Pennsylvania is strengthening its mask mandate and will require out-of-state travelers to test negative for the coronavirus before arrival, health officials announced Tuesday, taking additional steps to address a sharp increase in infections and hospitalizations.

Masks are now required indoors wherever people from different households are gathered — even if they are physically distant, the state health secretary, Dr. Rachel Levine, said Tuesday. The order applies to every indoor facility, including in private homes, but Levine acknowledged that officials are relying on voluntary compliance rather than on enforcement.

Health officials have said the unrelenting spread of the virus this fall is partly attributable to small indoor gatherings, and it remains to be seen how many COVID-fatigued Pennsylvania residents will heed Levine’s order to mask up inside homes and in other buildings where the state’s reach is limited.

Levine said that how Pennsylvania fares in the coming weeks and months will largely depend on the public’s willingness to wear masks and stay away from each other.

“In the end, people will have the consequences of their actions as well as their families and their communities, and if they do not wear masks, if they do not social distance, then those communities are going to see even more spread of COVID-19,” she said.

A separate order mandates that people who are traveling to Pennsylvania from another state, as well as Pennsylvania residents who are returning home from out of state, must test negative for the virus within 72 hours prior to arrival. The order does not apply to people traveling back and forth for work or medical treatment. People who refuse to be tested will be required to quarantine for 14 days, Levine said.

Again, the state has no plans to enforce that measure, but is asking for voluntary compliance.

Like the rest of the nation, Pennsylvania has seen coronavirus infections explode in recent weeks. The state is reporting more than 5,000 new infections per day, up more than 115% in just two weeks.

Moreover, hospitalizations are up sixfold since the beginning of fall. More than 2,700 people are now in the hospital with COVID-19, approaching the state record of about 3,000 in early May. Pennsylvania will run out of ICU beds next month at the current rate of admissions, according to modeling by the Institute for Health Metrics and Evaluation at the University of Washington.

The testing positivity rate has increased and deaths are on the rise, as well.

Democratic Gov. Tom Wolf imposed a state-at-home order and shuttered businesses deemed “non-life-sustaining” early in the pandemic, but Wolf and Levine have consistently said they have no intention of implementing another broad-based shutdown.

On Tuesday, Levine did not rule out additional mitigation measures.

“Whether we have to do anything else really depends upon you. It depends upon the public, each one of us taking our responsibility for the common good of everyone in Pennsylvania,” Levine said. “And if we all do our part, and we stand united, then we might not need any further mitigation measures.”

The departments of Health and Education also advised colleges and universities on Tuesday to have a testing plan for students returning to campus after the holidays. And Levine asked hospitals to move up elective surgeries and said they should be prepared to postpone them if they become flooded with COVID patients.

Governors and mayors around the country have been tightening restrictions in response to the worsening pandemic. On Monday, Philadelphia said it would ban indoor gatherings and indoor dining and shutter casinos, gyms, museums and libraries. Last week, suburban Montgomery County, one of the state’s most populous counties, ordered K-12 schools to halt in-person instruction until Dec. 6.

Pennsylvania already had a statewide mask mandate, limits on indoor and outdoor gatherings and occupancy restrictions at bars and restaurants.