HELENA, Mont. (AP) — The number of new coronavirus cases among residents of Montana's most populous county is straining the health care system, the county's health officer said Monday. He warned residents that he will put more restrictions in place on Nov. 2 if the infection rate continues to rise.

The proposed new restrictions could limit gatherings to no more than 25 people, regardless of the ability to socially distance; and set 25% capacity restrictions on bars, restaurants and churches, Yellowstone County health officer John Felton said. Any business that sells alcohol would have to close by 10 p.m. Schools would not be affected by the order.

“This health order need not take effect if enough people take action,” he said during a news conference in Billings. “If we consistently wear masks, watch our distance, stay 6 feet away, avoid group gatherings, wash our hands, and stay home when we are ill, we can reduce the number of new infections significantly over the next three weeks and stave off the health officer order.”

He strongly encouraged people to limit the duration of close interaction, within 6 feet (2 meters) or less, to less than 10 minutes and with fewer than six people per week.

Felton's announcement came just days after Gov. Steve Bullock urged counties with larger outbreaks to consider stricter measures, such as shutting down bars and other gathering places.

Dr. Deborah Birx, a physician on the White House Coronavirus Task Force, told Bullock in late September that she was concerned about the number of virus cases in Yellowstone and Flathead counties and several of the state's Indian Reservations, according to Bullock's office.

Birx suggested bars in Yellowstone County be closed, Bullock spokesperson Marissa Perry said. Restaurants and bars in Montana have been permitted to operate with few restrictions since June.

In Flathead County, health officer Tamalee St. James Robinson said Monday that the surge in new cases is challenging the health care system and the county's ability to trace contacts.

“If we as a community do not step up to take action to prevent the spread of COVID-19, additional control measures will need to be implemented,” St. James Robinson said in a statement.

Yellowstone County has seen newly reported virus cases range from 31 cases to 36 per 100,000 residents per day in recent weeks, Felton said. After talking with medical experts and the leadership of the two hospital systems in Billings, “together we have concluded that the increasing rate of COVID-19 is more than we can accommodate," Felton said.

If the rate of new infections reaches 40 per day or higher during the last week in October, the new restrictions will take effect.

The new restrictions wouldn't be imposed until the end of the month to allow time to see if people's efforts help reduce case growth.

However, if the infection rate increases to 50 per day per 100,000 residents for any Sunday-through-Saturday week in October, or a total of 565 new cases in a week, the new restrictions will immediately take hold, Felton said. Yellowstone County has about 160,000 residents, so 40 cases per day per 100,000 residents is 452 cases in a week.

Any new restrictions would have to stay in place for at least a month, because it can take two to three weeks to see the results of changes in behavior, Felton said.

Montana reported 212 new cases of COVID-19 on Monday, bringing the state's total cases to over 14,800. The number is thought to be far higher because not everyone has been tested and people can have COVID-19 without showing symptoms.

The state reports 5,000 people are currently infected with the respiratory virus, including 1,164 in Yellowstone County, while 9,650 have recovered, or no longer test positive for the virus. Just over 200 people are in the hospital and 190 people have died, state numbers show.

Every county is Montana has now reported at least one case of COVID-19 with the addition of a case in Petroleum County on Monday. Forty-six of the state's 56 counties have more than four active cases, putting residents under the state's mask mandate.

For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia, and death.