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By KIMBERLEE KRUESI

NASHVILLE, Tenn. (AP) — As their state faced one of its toughest months of the pandemic, Tennesseans watched Gov. Bill Lee’s rare primetime address to see whether new public restrictions to curb the spread of the coronavirus might be coming.

It was late December, and the state’s hospitals were bursting at the seams with virus patients. Spiraling caseloads placed Tennessee among the worst states in the nation per capita, medical experts were warning that the health care system could not survive another coronavirus spike, and Lee had been affected personally — his wife had the virus and the governor himself was in quarantine. If ever there was a juncture to change course, the speech seemed like the time and place.

But as he stood before the camera, the businessman-turned-politician declined to implement recommendations from the experts, instead announcing a soft limit on public gatherings while stressing once again that stopping the spread of COVID-19 was a matter of personal responsibility.

Lee’s decision to stick to his approach has dismayed critics who say the state’s situation would not be so dire if he had placed more faith in the government’s role in keeping people safe — criticism he pushes back against as he keeps businesses open.

The first term governor’s response has largely been in step with Republican governors in other states, including Arizona, Arkansas, Oklahoma, which along with Tennessee have ranked among the worst in the country as case numbers, deaths and hospitalizations increase while the governors rebuff calls for new restrictions.

As of Friday, Johns Hopkins University researchers reported 1,236 new confirmed cases per 100,000 people in Tennessee over the past two weeks, which ranks eighth in the country. One in every 187 people in Tennessee tested positive in the past week.

“We don’t have to be here. We don’t have to continue this trend. We can do something about it,” Dr. Diana Sepehri-Harvey, a Franklin primary care physician told reporters in a video conference Tuesday.

Lee, whose office declined a request for an interview for this article, has rejected claims he hasn’t done enough, countering that he aggressively pushed for more expansive COVID-19 testing throughout the state during the early stages of the pandemic and arguing that sweeping mask requirements have become too political to become effective. He says decisions about masks are best left to local jurisdictions, some of which have imposed them in Tennessee, particularly in more populated areas.

According to the Vanderbilt University School of Medicine, about 69% of Tennesseans — but fewer than 30 of 95 counties — are under a face mask requirement. Those researchers found that counties that don’t require wearing masks in public are averaging COVID-19 death rates double or more compared with those that instituted mandates.

Dr. Donna Perlin, a Nashville-based pediatric emergency medicine physician, sees mask-wearing and other precautions as basic government safety measures.

“Just as we have requirements to stop at red lights, or for children to wear seatbelts, or bans on smoking at schools, so too must we require masks, because the refusal to wear masks is endangering our children and their families,” she wrote in a recent editorial.

Despite the criticism, Lee hasn’t wavered from his vow never to close down restaurants, bars and retail stores after Tennessee became one of the first states in the country to lift businesses restrictions last year. He also has long advocated for schools to continue in-person learning and has sent school districts protective equipment for teachers and staffers.

The governor is quick to point out the state’s swift COVID-19 vaccine rollout, praising Tennessee for being among the country’s leaders in distributing the immunizations.

“In addition to creating a strong infrastructure for distribution, we’re currently one of the top states in the nation for total doses administered, vaccinating more than 150,000 Tennesseans in just two weeks,” Lee said in a statement earlier this month, omitting that the state’s initial goal to vaccinate 200,000 residents got delayed because of shipping issues.

The CDC reports that 3.7% of Tennessee’s population has been vaccinated, with more than 251,000 shots administered to date — making it among the top 10 states for administration rates.

But community leaders and Democratic lawmakers have tried in vain to appeal to the governor in their campaign for a mask mandate and other public health regulations.

“What we are doing now is NOT working!” Democratic state Sen. Raumesh Akbari tweeted. “We need a mask mandate, increased testing and contact tracing, and need to consider some business closures. Our hospitals are at the brink! We must act to save lives!”

Some have even appealed to Lee’s Christian faith, which he regularly touted on the campaign trail and references while governing.

“Wearing a mask is loving your neighbor, and taking care of yourself as a Temple of the Holy Spirit,” the Rev. Jo Ann Barker recently wrote to Lee, speaking for the nonpartisan Southern Christian Coalition. “A statewide mask mandate is caring for the community God gives you to care for. If that isn’t important to you, Governor Lee, then what is?”

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Associated Press writers Jonathan Mattise and Travis Loller contributed to this report.

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Follow AP coverage of the virus outbreak at https://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak.