open with occupancy limits, but it will entirely close down playgrounds and cardrooms.

It also bars all public and private gatherings except protests and church services. This is tighter than the current restrictions, which allowed people from up to three households to gather outside as long as they kept their distance and wore masks.

Unlike the original stay-at-home order in March, outdoor activities—like tennis, golf, hiking and beaches—will remain largely open, just with mandated masks and social distancing. Schools and day cares that are already open will also be allowed to continue operating.

The order does not automatically apply to Long Beach because the city has its own health department, but local officials have almost always followed the county’s lead. Long Beach Mayor Robert Garcia said in a tweet that the city’s health department is reviewing the order “and will release additional guidance.”

County officials said the order will be in place until Dec. 20 and include the following restrictions in addition to the restaurant closures already in place:

• Gatherings: All public and private gatherings with individuals not in your household are prohibited, except for church services and protests, which are constitutionally protected rights.
• Occupancy limits at various businesses (all individuals at these sites are required to wear face coverings and keep at least 6 feet of distance):
  • Essential retail – 35% maximum occupancy
  • Nonessential retail (includes indoor malls) – 20% maximum occupancy
  • Personal care services – 20% maximum occupancy
  • Libraries – 20% maximum occupancy
  • Fitness centers operating outdoors – 50% maximum occupancy
  • Museums, galleries, zoos, aquariums, botanical gardens operating outdoors – 50% maximum occupancy
  • Mini-golf, batting cages, go-kart racing operating outdoors – 50% maximum occupancy
• Outdoor recreation activities (all of which require face coverings, except for swimming, and distancing):
  • Beaches, trails and parks remain open; gatherings at these sites with members outside your household are prohibited.
  • Golf courses, tennis courts, pickleball, archery ranges, skate parks, bike parks, and community gardens remain open for individuals or members of a single household. Pools that serve more than one household may open only for regulated lap swimming with one person per lane.
  • Drive-in movies/events/car parades are permitted provided occupants in each car are members of one household.
• Schools:
  • All schools and day camps remain open adhering to reopening protocols. K-12 schools and day camps with an outbreak (3 cases or more over 14 days) should close for 14 days.
• Closed nonessential businesses/activities:
  • Playgrounds (with the exception of playgrounds at childcare and schools)
  • Cardrooms

Regardless of whether any particular activity is allowed, the public health department urged everyone to stay home as much as possible and avoid seeing anyone from other households, regardless of whether you feel sick.

“These targeted measures are in effect for the next three weeks and still allow for many essential and nonessential activities where residents are always masked and distanced,” the county’s director of public health, Barbara Ferrer, said in a statement. “We know we are asking a lot from so many who have been sacrificing for months on end and we hope that LA County residents continue following public health safety measures that we know can slow the spread.”

LA County also announced an extremely high number of new coronavirus infections today.

Officials said there were 4,544 newly confirmed cases of COVID-19, bringing the five-day average to 4,751. Local officials have said the virus’ spread has accelerated recently faster than at any point in the pandemic.

On Wednesday, they estimated the current rate of spread could cause bed shortages at hospitals within the next two to four weeks.

As of Friday, there were 1,893 people with COVID-19 hospitalized in LA County. That’s skyrocketed up from 747 just one month ago.

On Wednesday, officials also said the model they use to approximate the current state of the outbreak suggests that one out of every 145 people in LA County is likely infectious with COVID-19—meaning they are currently capable of spreading the disease.

“Acting with collective urgency right now is essential if we want to put a stop to this surge,” Ferrer said. “Please remain home as much as possible and do not gather with others not in your household for the next three weeks.”

To date, 387,793 people have tested positive for COVID-19 in LA County and 7,604 people have died from the disease.

Daily case numbers across California have also set records in recent days. Hospitalizations statewide have increased more than 80% in the last two weeks.

Meanwhile, public health officials are bracing for a wave of cases that could follow gatherings at Thanksgiving. Officials say it usually takes two to three weeks for such serious cases to show but about 12% of those infected could wind up hospitalized.

With infections out of control, the other options for public officials to take are even more onerous and unlikely to be enacted in the U.S., said Dr. George Rutherford, an epidemiologist at the University of California, San Francisco.

China, for example, tested millions of people and enforced quarantines. Italy brought in the military to enforce a shutdown.

“It’s hard to imagine how much further you can go in a society like we have,” he said. “It’s a balancing act, right? You want people to obey it but you don’t want to make it so draconian that people are trying to figure out ways around it all the time.”

The Associated Press contributed to this report.