Pennsylvania’s top health official issued a broader mask mandate Tuesday, a bid to force people to wear face coverings as coronavirus case numbers continue to soar.

Imposing new rules to combat the surge without ordering shutdown-style restrictions, Health Secretary Rachel Levine ordered that people wear masks when with anyone outside their own households and directed that anyone entering from out of state must get tested for the coronavirus within 72 hours before arriving as of Friday.

She also told colleges and universities to implement and enforce testing and quarantine procedures and urged the commonwealth’s hospitals to “prepare now” for the possibility of being strained or even overwhelmed as soon as December.

If the state and public do not follow measures to quash the spread, Levine warned, Pennsylvania could run out of intensive-care beds in December and could reach 12,000 total virus-related deaths by January and 18,000 by March. More than 9,300 deaths in the state have been blamed on the virus.

“How Pennsylvania does in terms of this pandemic and whether we follow the [projections] or whether we don’t is going to come down to the actions of every single Pennsylvanian,” she said, citing the surge estimates based on University of Washington modeling.

By Tuesday, the state’s hospitals had more than 2,700 coronavirus patients — nearly as many as they did at the pandemic’s April peak. Two months ago, fewer than 500 virus patients were hospitalized, according to state data.

Violators of the mask mandate could face warnings or citations from local law enforcement agencies. But the new orders rely on the public’s cooperation, and they don’t go as far as the restrictions Philadelphia and other states have imposed in response to the fall surge.

Levine declined to say how severe the surge must become for state officials to order a broader shutdown. But she said the commonwealth might not need more restrictions if the public follows the ones now in place.

“We all have a responsibility to work toward the common good,” she said.

Records broken again

The new rules came on a day when Pennsylvania again broke its record for new cases reported in one day, logging 5,900 Tuesday, and as nearly 800 nurses at a Bucks County hospital went on strike over what they describe as dangerously low staffing levels.

It was the fifth time in the last six days that the state has seen more than 5,000 people test positive in one day. The state also reported 30 more virus-related deaths.

» READ MORE: As coronavirus cases rise, 800 Bucks County nurses go on strike over ‘dangerous’ staffing levels

The United States is now averaging more than 150,000 new cases a day as infection rates climb across the country. Rather than improving, there is evidence of “further deterioration” nationwide, according to a weekly report from the White House Coronavirus Task Force cited by Levine, and “aggressive, unrelenting, expanding broad community spread.”

For 11 days straight, more than 100,000 people in the country each day have been diagnosed with the virus. More than 73,000 were hospitalized on Monday, the most at any time during the pandemic and 13,000 more than this time last week, according to the COVID Tracking Project.

States across the country have taken steps this week to reimpose restrictions, and Iowa, North Dakota, and Utah have put in place mask mandates. Philadelphia and New Jersey announced new rules Monday; Delaware did so on Tuesday.

Delaware Gov. John Carney set indoor gathering limits of 10 people in private homes; 30% capacity or 50 people outside of homes; and 30% capacity in restaurants, saying the decision was difficult, but the “focus must be on protecting lives.”

» READ MORE: New COVID-19 restrictions in Philly and N.J. as city officials warn of potential for more deaths

New Jersey reported 4,060 newly confirmed cases and 38 deaths Tuesday, as its new limit of 10 people for most indoor gatherings went into effect, and 2,320 virus patients were hospitalized, according to state data.

Philadelphia reported 1,034 new confirmed cases and eight deaths. Jury duty in the city was suspended until at least January, the court system announced Tuesday, citing the upswing in cases and the city’s new restrictions. Residents who have received a juror summons do not have to report as scheduled and will be given credit for at least one year.

‘A tremendous sacrifice’

Levine said hospitals needed to begin collaborating and planning for a patient surge, and sent a memo to the state’s health-care systems asking them to fast-track and prepare to reduce elective procedures. The state will leave it up to hospitals and health-care systems to determine what measures are necessary in their regions.

She also said colleges and universities must enforce violation of their coronavirus policies and establish routine protocols, including testing all students at the beginning of each term and undertaking regular screening throughout the semester.

The new face-mask rule extends to private homes if visitors are present; it also applies to every indoor facility, from schools to gyms to public transit, and applies even when people are social distancing.

People, businesses, or facilities that do not comply can be given warnings or citations by law enforcement or the Department of Health. Levine also said business owners would be responsible for asking employees and customers to follow the order.

The order requiring anyone entering the state to get a COVID-19 test within three days before arrival does not apply to people who commute from neighboring states for work or health care. If someone can’t or doesn’t get tested, they must quarantine for 14 days after arrival.

Levine acknowledged that Pennsylvania, like other states, can’t fully enforce the orders — for instance, officials won’t check to ensure the passengers of every car or airplane coming into the state have been tested — but said they are mandatory and people are expected to comply. She asked people not to travel for Thanksgiving, whether going to another state or coming into Pennsylvania.

“We want people to stay home in their households. I understand that this is a tremendous sacrifice for Pennsylvanians … but this is the biggest public health crisis that we have seen in 102 years,” she said, referring to the 1918 flu pandemic that killed at least 50 million people. “In order to stop the spread and not have those very serious [death] numbers, we all have to do our part.”

The stark predictions in recent days have mirrored the warnings health and government officials issued at the pandemic’s spring peak. But officials have noted that the shutdown and other mitigation orders in the spring helped the state avoid the models' worst-case projections.

“You can definitely see in areas where there were mask mandates, where we were closed up over a chunk of time, over the summer we had much lower numbers,” said Thersa Sweet, an associate professor of epidemiology and biostatistics at Drexel University.

It is difficult to know whether the United States would have experienced death tolls in the millions, she said, as some very early models predicted would occur if no restrictions were imposed. Those models were based on the information available then about a new and poorly understood virus.

“The models we have now presumably are going to be much better predictors than we had in March,” Sweet said.

Staff writers Laura McCrystal and Juliana Feliciano Reyes contributed to this article.

Correction: A previous version of this story misstated the timetable for mandatory testing for travelers entering Pennsylvania.