Missoula health officials on Tuesday extended local orders to keep many businesses closed for another three weeks, and they added a number of new businesses to the list in a reinvigorated push to limit the spread of COVID-19.

Missoula City-County Health Officer Ellen Leahy said signs of community spread in Bozeman are concerning. She said she expects to see signs of community spread in Missoula at some point as the pandemic plays out.

“Community spread, when we have that evidence, it's a big threshold,” said Leahy. “I fully expect we will have it if we don't find it in the current six (cases). Because we don't have as much testing as we all really need, it's very possible that it's here, but it's not showing up in our testing yet.”

As of Tuesday evening, 51 positive cases of coronavirus have been reported in Montana, including 19 in Gallatin County, where health officials have reported signs of community spread.

Two new cases were also reported in Missoula County on Monday, though Leahy said it's not yet known where they contracted the virus. The number of cases have climbed each day for the past week.

“I can't tell you if we have community spread in our last two cases. That's being investigated to identify all contacts,” Leahy said. “But I'm very concerned with our state and Gallatin County. Our demographics and healthcare hub here are very similar to that county.”

With concerns growing and the spike not yet here, local health officials extended the mandatory closure of bars and restaurants, health clubs, gyms, pools, movie theaters and concert halls for another three weeks. Take out orders are the only exception.

On Tuesday, they also added cosmetic salons, body art and massage parlors to the list. The local order will remain in place until April 15, at which point it will be reconsidered, Leahy said.

President Donald Trump on Tuesday said he wants the nation's economy back "up and running" by Easter, which falls on April 12.

“I cannot predict the acceleration of the curve of this pandemic, but I would be amazed if we were totally past the upper most peak of this by April 15,” Leahy said. “Our only prevention is the social distancing. I do not expect that social distancing will suddenly be able to go away in light of the fact that the cases will exponentially increase.”

While testing remains in short supply, it's more available now that it was last week. Leahy said as many as 70 suspected cases in Missoula County are awaiting test results.

“Yesterday from today – and tests will start coming in – there are over 70 that we're aware of in the county,” she said. “At the time a healthcare providers decides to test, we ask them to inform us and that is considered a suspect case. We work with the healthcare provider, and the patients being tested are in isolation while awaiting the test results in case it turns positive.”

As part of Tuesday's orders, health officials also directed retail locations that are still open to maintain a separation of at least six feet between customers, including those waiting in line at a grocery store.

“There have been some concerns by both elected officials and me – our staff and our team – that not all places have provided that social distancing,” Leahy said. “This is to make it clear that this is now required.”