Va. Gov. Ralph Northam

Va. Gov. Ralph Northam speaks during a press conference in Richmond, Va. on Friday, March 27, 2020.

Gov. Ralph Northam on Monday ordered all Virginians to stay at home until June 10 unless they need — not just want — to go out for food, work, medical care or fresh air.

“To date, this has been a suggestion to Virginians. Today, it is an order,” Northam said during a news briefing, adding that those who flout the order can face a criminal misdemeanor charge.

This latest directive comes on reports that 1,020 Virginians tested positive for COVID-19, including six in Roanoke. These are the first cases in the city. The virus on Saturday killed an elderly Botetourt County woman, who had been the area’s first confirmed case. She is among 25 Virginians who have died from the disease.

And the governor’s order comes as hundreds of local people await test results, including 22 at LewisGale hospitals.

Salem on Monday said an employee who works in the streets and general maintenance department has tested positive. The city is not saying whether the employee lives in Salem but the worker is at LewisGale Medical Center.

Spokeswoman Nancy May said that LewisGale has one patient with a positive test, but that it is treating 14 others at the Salem hospital, three each at LewisGale Alleghany and Montgomery, and two at LewisGale Hospital Pulaski who are presumed to have the virus but have yet to receive lab results.

Carilion Clinic spokeswoman Hannah Curtis on Monday said Carilion has received 22 positive test results, and two patients are in the hospital. Carilion does not release the number of patients in its hospitals who are thought to have the virus until the test results are known, which can take a week.

Salem City Manager Jay Taliaferro said in a letter to employees that staggered start times and social distancing procedures were in place before the city employee became ill, so few others were affected. The employee’s coworkers are now self-quarantined.

“This positive test shows each of us that no community or workplace is immune to the virus,” Taliaferro wrote. “We ask that you keep this employee in your thoughts and prayers, and continue to be vigilant and practice protective measures in your daily life.”

Also Monday, the Mount Rogers Health District reported an employee at the Southwestern Virginia Mental Health Institute in Smyth County had tested positive. The psychiatric hospital and health department are tracing patients and coworkers and having them quarantine.

The Virginia Department of Health on Monday reported another four cases for Botetourt County. There are now six in Roanoke, three in Roanoke County, five in Franklin County, and one each in Alleghany County, Montgomery County and Radford.

Northam said the numbers will continue to rise.

“What we are seeing now is the result of how people interacted two or three weeks ago. What we will see two to three weeks from now is determined by how people behave today and the following days,” he said.

Virginia health officials said they are working with academic centers and the Federal Emergency Management Agency to do modeling, but do not have information yet to share.

They said they now have enough data on the virus in the state to better predict what might occur and how many more beds and intensive care units would be needed to care for the critically ill.

Northam said Virginia’s hospitals have 18,500 licensed beds and 2,000 ICU beds.

“How many more we need depends on the actions we all take right now,” he said.

Some places in Virginia are seeing signs of community spread of the virus, in which it is no longer possible to know where a person contracted it.

Dr. Molly O’Dell, who heads up the COVID-19 response for the Roanoke City and Alleghany Health Districts, said she was not certain yet about the new cases in the valley, but until now each case could be linked to another.

As of 8:30 a.m. Monday, there were 14 active cases and one death in the combined district. Most of the people infected are isolated at home.

“If you look at the bell curve, we are on the left side. We know that Virginia to date has been increasing about 20% cases a day,” she said. “I see that we are behind the state curve in terms of onset of transmission into and through our community, and hopefully that will be a positive thing.”

That’s why social distancing and staying at home is necessary, she said.

Northam’s stay-at-home order does not differ much from the one he issued last week that closed all personal care businesses and fitness centers, but allowed other nonessential businesses to remain open as long as they had fewer than 10 people in their establishments and could accommodate distance between each person.

Last week, Northam had said a stay-at-home order, such as ones issued in neighboring states, differed only semantically from his order.

He was asked what changed over the weekend.

“I know what it’s like to be working in the hospital in the emergency rooms on the front line, and I have seen heroes, literally, across Virginia over the past couple of weeks: doctors, nurses, respiratory therapists, you could go right down the list. They are sacrificing their time. They are sacrificing perhaps their health, the health of their families,” he said.

“But I also see people congregating on the beach that are completely ignoring what we are doing. And I will remind those folks: You are being very, very selfish because you are putting all of us, especially our health care providers, at risk.”

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