SEATTLE (AP) — Authorities banned large gatherings in the hard-hit Seattle area and in San Francisco on Wednesday — including pro baseball and basketball games — in the most sweeping efforts yet to control the coronavirus epidemic in the U.S., with experts warning that the worst is yet to come.

In a state where at least 25 victims have died from the virus — 19 of them from the same suburban Seattle nursing home — Washington Gov. Jay Inslee prohibited gatherings of more than 250 people.

The ban, affecting 4 million residents of virtually the entire Seattle metro area, does not cover workplaces or classrooms, but affects houses of worship and applies to baseball’s Seattle Mariners, whose home games will be moved.

“This is not just your ordinary flu,” Inslee said. “This demands a response consistent with the nature of the threat.”

In San Francisco, Mayor London Breed banned all gatherings of 1,000 or more people for the next two weeks, including Golden State Warriors games. City officials had already called off non-essential gatherings of 50 or more people at city-owned properties, including the convention center and performing arts centers.

California’s Santa Clara County, home to San Jose and Silicon Valley, prohibited all gatherings of 1,000 people or more.

With cases in the U.S. topping 1,000 and the number of deaths climbing to 32, lawmakers and health officials set up containment zones and sought to limit contact with those who might be infected. The outbreak has spread to as many as 40 states, with Arkansas and New Mexico reporting their first cases of the virus.

“Bottom line, it’s going to get worse,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on Capitol Hill.

As for how much worse, Fauci said that would depend on the ability of the U.S. to curtail the influx of travelers carrying the disease and state and community efforts to contain the outbreak. He said if mild cases of the virus are counted, the mortality rate is probably about 1 percent — “roughly 10 times more lethal than the seasonal flu.”

The World Health Organization, meanwhile, declared the virus a pandemic, or a serious, global outbreak, noting that the number of cases outside China had increased 13-fold over the past two weeks. Designating the crisis a pandemic is the WHO’s way of putting countries on notice to take more aggressive action against the virus, which has infected over 120,000 people worldwide and killed nearly 4,400.

In the U.S., the Seattle area has been hardest of all.

Dr. Jeff Duchin, public health officer with Seattle and King County, said the region is facing an unprecedented health emergency as the number of cases double every few days.

“We expect a large-scale outbreak in weeks, and this will be a very difficult time,” he said. “It’s similar to what you might think of as an infectious disease equivalent of a major earthquake that’s going to shake us for weeks and weeks.”

Inslee said government has the authority to crack down on groups or individuals who ignore the directive, but added that he expects people will abide by the order. Asked about penalties for violations, he said: “The penalties are you might be killing your granddad if you don’t do it.”

Elsewhere around the country, Kentucky Gov. Andy Beshear urged churches across the state to cancel services.

“I don’t believe that whether you go to church during this period of time is a test of faith,” he said. “I believe God gives us wisdom to protect each other and we should do that.”

Massachusetts is dealing with of cluster of at least 70 cases connected to a meeting held last month by biotech company Biogen at a hotel in downtown Boston, while a cluster of over 100 infections in the New York City suburb of New Rochelle has prompted the closing of schools and houses of worship, with plans by Gov. Andrew Cuomo to send in the National Guard to sanitize public places and deliver food to those who are quarantined.

UCLA, Yale and Stanford were among the universities announcing plans to send students home and hold classes remotely.

Chicago canceled its St. Patrick’s Day parade, joining Boston and Philadelphia. Instead of hosting 100,000 at its twice-yearly conference in Salt Lake City next month, the Church of Jesus Christ of Latter-day Saints said it will hold the gathering online and on TV, with leaders delivering speeches without any attendees.

For most people, the virus causes only mild or moderate symptoms such as fever and cough. For some, especially the elderly and people with existing health problems, it can cause more severe illness, including pneumonia. Most people recover in a matter of weeks, as has happened with the majority of those infected in China, the virus’ country of origin.

“If you want to be blunt, Europe is the new China,” Robert Redfield, director of the Centers for Disease Control and Prevention, told Congress, meaning that the movement of people from Europe is the primary source of the virus in the U.S.

Tests by U.S. government scientists and other experts found that the virus can live in the air for several hours and on some surfaces for two to three days.

For those in the middle of a quarantine, it’s an anxious time waiting for the threat to pass.

Judy Aqua, who is in her 60s, is quarantining herself at home in New Rochelle after possibly being exposed to someone with the virus.

“People are really afraid to go to the supermarket. They’re afraid to go to the cleaner,” she said. When her husband made a recent run to a post office, she told him to wear gloves.

Some airport workers are also dealing with the outbreak, with several Transportation Security Administration officers at the San Jose airport testing positive. All TSA employees who had contact with them over the past 14 days are being quarantined at home, the agency said.

In Oakland, California, restless passengers on a coronavirus-struck cruise ship awaited their turn to disembark. By Tuesday night, Princess Cruises said about 1,400 of the 3,500 people on board had gotten off, and efforts were underway to move them to quarantine in their home countries or at military bases in California, Texas and Georgia.

California Gov. Gavin Newsom urged the state’s nearly 40 million residents to avoid sporting events, concerts and other large gatherings and strongly warned the elderly to stay away from cruise ships.

Geller reported from New York. Associated Press writers Rachel La Corte in Olympia, Washington; Jake Seiner in Surprise, Arizona; Janie Har, Jocelyn Gecker, Olga Rodriguez and Juliet Williams in San Francisco; Robert Jablon in Los Angeles; and Ricardo Alonso-Zaldivar in Washington, D.C. contributed to this report.

The Associated Press receives support for health and science coverage from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.