SAN FRANCISCO (AP) — The health officers in five San Francisco Bay Area counties issued a new stay-at-home order Friday as the number of virus cases spikes and hospitals fill.

The changes will take effect for most of the area at 10 p.m. Sunday and last through Jan. 4. The majority of the counties have not yet reached Gov. Gavin Newsom’s threshold announced a day earlier requiring such an order when 85% of ICU beds at regional hospitals are full, but officials said hospitals in the region will be overwhelmed in the coming weeks when Newsom’s order would apply.

“We don’t think we can wait for the state’s new restrictions to go into effect…..This is an emergency,” said Contra Costa Health Officer Chris Farnitano.

The order came the same day the state recorded another daily record number of cases, with 22,018, and hospitalizations topped 9,000 for first time.

It means restaurants will have to close to indoor and outdoor dining, bars and wineries must close along with hair and nail salons and playgrounds. Retail stores and shopping centers can operate with just 20% customer capacity. Gatherings of any size with people outside a household are banned.

Berkeley Health Officer Lisa Hernandez said people should not meet in person with anyone they don’t live with, “even in a small group, and even outdoors with precautions.”

“If you have a social bubble, it is now popped,” Hernandez said. “Do not let this be the last holiday with your family.”

The new stay-at-home order will cut sharply into the most profitable shopping season and threaten financial ruin for businesses already struggling after 10 months of on-again, off-again restrictions and slow sales because of the pandemic.

The new restrictions were imposed in San Francisco, Santa Clara, Marin, Alameda and Contra Costa counties. Those counties, along with San Mateo County, were the first region in the country to order a lockdown on March 17 when the area of 7 million people had fewer than 280 cases and just three deaths. This time San Mateo County opted to wait for the threshold set by the governor, though officials said it would continue to share hospital beds with others in the region.

Bay Area counties are so closely connected that it was much easier to implement a regional order, officials said.

In Santa Clara County, headquarters of Apple and Google, officials previously banned all high school, collegiate and professional sports and imposed a quarantine for people traveling to the region from areas more than 150 miles (241 kilometers) away after officials began seeing an uptick in cases following Thanksgiving Day. Compliance officers fanned out throughout the county on Thanksgiving Day and continue to visit businesses to make sure they follow capacity rules and other precautions.

Dr. Sara Cody, health officer for Santa Clara County, said the number of ICU beds filled with COVID-19 patients has tripled in the last month, and continues to accelerate. On Thursday, there were 67 new COVID-19 patients admitted to hospitals — a record.

As of Friday, the county of 2 million people, had 14% of ICU bed capacity remaining, lower that the 15% minimum required by rules set by Newsom, Cody sadi.

San Francisco Health Officer Dr. Grant Colfax estimates the city, which is also a county, has a week to stabilize the spread of the virus. If hospitalizations continue at the same pace, it is estimated the nine hospital systems will run out of intensive care unit beds on Dec. 27, he said.

“The problem will be that no one can help because of the hospital bed shortage statewide,” he said.

All the counties, except for Marin, are in the most restrictive purple tier in the state’s pandemic blueprint for the economy, which has already forced most non-essential indoor activities to stop and imposed a daily curfew from 10 p.m. to 5 a.m.

Public health officials have warned that the toll from Thanksgiving gatherings could start to swamp hospitals by Christmas.

In the last month, the state imposed restrictions in 52 of the state’s 58 counties, including asking people not to leave the state and implementing an overnight curfew for all but essential trips, such as getting groceries.

But it hasn’t worked because data shows people are ignoring the rules, Dr. Mark Ghaly, the state’s top public health officer, acknowledged Thursday.