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Gov. Bill Lee speaks during the Tennessee Higher Education Commission session of the state budget hearings Tuesday, Nov. 10, 2020, in Nashville, Tenn. Lee said Tuesday he's looking to include "meaningful" teacher pay raises in next year's budget despite facing financial crunches brought on by the COVID-19 pandemic. (AP Photo/Mark Humphrey)

NASHVILLE — Tennessee Gov. Bill Lee announced Sunday night he is issuing a new executive order restricting public indoor gatherings to no more than 10 people but rejecting a mandate on mask usage.

His own state health officials are warning that if the state experiences post-Christmas and New Year's coronavirus-infection surges similar to those that occurred over Thanksgiving, "it will break our hospitals."

"Many think a statewide mandate would improve mask wearing, many think it would have the opposite effect," the Republican governor said in a five-minute address carried live on Facebook and YouTube. "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."

His decision drew praise from Republican legislative leaders but sharp criticism from the medical community.

Dr. Aaron Milstone, a Middle Tennessee pulmonologist who with other physicians has repeatedly called on Lee to implement a mask mandate, bluntly told the governor in a statement that "we need you to find the political courage to do your part, and stand up."

Hospitals are "overwhelmed and our health care workers are exhausted," Milstone said. "This is the moment of greatest need our state has seen since the beginning of the pandemic. 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."

Lee, whose wife Maria Lee tested positive for COVID-19 on Saturday and is experiencing mild symptoms, acknowledged around 10,000 Tennesseans have been getting sick daily in recent days with "thousands of our neighbors" now in hospitals.

"More than 100 people are dying each day. We are in a war," the governor added, noting that with the arrival of the first vaccine, "we have launched an offensive that will end this war. But it is the next few weeks that is going to be the most critical [time] for our state."

He said he is signing an order that will limit indoor public gatherings to 10 people, also noting that he believes high school sports are important for students and "should continue." However, Lee said, "we are limiting attendance at indoor events" in coordination with the Tennessee Secondary School Athletic Association.

"We know that it is gatherings that have caused this surge," Lee said. "That is why we are making these decisions around gatherings that will help us blunt the rise in cases."

The governor's decision comes as Tennessee last week ranked worst in the nation in terms of new COVID-19 cases by population, according to the U.S. Centers for Disease Control and Prevention. Over a seven-day rolling average, Tennessee's average number of newly diagnosed COVID-19 cases per day was 135.6 per 100,000 people. No other state was even close.

Latest figures released Sunday by the state health department show Tennessee with an additional 9,689 cases, raising the total of residents who have had the virus to 519,687. There were 54 more deaths, raising the total of people dying from COVID-19 to 6,071. Current hospitalizations, however, fell slightly by 104 to 2,789.

Since late October the number of patients with COVID-19 in hospital intensive care units has shot up from 394 to 747, according to the state.

Lee's original mask mandate and stay-at-home directives drew fire from a number of Republicans, including several elected district attorneys general.

His approach drew praise Sunday night from mask-mandate-wary Republican legislative leaders.

"I am fully supportive of the directives @GovBillLee issued tonight," Lt. Gov. Randy McNally, the Republican state Senate speaker from Oak Ridge, said in a tweet. "The actions he is taking are measured, thoughtful and absolutely necessary. I support him fully and I appreciate his leadership.

Likewise with House Speaker Cameron Sexton, R-Crossville, who said, "I greatly respect Gov. Lee, his authority and his desire to do what he believes is best for Tennessee and for its citizens. I fully support the governor's approach to not place further restrictions on our businesses through lockdowns or another safer-at-home order."

Many legislative Republicans oppose mask mandates. Lee, who early on in the pandemic issued a statewide mask mandate, later pulled back in response to criticism but allowed county mayors in 89 counties with state-run health departments to call the shots.

In six other counties that run their health departments, including Hamilton County, the boards make the decision. That's gone smoothly in Hamilton County with Mayor Jim Coppinger joining with the board on the requirement.

But Knox County Mayor Glenn Jacobs, who opposed the county health board's mandate, has enlisted the help of some legislative Republicans to try to strip all six health boards' ability to issue the mandate and hand the power over to county mayors.

Earlier Sunday, state health Commissioner Lisa Piercey issued dire warnings about what Tennessee's hospital system faces if it experiences new COVID-19 post-holiday surges, citing Thanksgiving and multiple household gatherings where people infect others.

"We know how this happens," Piercey said in a conference call with reporters. "People get together and think 'it's OK for me to be home or not at a bar,' and think 'it's OK for me to have a few friends over.' That's a dangerous mentality."

Health officials need to "preserve access to hospital resources," Piercey said. "If we have another surge over Christmas, it will break our hospitals. Don't gather with those outside of your households. We have to change our behavior over the next several weeks."

The state has already deployed some medically trained National Guard members to work in Northeast Tennessee as well as in Memphis and Shelby County. At the same time, five large hospital systems have under state authority begun using paramedics.

But while the state has put up some $51 million to help hospitals, Piercey warned a flood of new patients would threaten to overrun hospitals.

"I tell you this because we are looking under every rock," said Piercey, a physician. "We are turning over every stone to help hospitals. We are running out of options."

While the state has compiled a list of 700 health care professionals that could possibly help out, Piercey warned that "all of the money in the world can't buy more staff. That money will only go so far. We have spent all the money we can spend on staff. There are no more staff to spend money on."

Contact Andy Sher at asher@timesfreepress.com or 615-255-0550. Follow on Twitter @AndySher1.

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