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April 21, 2020

Thank you for joining us for our Tuesday COVID-19 briefing where we share the latest on our efforts to slow the spread of COVID-19, reboot our state’s economy, and get Tennesseans back to work. 

Today I will go over our phased reopening of the state, our support for small and rural hospitals, next steps for stimulus money, and our efforts to engage the minority community in the fight against COVID-19.

Yesterday I announced that I will not be extending the safer at home mandate beyond April 30. I also announced that  89 of our 95 counties will begin the process of getting back to work next week during a phased re-open of our state’s economy as we work to bring industries like retail, restaurants, and close contact services to a safe, methodical opening. 

We anticipate that some of these businesses can work to safely re-open as soon as Monday, April 27. We will provide specific guidance about which businesses can open on which dates later this week. 

As we safely reboot our economy, social distancing and proper hygiene will be more important than ever. As we re-enter routines, Tennesseans must keep habits like social distancing, working from home when possible,  handwashing, and utilizing cloth masks as part of their routine. We continue to encourage Tennesseans who feel sick to stay home and self-quarantine if they have been in contact with someone who is COVID-19 positive. 

Earlier today I spoke with the mayors of the remaining six counties that include major metro areas. This includes Shelby, Madison, Davidson, Hamilton, Knox, and Sullivan counties. We reiterated our support to help these areas determine the best pathway for their safe reopening efforts. 

As we are making progress toward reopening, I want to remind Tennesseans that some restrictions will stay in place to ensure we do this properly and safely. And while we want to have everything open as soon as possible, we will continue to discourage social gatherings of 10 or more. We will also continue to restrict visitors to nursing homes and hospitals until further notice. These restrictions are out of an abundance of caution for our vulnerable populations like the elderly and also to keep our health care workers safe. 

Our Economic Recovery Group is hard at work to issue guidance this week for businesses as we prepare for reopen next week. 

There are 7,394 confirmed cases, 157 confirmed deaths, and 3,828 recovered Tennesseans. These numbers are the result of 7,000 tests added into our total which represents the highest number of tests added in a single day yet we saw less than 200 new COVID-19 cases appear in this total. 

Our number of recovered cases continues to exceed the number of new positive cases. We are encouraged by this news and know that Tennessean's efforts to social distance are paying off. 

COVID-19 has placed a considerable strain on our small and rural hospitals, especially as elective procedures remain suspended to preserve PPE and federal funding has not been fully deployed. Earlier this month we announced $10 million in grants to keep small and rural hospitals open and offering services as we bridge the gap for federal funding. 

Yesterday, we made our first four grant distributions totaling more than $1 million in state funds to the following organizations: 

  • Lincoln Medical Center
  • Henderson County Community Hospital
  • Lauderdale County Community Hospital
  • Three Rivers Hospital in Waverly

In addition to the funds we are providing, these hospitals have also successfully drawn down $7.5 million in federal COVID relief funds. Ensuring these funds are maximized by Tennessee providers is a core objective of this program and we’ll continue to partner with these hospitals.

We are projecting several more applications from small and rural hospitals that will be processed and verified in the coming days and offer our thanks to the Tennessee Hospital Association for their input in this process. 

Funds from the Coronavirus Aid, Relief, and Economic Security Act or CARES Act began flowing to Tennessee last week. Our state is expected to receive more than $2.3 billion with additional funding going directly to Memphis and Nashville from the federal government. 

With this funding comes tremendous opportunity and significant responsibility to ensure we are prudent and serve Tennesseans well. In partnership with the legislature and constitutional officers, I have pulled together a bi-partisan group to properly steward these funds. 

Our first meeting will happen virtually tomorrow and it will be an open press meeting. During this time we will discuss major spending priorities and review the federal expectations for this money. I look forward to reporting further about our plans for this money.  

We thank Lt. Gov McNally, Speaker Sexton, Sen. Watson, Sen. Akbari, Rep. Marsh, Rep. Love, and Comptroller Wilson for their service in these efforts.

As we’ve worked to fight COVID-19 in our state, we have worked to ensure every Tennessean can get the testing and medical care that they need, especially in our minority communities. I invite Dr. Kimberly Lamar from the Department of Health to share more about our efforts. 

Governor:

So we're happy to take questions, open up the lines for... And we have with us, by the way, again, as always, members of our unified command group here, members from the Department of Health, from TEMA, to answer any questions that you might have.

Speaker 2:

Thank you, governor. First, we'll go to Jonathan Mattise with the Associated Press. Jonathan, your line is open.

Jonathan:

Hey, Governor, thanks for taking our questions. A lot of other states have teamed up in different sorts of groups to reopen. Is that something that you're considering doing, and why or why not would you consider that?

Governor:

Well, I've certainly talked with governors all across the country. I've been doing that for weeks now. We have weekly calls with the National Governors Association. I had calls with governors in our region about the efforts that they're taking, so we're not coordinating a group effort to move forward, but we certainly are talking one with the other about how it is that we individually move forward in our states. Governors all have the same goal, and that is to protect the lives of their citizens and to restart, at the right time, their economies. And that's what every governor's doing, that's what we're doing here in Tennessee. We don't have a formalized effort with other states, but we're certainly working together to share best practices so we can do what's best for Tennesseans.

Jonathan:

Thank you.

Speaker 2:

Next, we'll go to Natalie Allison with the Tennessean. Natalie, your line is open.

Natalie:

Good afternoon, Governor.

Governor:

Hi, Natalie.

Natalie:

My question today pertains to the guidelines that the White House has released for beginning the process of reopening businesses. So per their gating criteria, they shouldn't move forward with reopening until they've seen 14 days of downward trajectory or decline in positive cases. So we've seen more than a couple of weeks of single-digit increases as a percentage of the overall cases, but not a sustained decrease. So is Tennessee fully compliant with the guidelines provided by the White House to reopen, and if not, have you all gotten the green light from the White House to do what we're doing?

Governor:

Well, as you know, the White House has given the decision on when and how to reopen to individual governors. And we actually are on our 18th, we've had our 18th today. As you saw, as you heard Dr. Piercey say earlier, our day over day increase today was the smallest number in all of those 18 days. So the day over day increase has been single digit for 18 days, but on balance has continued to decline throughout that period. That's what's been driving this decision. It's a piece of data that is incredibly encouraging, particularly as we see that today's numbers, for example, had 7,000 cases, but had less than 200 new confirmed cases. So we know that we're in the right direction.

Governor:

There are a lot of other things that we want to make sure are in place, too. Our hospitalizations and our available hospital beds have to be at a capacity that has been sustainable, and that will allow for a caseload. That's the case that is true in our state. The guidance has indicated that there should be broad and increased testing, which we have worked really hard to do and today was the largest testing number day that we've had. So we really believe that Tennesseans have done what they were called upon to do, and we've achieved the results that we wanted to achieve in order to be in a place where we can begin a phased reopening that is strategic and smart and safe, and that's been our plan.

Natalie:

Today, Knox County's health department announced that its demand for testing has exceeded its capacity. They suspended tomorrow's drive through testing. They're going to switch to an appointment-only later in the week. Do you support a county reopening if they don't have enough testing supplies?

Governor:

Well, I'll tell you, I'm going to let Dr. Piercey specifically address our testing, but the expansion of testing has occurred in every region of the state. And there will be a case or a day or a particular drive through the pop-up site that may run low. But on balance, our testing capacity continues to increase, and we are testing more and more every day in many of our regions and almost all of our major cities. As I said, there'll be an up and down, but the testing expansion has been true for the entire state. You want to add to that, Dr. Piercey?

Dr. Piercey:

Sure. The governor's correct that it's sometimes difficult to predict demand on any certain day, and for those of you who were at our testing sites on Saturday, we did a pretty good job of keeping up with demand, but that's because our partners, specifically in the National Guard, as well as our Department of Health staff really were agile and flexible in picking up things, and shifting supplies and human resources between sites. And it's no different in Knox County, either. We've been in contact with Dr. Buchanan there who is the health official, and she has requested those supplies, and I got confirmation a little while ago that she will have delivery of those on Thursday of this week to get them back up into normal operations. So we're willing and able to help any partner across the state, particularly those health departments that are doing such important work for testing.

Natalie:

Okay. Thanks.

Speaker 2:

Next, we'll get to Sergio Martinez-Beltrán with WPLN. Sergio, your line is open.

Sergio:

Thank you, [inaudible 00:06:07]. Good afternoon, Governor. You talked about how some restrictions will still remain in place even when the executive order expires. You talked about restricting social gatherings of 10 or more people. This week we saw protests where there were hundreds of people in front of the Capitol. Are these protests violating those restrictions, and what is the state going to do to keep enforcing that?

Governor:

Yeah, I think it's most important that Tennesseans remember that the reason we got where we are today is that we have been very vigilant and diligent as a population in our social distancing efforts and we need to continue to do that. And the requirements will continue to be that we encourage gatherings of 10 or less, and when that happens, we certainly want to address those and talk about those events and discourage that kind of activity. We've had really very little problem with that across the state. We expect that we'll continue to not have a significant problem with that across the state. And when we have it, we want to talk with those groups and tell them why it's so important that they keep one another safe and that they keep others safe as well.

Sergio:

Expecting more protests this month, and I'm wondering have you talked to, or your office has talked to the groups that organized this week's protest, and what's the type of conversation you're having when many of them are not even using a cloth mask?

Governor:

Well, again, we haven't specifically addressed that group, but we want to address and talk to and encourage any groups that gather and do not employ social distancing to do that thing, I mean, to do that very thing and we'll do so. When we see that happening, we'll address those groups, because we believe that, we really believe that Tennesseans do want what's best for one another across the state. And we all know that social distancing works. We know that any virus that spreads with social contact, with human contact, the way to prevent that is by providing social distancing. So we'll encourage that for every gathering and every meeting.

Sergio:

[inaudible]

Governor:

Thank you.

Speaker 2:

Next, we'll go to Andy Sher with The Times Free Press. Andy, your line is open.

Andy:

All right, thanks, Governor. I had a question about the tornado damage. So this letter went out requesting a federal declaration for disaster today? Is that, am I correct on that, or...?

Governor:

That's correct. I signed that letter today.

Andy:

A, can I get a copy-

Governor:

I signed that letter today, and that letter was submitted to President Trump today.

Andy:

Can I get a copy of that?

Governor:

Certainly can.

Andy:

Okay. And so you're saying it's a total of $35 million in damage? Is that correct, or...?

Governor:

Yeah. I'll let Patrick, I'm going to let Patrick Sheehan talk about the details of that declaration.

Patrick:

Hi Andy. Yeah. Over the eight counties that we submitted or the governor included in the letter, it's approximately $35 million in damage, public assistance.

Andy:

I'm sorry, 35 dollars in damage and public assistance.

Patrick:

Public assistance categorized damages. So that doesn't include houses. It doesn't include residential structures, cars, it just includes the public assistance program grants.

Andy:

And any estimates on what houses, residential businesses, structures and that sort of thing is.

Patrick:

Any aggregate loss. No, not yet. Yeah. Not yet. We're working on those figures now.

Andy:

And how soon do you expect to have those?

Patrick:

We'll have some figures by the end of the week.

Andy:

And if I can follow up, when would you expect to put that in the form of a presentation to the federal government?

Patrick:

So the figures don't get reported to the federal government in that way. So you asked for individual assistance by doing a joint preliminary damage assessment. So FEMA personnel on the ground with TEMA, some other state partners and with local personnel, building inspectors, first responders. And so more than 250 structures were categorized with major damage, more than that was destroyed between Hamilton and Bradley counties. And so that's how those figures are reported for requesting a major disaster declaration that includes individual assistance.

Andy:

Okay. And I guess, I mean for those who lost their buildings actually will be dealing with their own respective insurers if they have insurance companies or have insurance policies.

Patrick:

That's right. So insurance is the first line of defense for anybody that includes public assistance costs. So insurance costs are not eligible, the federal government doesn't allow double-dipping, so everyone should be again, and now we're seven days into this. So documenting expenditures, documenting, keeping their receipts, taking lots of pictures, documenting the damage. And everyone at this point, a week in should have at least talked to their insurance provider at this point.

Andy:

Thank you.

Speaker 2:

Next, we'll go to Chris Bungard with WKRN. Chris, your line is open.

Chris Bungard:

Thank you, Governor. I'm going to go back to Natalie's question about 14 days of declining COVID cases as a White House guideline for reopening state economies. Are we ignoring that deadline or just or that guideline or we're you just saying it doesn't matter as to where we are right now?

Governor Lee:

We've had on balance over the last 18 days a decline in the number of days over day cases that we have seen as a state. So if you look at the single-digit percentages over those 18 days, they go up and down, but they steadily as on the aggregate decline. And that is consistent with a decline over a 14 day period of time in cases. Again, today was the lowest of that day over day case in number increases, which is consistent with that aggregate decline. Dr. Pearson, you want to add to that data?

Dr. Pearson:

Sure. So we watch every day have a big spreadsheet of all of the different metrics that we're watching. And as the governor mentioned, 18 days ago was the first time we saw that day over day growth rate be in the single digits. When we first got into the single digits from memory, it was in the upper eights I believe. And we have watched it trim down over the last 18 days. And anytime you're looking at a trend it is just that. You're going to have little blips. We call that statistical variation. You're going to see that but on balance, as he said, it goes down. And so 18 days ago we were at eight or eight and a half, and for the last several days we've been in the two to three range.

Dr. Pearson:

You also have to remember that on those days where you have blips, those might have been days where we did targeted testing. For example, if we tested 450 and 150 of those were positive, that's a 30% positivity rate. That's going to take your overall number up that day, but the next day it's probably going to be a little bit lower. So we've been watching that and there is a very clear statistical trend of a downward trajectory over the last 18 days.

Chris Bungard:

Looking at it that it was an actual decline in the number of cases over the 14 days, instead of a decline in the increased number of cases.

Dr. Pearson:

That's a good question because you have to keep that in context with your denominator of testing and so, if you-

Chris Bungard:

I'm just trying to ... I guess it's some thing's have been brought up and it may be a misinterpretation of what that guideline is, and that's where I think the question keeps coming up.

Dr. Pearson:

I understand and it's a legitimate question. The response is, is that you have to keep it in context of how much testing you're doing. In theory, hypothetically, we could artificially reduce that number by reducing the number of tests. If we only do five tests tomorrow and one is positive, then we only have one confirmed case, but because we're expanding our testing by leaps and bounds day over day, that's why you have to look at rates. Because yesterday we added 7,500 tests, but only about less than 200 of them were positive. And so you have to keep that overall positive case count in context with your denominator of testing, because the more you test, the more you're going to find and that's exactly what we want.

Chris Bungard:

Thank you.

Governor Lee:

Thank you.

Speaker 2:

Next, we'll go to Kathleen Jacob with Fox 17. Kathleen, your line is open.

Kathleen Jacob:

Sure. Thank you again, Governor, for taking our questions.

Governor Lee:

Mm-hmm (affirmative).

Kathleen Jacob:

I know we're talking about reopening, but right now still so many Tennesseans have not seen any unemployment benefits. And the biggest concern that I've heard from them are major website issues. Whether that be, I spoke to a woman who couldn't even log in today. Her application has disappeared. People dealing with questions that don't make sense and then they're not able to get help when they're trying to fill out these applications. My question is, is there a push on you guys' part too, I guess upgrade this website and just make it more user friendly so that people are struggling with one less thing right now?

Governor Lee:

Yeah, there's actually a major push for that, and I appreciate that question because so many Tennesseans have had to deal not only with unemployment and the loss of a job but then with the challenges of dealing with unemployment benefits. And certainly, our system has been significantly strained. As you know, when this began, the increase in our unemployment benefit applications immediately increased by about 25 times over a week period from the previous week. So 25 times more folks have applied, and those are hundreds of thousands of people that have been applying for those benefits.

Governor Lee:

We've absolutely been strained. It's been a challenge. We have upgraded our system as of this weekend. There is an indication that it's working significantly improved in the last day or two, but we'll continue to work ... And we have a great push there. We've employed a couple of hundred extra folks into that department to try and relieve this strain. So we recognize this has been a great challenge for ... the greatest challenge for those who have lost their income and who are dependent on unemployment benefits.

Governor Lee:

And because we know that that challenge is so great to them and we want to be helpful, we've put a great push on that. And we believe and we have seen, by the way, hundreds of thousands of people have gotten those processed, but we've seen improvement in the last few days and we hope to believe and continue to see improvement in the next few days.

Kathleen Jacob:

Okay. Thank you. I appreciate.

Governor Lee:

Thank you.

Speaker 2:

Next, we'll go to Larry Stone with News Talk 94.1 in Cookeville. Larry, your line is open.

Larry Stone:

Thank you for taking the question. For Dr. Pearcey, do you have a sense at this point of what the lag time is between someone getting a test and when that data is reported either to them or in the state numbers?

Dr. Pearson:

Yeah. So the answer is, it varies and I'll tell you there are a couple of variables in there that you have to keep in mind. I do want to acknowledge that there is a delay in the Bledsoe County numbers; we talked about that yesterday. And that's because one of the delays that might happen is a delay when the lab tells us about the positive result. That is supposed to happen within 24 hours, but quite frankly, a lot of these labs are completely overwhelmed with getting hundreds and now sometimes thousands of tests per day, and sometimes that's a little bit slower than we would like.

Dr. Pearson:

However, please know that that does not in any shape, form, or fashion delay notification of the patient. So we've talked several times before about all of the different time gaps during the process. So usually a patient gets sick and then a few days later they get tested. And then between two to four days, on average, they get their result back. Sometimes as little as 24 hours sometimes and we've seen at least in the past, not so much now that the lab result can take up to seven days. We are watching all of the labs in the state and really all the ones that we use all over the nation, keeping an eye on their turnaround times. Our state lab is a 24 to 36 hour turnaround time and most of the ones in the state have no more than two to three days. There are still a couple that are taking longer than that and quite frankly we try not to use those that are having longer turnaround times. So there may be a lag in how long it takes the patient to know and then there might be another lag in getting them reported officially. But I want to reemphasize that as soon as that result comes positive, the patient is told and that's the most important part.

Larry Stone:

A follow up on that, how important is it to decrease that amount of time that it's taking as you begin to try to reopen the state?

Dr. Pearson:

Sure. It's incredibly important, but interestingly, that brings up a point that you need to remember. Case counts are oftentimes several days after the patient starts getting sick and we even know that patients can be infectious a couple of days even before they show symptoms. So the worst thing you can do is wait until that number clicks in your county before you think there's a case, because there's been a case long before then and there's all of that takes place before then. Likewise, when you look at hospitalizations and deaths, those are what we call a lagging indicator. And that means that sometimes it's two or three weeks later, just how long it takes the illness to manifest and then how long it takes for the person to be hospitalized for those numbers to pop up. So the most important part is to pretend like or act like everybody's infected and that you're infected so you don't pass that on to someone else. That's why physical distancing, social distancing are way more important than the numbers on a chart.

Larry Stone:

Thank you, doctor.

Speaker 2:

That's all the time we have for questions today.