Alabama nursing home and national assisted living officials are taking the coronavirus threat seriously enough to analyze visitors’ health even though Alabama did not have any reported cases of the virus late Tuesday.

The president of the American Health Care Association, Mark Parkinson, on Tuesday advised nursing homes and assisted living centers to curtail social visits and take steps to keep some employees away.

Parkinson called the mortality rate at five Seattle-area nursing homes “shocking.”

Eighteen residents have died from the virus in that area, and he predicted that the death rate from the infected may well exceed the 15% reported in China for people aged 80 and older.

Parkinson recommended that family members not visit nursing homes.

While Alabama nursing home officials have not gone that far, they have increased security for visitors at most nursing homes.

The virus is “a severe threat that we take seriously because it affects the elderly and the medically frail,” said John Matson, Alabama Nursing Home Association spokesman. “We are in a heightened state of awareness.”

Matson said almost all of the association’s 216 nursing homes have increased visitation rules. There are 231 nursing homes in Alabama.

Visitors are now restricted to using a single entrance to association nursing homes. When admitted, they are asked questions including whether they have a fever or have traveled internationally. Some visitors who appeared to be sick have been turned away. “We cannot knowingly put our nursing home residents in harm’s way,” Matson said.

Approved visitors are asked to go directly to their family member’s room and exit the building quickly.

The Center for Disease Control’s advocacy of hand washing is imposed on nursing home visitors entering and leaving the facilities, and visitors must cover sneezes and coughs.

Matson said group visits from churches and schools may be curtailed simply because it is difficult and time-consuming to screen the larger number of visitors.

He said family members are encouraged to call and check on residents or schedule a time to talk by phone to residents.

“The key word is prevention in any way that we possibly can, but we want to keep families involved. We may possibly use video calls,” he said.

A spokeswoman for the Assisted Living Association of Alabama said stricter guidelines for visitors are being done on a facility-by-facility basis. As of Thursday, some assisted living facilities had chosen to bar visitors except in emergency situations.

Parkinson’s stricter recommendations also were issued by the association’s sister organization, the National Center for Assisted Living.

The recommendations include actively screening every person who comes into an assisted living center — family visitors, staff, vendors, contractors and government officials — and, as nursing homes are doing, focusing on good hand hygiene.

NCAL spokeswoman Renee Reeves said the group is exploring alternate ways for residents to stay in touch with their loved ones and encouraging facilities to communicate and provide updates to families.

Both associations stressed that the virus is serious and deadly to the elderly, and the serious risk of spread and death needs to be taken into consideration when evaluating how to limit visitors.

If there are extenuating circumstances for visits, individual assisted living facilities and individual residents can decide a course of action.

There are 300 assisted living facilities in Alabama with 50% of the residents over the age of 85. Matson said 85 is also the average age of long-term care of nursing home residents.