Tennessee has been at or near the top of the list of US states with the highest rate of new Covid-19 cases over the past week, data from the US Centers for Disease Control and Prevention show.
Just in the last few days, the novel coronavirus sickened the state's first lady, sending Gov. Bill Lee into an extended quarantine. The virus also tore through the University of Tennessee's football team, infecting coach Jeremy Pruitt and abruptly ending the team's season.
People sick with severe Covid-19 have put a critical strain on hospitals, but there are no plans to open a field hospital -- because there is not enough health care staff to support one.
In a video address Sunday night, Gov. Lee acknowledged that Tennessee "is ground zero for a surge in sickness."
No state has more total new cases than California, but adjusted for population, Tennessee's outbreak is worse. Over the past week, Tennessee has averaged about 9,300 new coronavirus cases per day, the 5th-most of any state in the country despite having the 16th-highest population. That daily number of new cases is even more than Pennsylvania, which has nearly twice as many people.
Tennessee's sharp increase in new cases began in early November and has been exacerbated by Thanksgiving gatherings, state officials said.
Tennessee Health Commissioner Dr. Lisa Piercey said active cases grew by two-thirds just over the last week. She said she was concerned that a further surge over the holidays "will completely break our hospitals."
In his video address, Lee pleaded with people to avoid indoor gatherings with anyone outside their household for the holidays.
"We have seen firsthand that Thanksgiving gatherings and extended time indoors have been the principal driver in spreading Covid-19 like wildfire," he said. "It only took a matter of days to see gatherings around Thanksgiving translate into a record level of sickness. Tennessee cannot sustain a similar surge after Christmas or New Year's."
But no mask mandate
Despite the urgent warnings, Gov. Lee, a former businessman elected as a Republican in 2018, has resisted taking the aggressive actions favored by other states including New York or California and has instead taken a similar hands-off approach as that of North or South Dakota, the states with the most cases per capita in the pandemic.
Crucially, Lee declined to issue a mask mandate, leaving the decision up to local officials.
"Many think a statewide mandate would improve mask wearing, many think it would have the opposite effect," he said Sunday. "This has been a heavily politicized issue. Please do not get caught up in that and don't misunderstand my belief in local government on this issue. Masks work and I want every Tennessean to wear one."
Lee's executive order also limited indoor gatherings to 10 people -- but excluded churches, weddings and funerals, intimate gatherings that are ripe for Covid-19's spread.
His refusal to take more aggressive actions has frustrated and angered Protect My Care, a coalition of health care workers that have called for a statewide mask mandate for months.
"Gov. Lee, this is no time for half measures, loopholes or symbolic gestures. We need action. We need concrete steps taken to get the virus under control. We need you to find the political courage to do your part, and stand up," said Dr. Aaron Milstone, a critical care pulmonologist, according to CNN affiliate WTVC.
State Sen. Jeff Yarbro, a Democrat and the minority leader of the Tennessee Senate, mocked Lee's order as an "executive suggestion." But other state Republican leaders supported Lee's more limited approach.
Still, Lee previously acknowledged that many people have resisted wearing a mask despite his pleas. Last week, in speaking about the coronavirus vaccine, he sharply criticized those who refused to wear masks as selfish.
"One thing this vaccine will not solve, one thing it will not cure is selfishness or indifference to what is happening to our neighbors around us," he said.
"This vaccine will not cure foolish decisions about how we gather. It won't cure an attitude of a refusal to wear a mask. And it won't cure the idea that I will take my chances and that will not impact someone else's life."