The novel Coronavirus is having the most severe effects on older populations. After a nursing home in Washington State experienced 18 deaths as a result of the virus, the Maryland Department of Health issued new guidance to nursing homes here, Gov. Larry Hogan announced at the beginning of a cabinet meeting Tuesday.

“Older people and those with underlying health conditions are much more vulnerable and at significantly higher risk of contracting the disease,” Hogan said. “We are advising older people to avoid crowds and large gatherings, and to avoid traveling, flying on planes as much as possible.”

Nursing homes are the biggest concern, he said.

Nursing homes should restrict access to visitors and instead make online methods of communication available to residents.

Anyone who works in a nursing home should refrain from international travel. If they have returned from abroad in the last two weeks, they should be monitored for signs of the virus. Employees should also be monitored if they have symptoms of a respiratory illness or if they have been in contact with anyone who is under investigation for possible infection. Health care workers who have symptoms of a respiratory illness should not go to work. If someone develops symptoms while at work, they should immediately put on a mask and leave work as soon as possible.

Nursing homes should also make hand sanitizers and tissues readily available and remind both staff and residents about good hygiene practices.

“I want to continue to remind everyone that this really is an all-hands-on-deck operation, and it is going to get worse before it gets better,” Hogan said.

Maryland residents can get the latest Coronavirus updates at health.maryland.gov/coronavirus.