Staff photo by Troy Stolt / Hamilton County Mayor Jim Coppinger speaks during a news conference about vaccinations for COVID-19 at the Hamilton County Health Department's Golley Auditorium on Tuesday, Dec. 22, 2020, in Chattanooga, Tenn.

In a last-ditch effort ahead of the holidays, public health officials across Tennessee on this week issued a flurry of warnings and pleas for people to avoid gathering with others outside their own households.

Tennessee continues to occupy the top spot in the nation for the rate of COVID-19 transmission, a dramatic surge that began in early November then accelerated after the Thanksgiving holidays. As of Tuesday evening, Tennessee had a seven-day average of 137.1 new cases per day per 100,000 residents. The next closest state was Oklahoma, with 115.

"If people pretend like the virus doesn't exist and decide to have Christmas as usual, then they are putting themselves and presumably the people they care for at risk of getting ill and maybe even having to go to the hospital and maybe passing away," Knox County Public Health Director Martha Buchanan warned Tuesday, just days after she herself recovered from the virus.

(READ MORE: Tennessee ranks worst in nation in new COVID-19 cases by population, spurring harsh criticism of Gov. Lee)

"That's not a Christmas gift you want to give somebody," she said.

In Memphis, Reginald Coopwood, CEO of Regional Health One, warned that Tennessee hospitals could soon resemble the chaos and crowding of New York City hospitals at the height of that city's surge when patients were forced to share ventilators and nurses and doctors treated patients in hallways.

In Chattanooga, Hamilton County Mayor Jim Coppinger told residents hospitals were seeing large numbers of COVID patients.

"What we're seeing right now in our hospitals and in our community is certainly a large uptick in the number of new cases as a result of the gatherings at Thanksgiving," he said.

He urged residents to "think this through as you plan your Christmas gatherings."

(READ MORE: Hamilton County will begin COVID-19 vaccinations Wednesday)

In a call with reporters Tuesday afternoon, Tennessee Department of Health Commissioner Lisa Piercey noted that the number of hospitalized COVID-19 patients continues to rise, and people suffering from coronavirus now account for nearly half of all patients in hospital intensive care units and more than one in four of total inpatients.

Warnings from public health officials come two days after Gov. Bill Lee, in an unusual Sunday night address, asked Tennesseans to forgo Christmas gatherings with family or friends from outside their households. The governor also issued an executive order limiting certain types of public gatherings to no more than ten people.

He stopped short of ordering a mask mandate.

That messaging, he has long insisted, is best heard from local officials.

In urging local communities to wear masks and limit holiday celebrations to members of one household, some local officials also expressed frustration with Lee's unwillingness to require masks statewide.

Asked why Tennessee is experiencing such a surge in coronavirus, Buchanan – the Knox County public health director – said one reason was the "lack of consistency" from state officials.

"It's inconsistent across the state," she said. "Wearing masks, not wearing masks, social distancing. What they're doing in beauty shops and what they're doing in different places is varied across the state. Without consistency our numbers are going up."

In Shelby County, Mayor Lee Harris sent a letter to fellow west Tennessee mayors urging them to implement mask mandates on the day following Lee's address

"It would have helped us a great deal to see more interventions at the state level, and, like many of you, I have repeatedly encouraged state officials to implement a state-wide mask mandate," he wrote.

Read more from Tennessee Lookout.