Los Angeles Mayor Eric Garcetti issued an order for residents to stay at home, warning that the city is approaching a “devastating tipping point” in its fight against COVID-19 that would overwhelm the hospital system.

“We must minimize contact with others as much as possible,” Garcetti wrote in the order dated Dec. 2. The steps were needed to avoid risking “needless suffering and death,” he said.

The order, which supersedes one from June, prohibits public and private gatherings of people from more than one household and states that all businesses in the city that require people to work on location must stop operations. Walking, driving, travel on public transport, bikes, motorcycles and scooters are prohibited, other than for those undertaking essential activities.

There are several exemptions, including for faith-based outdoor services and the homeless. Others that can continue to operate include supermarkets, grocery stores and health-care operations, but that doesn’t cover gyms and similar facilities. Still, activities such as golf, tennis and pickleball are permitted, according to the order.

The city’s safety protocols on social distancing follow those developed by Los Angeles County, Garcetti said. S&P futures turned negative after the order.

Los Angeles County has the most infections of any county in the U.S., with 408,396 confirmed cases and 7,700 deaths. Nationwide, COVID-19 fatalities reached more than 2,700 Wednesday, the deadliest day so far, according to data compiled by Johns Hopkins University.

Anyone over the age of 16 traveling into L.A. must complete an online form upon arrival to acknowledge they’ve read and understood a California travel advisory. Failure to submit the form is punishable by a fine of up to $500.

The Rust Belt, New York and California are likely to drive up the pace of virus-related deaths in coming weeks as the U.S. approaches 300,000 fatalities, based on a forecast from the University of Massachusetts Amherst’s Reich Lab.