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This story was updated at 11 p.m. on March 26, 2020, with more information.

Thousands of health care providers across the state are continuing to call on Tennessee Gov. Bill Lee to issue a mandatory shelter-in-place order amid the spread of the novel coronavirus.

As of Sunday, an online petition already circulating had gathered more than 2,000 signatures in Tennessee.

At least 20 states and some major cities have already enacted such orders, including California, New York, parts of Florida and even four counties in Tennessee, according to The New York Times.

Dr. Aaron Milstone, a pulmonary/critical care specialist in Franklin, worked with ICU physicians across the state to develop the petition. During a press call Thursday, he characterized Lee's failure to act this week as a "betrayal."

"Gov. Lee's failure to issue a stay-at-home order essentially allows the pandemic to spread through communities unchecked," Milstone said. "Gov. Lee, you must do more. Your failure to do what's right betrays the doctors and nurses fighting the pandemic. Join the other 20 states in our country who have already taken this bold move."

At least 957 confirmed cases of COVID-19 have already been reported by the Tennessee Department of Health as of Thursday, and at least three fatalities linked to the disease.

Mayors across the state have issued their own executive orders, such as Chattanooga Mayor Andy Berke's order that "non-essential" businesses temporarily close, but lack of statewide action allows for confusion, Milstone and his colleagues argue.

"It creates tremendous confusion that is undermining the early steps that many mayors of cities and counties took to protect Tennesseans," Milstone said Thursday. "A stay-at-home order is really our only tool left."

The Chattanooga-Hamilton County Medical Society joined other state organizations, such as the Tennessee Medical Association, this week and also sent a letter to Lee calling for action.

"Most medical researchers project that we have only days to act to flatten the curve of COVID-19, to expand the surge capacity of our health care systems, and to save the lives of many Tennesseans," said James Haynes, president of the Chattanooga-Hamilton County Medical Society, in a letter to the governor. "We urge you to issue an immediate four-week 'shelter at home' order, with need assessed on a weekly basis and with the potential to extend as needed. We recognize the difficulty that creates for so many of our citizens, but we also recognize the greater danger from failing in our duty to mitigate the spread of this novel virus as directed by scientists, epidemiologists, the CDC and our President."

The Tennessee Medical Association is also calling on Lee to declare all counties in the state disaster areas to open up more funding options, as well as for increased production, procurement and coordination of personal protective equipment (medical supplies such as N95 respirators, surgical masks and face shields).

Local businesses, organizations and even schools in Chattanooga are already donating supplies to local hospitals, and Hamilton County Mayor Jim Coppinger encouraged community members to donate needed supplies to the Chattanooga-Hamilton County Health Department during a news conference Wednesday.

On Sunday, Lee issued Executive Order No.17 that bans social gatherings of 10 or more people and requires restaurants and bars to transition how they operate, but Lee has not issued any "stay at home"-type mandates.

During his daily news conference Thursday, Lee told a reporter he was not opposed to shelter-in-place options, but he doesn't consider a statewide order appropriate at this time.

"More than 50% of our population in the state are under stay-at-home requirements; those populations are in our most densely populated areas of our state, and I have commended those leaders," Lee said. "There is not a one-size-fits-all approach in this country for the right way to approach this. That's why you have different things going on across the state. There's nothing off the table. Every day the numbers change and decisions will be made off data."

Dr. Sonal Gupta, an internal medicine specialist in Brentwood, is married to an anesthesiologist who works at Vanderbilt University Medical Center.

She said the couple is already taking measures in their home to prevent the spread of COVID-19, including living in separate areas of the house.

"We are aware that there is a very high likelihood that [my husband] will test COVID-19 positive in the future," Gupta said of her husband. "Our hope is we can mitigate the effect of the disease in our home by distancing within our house."

She added that the state is already playing catch-up as COVID-19 continues to spread rapidly.

"Epidemiology 101 shows us when you are trying to play catch-up you have to think two steps ahead and two steps behind. COVID-19 is at least two weeks ahead of us," Gupta added.

Staff writers Andy Sher and Elizabeth Fite contributed to this story.

Contact Meghan Mangrum at mmangrum@timesfreepress.com or 423-757-6592. Follow her on Twitter @memangrum.

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