LOS ANGELES (AP) — With Thanksgiving two days away, California's health secretary on Tuesday urged people to say “no” to family and friends who want to gather, joining other officials in issuing dire warnings about the spread of the coronavirus.

Dr. Mark Ghaly said it's not too late to cancel or change plans to limit celebrations of the holiday.

“It’s as important to say no even when it comes to the closest people in our family,” said Ghaly, who has barred his mother from his family's dinner table this year. "Game time decisions happen all the time. ... Call that audible, make a decision to do something a little different.”

The warning came as the pandemic forced four more counties with surging cases to be placed under the most restrictive rules for business operations and as Los Angeles was poised to issue the first stay-home order since spring.

“Our metrics are the most alarming metrics that we’ve ever seen,” Los Angeles County Public Health Director Barbara Ferrer said. “Inaction in the face of this devastating acceleration of cases will cause irreparable harm.”

Los Angeles has issued an order closing restaurants Wednesday night for three weeks. City officials were expected to tell residents to stay home as much as possible after cresting the threshold for issuing a stay-home order Monday. But the Department of Public Health did not immediately issue that order.

Like all states across the country, California is experiencing a rapid rise of cases that threaten to overwhelm hospitals.

The state has set records on several recent days for total infections detected. Hospitalizations statewide have increased 81% in the past two weeks and by nearly 400 patients in a day.

“Statewide, I don’t believe we’ve ever seen as many hospital admissions increase like we did just in the past 24 hours,” Ghaly said.

Most of California is under the strictest rules for operating retail businesses at limited capacity and preventing indoor dining. They are also subject to a 10 p.m. to 5 a.m. curfew.

Residents were urged to avoid nonessential travel during what is typically the busiest travel period of the year. Anyone entering California was advised to quarantine for two weeks.

Public health officials are bracing for a wave of cases that could follow gatherings at Thanksgiving, particularly as people arrive or return from states or areas with higher infection rates.

Ferrer noted that Los Angeles International Airport reported 1 million travelers on Monday.

“If you’re a public health person, you just start crying when you hear those numbers,” Ferrer said, noting the effect will likely be felt in the weeks to come because of a lag between exposure and developing symptoms of COVID-19.

Ferrer told county supervisors that a proposed stay-home order would be more modest than a statewide closure in the spring but was necessary to try to curb a dramatic spike in cases.

Supervisors rejected a motion to allow restaurants to continue to serve meals outdoors at half their seating capacity to spare the industry that has been particularly hard hit by restrictions that have reduced service or limited them to offering takeout and delivery.

Two of the five supervisors said there wasn’t enough evidence to show restaurants were a significant part of the spread of the virus.

Supervisors Kathryn Barger said the closure of restaurants was “arbitrary and punitive” and that private gatherings and celebrations after the recent election, the World Series victory by the Dodgers and NBA championship win by the Lakers were larger sources of spread.

“I remain skeptical of the fact that the thought process behind this makes sense,” she said.

Ferrer said there was increased risk at restaurants because diners generally aren't wearing masks and they're mingling closely with people they don't live with.

Supervisor Sheila Kuehl, who said she had heard a “cacophony” of opposition from restaurant owners, said that closing restaurants was a difficult but necessary move.

“This is a serious health emergency and we must take it very seriously,” Kuehl said. “This is the only business that allows its customers to remain — and often for quite a while — unmasked. And that I think is enough to single it out right there.”

Restaurants went to court Tuesday to halt the restaurant closure from taking effect, but a Los Angeles judge rejected their case. The California Restaurant Association had argued that Los Angeles County health officials should have to provide medical or scientific evidence that outdoor restaurant dining poses an unreasonable risk to public health.

The city of Pasadena, which has an independent public health department, broke with Los Angeles County and decided to allow outside dining to continue at restaurants while it assesses virus numbers.

“We need to balance our growing numbers and the economic hardship of restaurant personnel,” said a statement released by spokeswoman Lisa Derderian.

___

Associated Press writers Michael R. Blood and John Antczak in Los Angeles and Daisy Nguyen in Oakland contributed to this report.