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An Italian police vehicle sanitizes a street amid concerns about the spread of coronavirus, in Milan, Italy, on March 20, 2020.DANIELE MASCOLO/Reuters

Illinois is joining New York State and California in ordering all residents to stay in their homes unless they have vital reasons to go out.

Together, the actions by the states’ governors amount to the most sweeping efforts in the U.S. yet to contain the spread of the coronavirus.

The three states encompass more than 70 million people and the three biggest cities in America: New York, Los Angeles and Chicago.

New York State moved to join California on Friday in ordering nearly all residents to stay in their homes, as governors undertook their most sweeping efforts yet to contain the coronavirus and fend off the kind of onslaught that has caused southern Europe to buckle.

“No, this is not life as usual,” New York Gov. Andrew Cuomo said as the death toll in the U.S. topped 200, with at least 35 in his state. “Accept it and realize it and deal with it.”

Cuomo said that starting Sunday, all workers in non-essential businesses must stay home as much as possible, and all gatherings of any size will be banned in the state of over 19 million people. He acted after California all but confined its 40 million residents Friday in the biggest lockdown in the nation.

Illinois planned to issue a similar order later in the day, according to two government officials who spoke on condition of anonymity ahead of the governor’s announcement.

New York and California both made exceptions for vital jobs and errands, such as grocery shopping, as well as exercise.

The increasingly drastic measures in the U.S. came as gasping patients filled the wards of hospitals in Spain and Italy, and the global death toll surpassed 11,000, with the virus gaining footholds in new corners of the world.

Italy, the hardest-hit country in Europe, reported 627 new deaths Friday, its biggest day-to-day rise since the outbreak began, and said new cases also shot up. Italy now has seen over 4,000 deaths – more even than China – and 47,000 infections. The soaring numbers came despite a nationwide lockdown.

The World Health Organization noted the epidemic’s dramatic speed, pointing out that it took more than three months to reach the first 100,000 confirmed cases but only 12 days to reach the next 100,000. As of Friday, Johns Hopkins University counted more than 260,000 infections worldwide.

Across the U.S., governors and public health officials watched the crisis in Europe with mounting alarm and warned of critical shortages of ventilators, masks and other protective gear at home.

As promised earlier in the week, President Donald Trump officially invoked emergency wartime authority to try to speed production of such equipment.

But while the government has vowed to fix the botched rollout of widespread virus testing, laboratories reported serious shortages of test supplies such as swabs and chemical components.

Countries frantically prepared for a deluge of patients in the coming weeks.

In Britain, the government asked 65,000 retired nurses and doctors to return to work. A convention centre and hotels in Madrid were being turned into field hospitals for nearly 10,000 patients. France’s military worked to build a makeshift medical centre in the hard-hit town of Mulhouse. The U.S. readied military hospitals for civilian use, and more than 4,000 National Guard members were deployed in 31 states to help distribute food, scrub down surfaces and help in other ways.

Trump also announced the closing of the Mexican border to most travel but not trade. That brings it in line with the restrictions on the Canadian border earlier this week. The income tax filing deadline was also moved from April 15 to July 15.

“We’re about to enter into a new way of living here in Los Angeles,” Mayor Eric Garcetti said as California went into lockdown. “What we do and how we do it and if we get this right will determine how long this crisis lasts.”

On Friday morning, the streets of downtown Los Angeles were quiet but not desolate. Residents walked their dogs or jogged, while some homeless people slept. Cars drove along Figueroa Street, but the usual traffic jams were gone.

Scott Sorensen, who was walking his boxer, Chewie, said he is limiting how much attention he pays to the news so that he is not overwhelmed.

“I remember my great-grandmother describing the Depression,” said Sorenson, 50. “I’m trying to keep it in focus.”

The virus has struck at the very identities of many countries: closing down cafes, restaurants and boulevard life in France, ending la dolce vita in Italy, shutting down England’s pubs and the ceremonial changing of the guard at Buckingham Palace, wrecking sales of tulips in Holland and shuttering the Statue of Liberty in the U.S.

Governments are trying to balance locking down residents with the need to keep food, medicine and other essentials flowing.

In Britain, the category of vital workers includes doctors, nurses and paramedics – and also vicars, truckers, garbage collectors and journalists. In New York, people venturing outside will have to stay at least 6 feet apart. And while they will be free to go out to get some exercise to keep their sanity, there will be no “playing basketball with five other people,” Cuomo said.

“These provisions will be enforced,” the governor said. “These are not helpful hints.”

In Bergamo, the epicentre of the Italian outbreak, cemeteries were overwhelmed. Patients at the city’s main hospital lined up in a narrow ward, struggling for breath as doctors and nurses moved swiftly from one beeping machine to the next.

“When the virus arrived here, there was no containment and it spread through the valleys very quickly. … Some said it was the normal flu. We doctors knew it was not,” said Dr. Luca Lorini, head of intensive care at the hospital, where nearly 500 beds were dedicated to people suffering severe virus symptoms. Eighty patients were in intensive care.

In the Italian farm town of Fondi, home to a wholesale produce market serving Rome and Naples, a new ordinance banned all but essential people from entering or leaving after 40 elderly residents became infected.

At a convent on the outskirts of Rome, 19 of 21 nuns were infected, according to the Italian daily Il Messaggero. A Vatican decree absolved the sins of the faithful who were sick or in quarantine, as well as those of their caregivers, if they met certain conditions.

“Certain medical centres are suffering stress that is reaching the limit,” said Fernando Simón, director of Spain’s centre for health alerts and emergencies. “The difficult days in which we must bear down are coming now. We must keep our focus.”

While the illness is mild in most people, the elderly are particularly susceptible to serious symptoms. Italy has the world’s second-oldest population, and the vast majority of its dead – 87% – were over 70.

Still, even younger people are at risk.

“You’re not invincible,” WHO chief Tedros Adhanom Ghebreyesus warned them. He noted that many countries are reporting that people under 50 make up a “significant proportion” of patients needing to be hospitalized.

Some of the only good news came from Wuhan, the Chinese city where the outbreak began and where hospitals were struggling just weeks ago. For the second day in a row, no new infections were reported and only 39 cases were recorded nationwide – all brought from the outside, the government said.

With the crisis waning there, China has begun sending medical supplies to Europe.

The effects of the global economy grinding to a halt took their toll, from millions of unsold flowers rotting in piles in Kenya to the slow emptying of the world’s skies.

Canada received 500,000 applications for unemployment benefits, versus 27,000 for the same week last year.

In the U.S., Congress worked to put together a $1 trillion emergency package to prop up industry and small businesses and dispense relief checks of $1,200 for adults and $500 per child. The British government likewise unveiled a huge relief package under which the country for the time in its history would help pay the wages of those in the private sector.

Iran’s official toll of more than 1,400 dead was rising quickly as well amid fears it is under-reporting its cases.

As the virus strengthened its foothold in Africa, the continent’s busiest airport, in Johannesburg, announced that foreigners will no longer be allowed to disembark.

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