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April 29, 2020

Thank you for joining us for our Wednesday COVID-19 briefing as we keep you updated regarding the fight against COVID-19 and the gradual re-open of Tennessee businesses. 

In 89 of our counties, we see businesses taking the Tennessee Pledge and opening at limited capacity: restaurants are beginning to open, retail outfits are opening up today and gyms across our state will be opening on Friday. 

Social distancing works and we remind every Tennessean that continuing social distancing practices and good hygiene, like frequent hand-washing, will ensure we can stay on track with safe re-open plans. 

The Tennessee Pledge asks businesses to provide safe working conditions for their employees and customers. We’re also asking employees to commit to protecting themselves, their co-workers and the customers they serve. And we’re giving them very specific and detailed guidelines to help them do that. 

As we see Tennessee businesses adopt the Tennessee Pledge, I want to recognize those who are doing right by their employees and customers. Today we are shouting out Three Dog Bakery in Mt. Juliet and Sprout’s Children’s Shop in Manchester for their efforts - keep up the great work. 

During our time today, we will discuss next steps for our aggressive testing efforts as well as the next round of guidance that Tennessee businesses can expect.  Our case count today is: 

Case Count

  • 10,366 confirmed cases 
  • 168,549 total tests conducted 
  • 195 deaths

Dr. Piercey will share more during her report today about efforts we are making to ensure the integrity of our data and measures that are in place to make sure patients are properly accounted for as we learn more about the movement of this virus every day. 

Earlier this week President Trump announced that states should move to test 2% of their population every month. With almost 170,000 Tennesseans tested already, we have met this goal for April. 

Now that we are putting our eyes on May, we are encouraging Tennesseans to help us meet this goal as aggressive testing ensures we can continue to safely re-open our economy. As more Tennesseans prepare to return to work, we especially encourage you to get tested at your local health department. These tests are free of charge and offered 5 days a week.

For the last two weekends, we have also offered drive-through testing sites across the state. These sites will continue this weekend and we encourage every Tennessean, regardless of symptoms, to take advantage of this free service. 

While every Tennessean should keep close watch on how they are feeling and embrace our motto of “when in doubt, get a test”, we are especially cognizant of our vulnerable populations, including the elderly. 

Today we are announcing that in the next several weeks, the Unified-Command group will embark on widespread testing of all long-term care facilities in Tennessee to help these facilities identify COVID-19 positive patients and staff more quickly. There are more than 700 long-term care facilities in our state with more than 70,000 residents. 

For this initial push, we are partnering with National Health Care Corporation to test all residents and staff within their 38 Tennessee facilities. We thank NHC for their partnership as we work to protect the most vulnerable in our state and we look forward to working with all long-term care facilities. 

The Unified-Command Group is also finalizing plans to make testing more widely available, especially within the minority community and we look forward to sharing more about these efforts in the coming days. 

Yesterday I signed Executive Order 30, which is predominantly about reopening our economy in the safest way we can. In this order we continue to restrict social gatherings to groups of 10 or fewer, we continue to encourage working from home or staying home whenever possible, and to wear cloth face masks in public. 

While we did extend the closure orders for a number of businesses, we included some language that signals that we are working to open up businesses even if they are on this list for now. The situation there is that we had to issue an updated order yesterday to allow retail to open today. But, as we said in the order, there are some places that we anticipate opening before the end of May. The first example of this, as you may have heard, is close contact services like salons and barbershops.

Today I’m announcing that close contact services will be opening one week from today in 89 of 95 Tennessee counties. We know that for these businesses things like masks will be especially important because of the close contact that employees have with customers. We will have guidance for those businesses before the end of this week, and we will be asking those businesses to take the Tennessee Pledge just as we have restaurants, retail businesses, and gyms. 

Governor Bill Lee:

... so we're happy to open up the lines and take questions.

Speaker 1:

Thank you, Governor. First we'll go to Jonathan Mattise with the AP. Jonathan, your line is open.

Jonathan Mattise:

Hey Governor. Thanks for taking the question. It looks like in the executive order from yesterday, religious services are now allowed, although it's encouraged that services would still be virtual or online. It also says that your Office of Faith-based and Community Initiatives is issuing some sort of guidance. Can you talk a little bit about that? What is your guidance on in-person services for churches, and weddings, and funerals, and that sort of thing?

Governor Bill Lee:

Yeah. Well, it's important to remember and know that church services have never been closed even through the first level of executive order. First Amendment rights are incredibly important, and we have worked with faith leaders all across this state to encourage ... I want to applaud the efforts of churches all across Tennessee to find alternative ways to meet, and to worship, and to serve, and to communicate with their congregations and with the people that they are in connection with.

Governor Bill Lee:

The faith community is incredibly important, even more so in the midst of crisis, and we want all churches to remember that. We will be issuing guidance by the end of the week regarding best practices for operating in this COVID environment. We continue to encourage churches to utilize alternative ways, drive-in services, online services, but we will also continue and provide them additional guidance so they have a better understanding of what the weeks ahead can look like.

Jonathan Mattise:

Thank you.

Governor Bill Lee:

Thank you.

Speaker 1:

Next we'll go to Joel Ebert with The Tennesseean. Joel, your line is open.

Joel Ebert:

Yeah. This might be better for Dr. Piercey, but I'm trying to understand the latest death count went up, what, I believe seven since yesterday. You said that the hospitalization numbers increased due to just more reporting that you guys got. Was that increase in deaths due to just literally people that died in the last day, or is that due to reporting?

Dr. Piercey:

The death count has been pretty stable, and you'll see just typical increases of a handful of new numbers recorded each day. That has been easier to confirm and crosscheck, that I referenced a few minutes ago, because we have the death certificate data. Now the thing that you have to remember about death certificate data is that that is the last piece of information typically that we get on deaths. We'll get notified first, typically by a hospital, that there is a suspected death due to COVID-19, and then it takes several days.

Dr. Piercey:

I know a lot of people have had to deal with the process of going through the certification and getting a death certificate after a loved one has passed, and so you know that it takes several days to do that. Once that death certificate data comes in, we cross reference that with the reports of deaths that we have, and that's how the death reporting is done. You will oftentimes see that family reports or facility reports will come out much sooner because our death certificate data is delayed for typically a couple of weeks.

Joel Ebert:

Then a followup. Earlier this month, the CDC recommended that states include probable COVID-19 death cases. Tennessee has not done that for some reason. Can you explain that decision, and will that change?

Dr. Piercey:

Yeah. We actually do track that because we track all of our data just like the CDC has. In fact in some instances, and I actually think you and I have had this conversation, Joel, that we do things even more specifically than the CDC requires. What I'm specifically referencing is age range. We record it in 10-year bands. The CDC reports it like I think 18 to 49 and maybe 49 to 65. But we have the CDC standard, and sometimes even more stringent in certain areas. Related to probable or suspected cases, that's a mixed bag because some of those pan out to be actual cases, and some of them don't.

Dr. Piercey:

We collect that information and have actually had significant discussion on whether or not to post that information. Have no problem doing it. We just don't see that it adds a lot of value until we actually have a confirmed case or not. I'll tell you that probable or suspected cases, that was a lot more important data point when we didn't have widespread testing, and now that we have widespread testing availability, I'd much rather you have a test and me know positive or negative versus calling you suspected or probable.

Joel Ebert:

But why not release that probable amount as what the CDC is recommending? Do you fear that the state's count right now is under what it really is, what the actual death count is?

Dr. Piercey:

We're happy to release the probable statistic. We're going to have to give a lot of context on what that is, and how people should interpret that. We don't have any problem releasing that. In fact, we've discussed that several times. And no, to answer your question, I don't have a suspicion that our case count is off.

Joel Ebert:

Thank you.

Speaker 1:

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

Chris Bundgaard:

Good afternoon Governor. Did you anticipate such an outcry from hair salons and the like to reopen this soon, and how do you make sure that it's done safely? What kind of enforcement or overseeing that will you have?

Governor Bill Lee:

You know, I think any Tennessean that is not working right now because of COVID-19 is hoping to go back to work as soon as possible, and any business owner that has had their business closed as a result of COVID-19 is very hopeful that they will be allowed to go back and open their businesses again. So it never surprises me that people want to go back to work, or that they want to reopen their businesses, and it doesn't surprise me either that they want that to be done in a safe way. Our economic recovery group has worked with industry groups that are representing those businesses.

Governor Bill Lee:

They want guidance, they want guidelines, they want real clear tools that they can use to open safely because they know that if their businesses are open safely, and that we can give them information about how to do that, they know that if they open those businesses safely, then they're more likely to have customers. So I'm very encouraged by the way the economic recovery group has worked with industry groups in particular and the medical community to make sure that our guidance is very clear. It's very detailed. We have taken the time to develop the right guidance for these industries, and because of that, that's why we are certain that they'll be able to open safely.

Chris Bundgaard:

Just a followup. That information, that guidance, will be exactly where and when? I'm assuming it'll be on your website.

Governor Bill Lee:

It'll be on our web-

Chris Bundgaard:

[inaudible 00:00:07:40].

Governor Bill Lee:

Right. It's not there. The close contact businesses guidance, that'll be developed, and we'll have that by the end of the week. It'll be on our website, and we will actually push it out to industry groups. We're using industry organizations to push that guidance out as well. We want every company, every business, to understand fully what that is because we know that they want to comply with that in order to open safely.

Chris Bundgaard:

Thank you governor.

Governor Bill Lee:

Yes sir.

Speaker 1:

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

Andy Sher:

Thanks. Governor, in terns of in getting back to the nursing homes, NHD has stepped up. What about Life Care Centers, which is based in Cleveland and had issues in Washington State. You think that having the experience that they had in Washington State, now the experience they're having in Athens, that they would have been more than happy to step up to participate early?

Governor Bill Lee:

Doctor, so you want to-

Dr. Piercey:

So in fairness to Life Care, this has just been a discussion that's been over the last few hours. We've spoken with the association that represents the long-term care facility industry, but we have not yet spoken to all of the different provider franchises or independent providers. Life Care in Athens specifically was very welcoming and compliant when we asked them to test all of their residents and staff just in the last day or two, and so I don't have any reason to believe that they wouldn't be. That's just a function of us not having made contact yet, so I'm not suggesting that they are not volunteering.

Speaker 1:

Next we'll go to Chris Davis with News Channel 5. Chris, your line is open.

Chris Davis:

Good afternoon, Governor Lee. You have said that reopening decisions will be data driven, yet many state lawmakers have posted on social media today about how they reached out to you with constituent concerns over hair salons opening back up, and that you've listened and potentially decided based off those concerns. How big of a factor did constituent concerns play into this decision to reopen salons, and what's the data that you're looking at to determine why they can go ahead and open up next week?

Governor Bill Lee:

You know, we've been watching that, as you know, since the beginning of this. We looked specifically at the downward trend of day over day cases. We've talked about that at length. We've looked at the downward, and continued downward trend of positivity rates in our state. We have matched that with the increased testing capacity as was noted earlier, the amount of testing required in order to get 2% of your population tested in a single month. We certainly have considered the fact that there are 400,000 Tennesseeans out of work, as we consider all the data points that weigh into a decision to open up businesses.

Governor Bill Lee:

These are a few of multiple pieces of information and data that we look at every single day. One of the most important ones is our hospital capacity, our healthcare capacity, the amount of PPE that we have available, and our access to the opening of the supply chain. We track that every single day through TEMA, and we push out purchases of that personal protective equipment to all 95 counties on a regular basis. We've shipped hundreds of those out, so we keep track of that supply chain of PPE. All of those things have weighed into the decision of when and how to open which businesses.

Speaker 1:

Next we'll go to Shannen Sharpe of WTVC. Shannon, your line is open.

Shannen Sharpe:

Governor, I know that Andy mentioned the Life Care Center of Athens, but now that they've had two deaths and 70 other positive cases between residents and staff, does this concern you as much as the Gallatin nursing home outbreak?

Governor Bill Lee:

You know, anytime we have an outbreak, we're concerned, and that's the reason that we've required longterm care facilities to provide notification to us as soon as they have cases, two or more cases. It's why we, within 12 hours, are in that facility, working with them to develop an assessment of that facility. And then it's why we have created a measurement by which we will use to do mass testing in any facility that we find a multitude of cases relative to their population. So we're always concerned, we're most concerned, in fact, about our most vulnerable population, and that's the elderly, which is exactly why we have announced, even today, this strategy to do testing in every single of our 700 longterm care facilities across the state. So we do have concerns anytime there is an outbreak.

Shannen Sharpe:

And just quickly to follow up, I know I asked this on Monday, but are there still, are there any plans to update the Friday numbers on nursing homes any sooner than once a week, or is it still just staying at once a week?

Governor Bill Lee:

Dr. Piercey, you want to address that?

Dr. Piercey:

It's really just a matter of utility. It takes several days to... Once we identify somebody needs testing, we get the test results back and post it. There's no reason we can't, but the numbers just don't change very much on a day to day basis. But the short answer is there's no reason we can't post it every day.

Speaker 1:

Next we'll go to Kara Hartnett with the National Post. Kara, your line is open.

Kara Hartnett:

Hi, thank you for taking questions. If we see an upward trend in cases of the infection rate over the next week, are you considering backtracking on some of the reopenings that have been announced?

Governor Bill Lee:

No, I think I've said all along that nothing's ever off the table, but I also have said that we watch trends, and we... Trends are not normally found within a few days. We've seen, for example, we've seen cases, we've seen days where we had an uptick in numbers relative to a percentage, day to day percentage increases. Oftentimes those are connected to a targeted population. Last week for example, I think we had about 600 positive tests out of the prison system, and that creates a large number for a couple of days. That is not particularly reflective of what's happening in the general population. So what we will do if we see increases in numbers is actually analyze those to determine just where they are, where they're coming from, if they in fact are indicative of something that's happened in the general population, and then make decisions as a result of that.

Kara Hartnett:

Why aren't we looking at how these first phases of reopening are affecting these metrics before making these additional decisions?

Governor Bill Lee:

Well, we don't know what impact opening will have on these numbers. We believe and we feel confident that opening safely will mitigate the spread of this virus, and that we can in fact open safely and manage the spread of COVID at the same time. That's why we have used data to make the decisions. And that's why we believe that the decision only to open with very strict guidelines and principles and tools for businesses to open in an entirely different way than they were operating before will allow us to get our economy moving again without undue risk to the public. So that's the movement forward, but we're going to watch data every single day.

Kara Hartnett:

Okay. Thank you.

Governor Bill Lee:

Thank you.

Speaker 1:

Next we'll go to Sam Zern with WPLN. Sam, your line is open.

Sam Zern:

Good afternoon. I'm wondering what changed from yesterday's guidance to today's guidance with regards to close contact businesses, and why that revision to Executive Order 30 happened, and on a different note, is there any interest in widespread testing for prisons?

Governor Bill Lee:

I'll address Executive Order 30 first, so that order was made because we had businesses that would be closing, and actually in order to open retail today, we had to update that executive order yesterday. That order had to be made in order for the retail businesses to open today. And the order extended through the end of May, but it specifically stated that it allowed for continued opening of additional businesses. It stated the businesses that were closed with the understanding that we would be allowed to and would anticipate, frankly, and we knew actually when we wrote that order, that we were going to be opening additional businesses, specifically close contact businesses. We had planned to announce those tomorrow, but we did that today instead. We've gotten guidance that that let us know that we'd be able to open them in the middle of the week. We'll complete and publish that data on Friday. And that's how that all occurred. Oh, and your second question about widespread prisons, I'll let Dr. Piercey address that.

Dr. Piercey:

So prisons are certainly another population that we're very concerned about. They are a contained population where people can spread infection amongst themselves very easily. And so that's something that we've kept a close eye on. The governor mentioned that we did do widespread testing of the Bledsoe facility several days ago, and that there has also been widespread testing of the Trousdale facility earlier this week. We have what I call a tiered approach to prison testing, and we benchmark that, or I benchmark that, against what my peers and other states are doing.

Dr. Piercey:

You've probably heard me reference before that a once a week I'm on a call with all of the southern state health officials. Our approach is consistent with theirs, and then I've reached out to some of my colleagues outside of the southeastern United States to see what they're doing. And with minor variation, most everybody's taking the same approach. And that approach is when you have a case or a suspected case, you do sort of expanded testing of contacts and anybody else that might be symptomatic, but as soon as that number grows, or if at any time you recognize a case that isn't linked to the first one, almost akin to community transmission, then we institute the next tier, which is essentially a unit based or a much more wider spread of testing.

Dr. Piercey:

That typically involves anywhere from 300 to 500 folks, at least in our prison system. And then if the percentage positivity in that is reflective of a bigger problem, we're very quick [inaudible] flip the switch and do widespread testing of the facility as a whole. The good news is, is we have only had to do that mass population testing in two facilities now. We have done widespread unit-based testing, so about 400, 500 people in several other facilities, and their positive percentage rate has been pretty low, which is exactly what we want to see. But we do have that tiered system, which is consistent with how our peer States are approaching it.

Sam Zern:

Thank you.

Speaker 1:

That's all the time we have for questions today