President Trump's White House Coronavirus Task Force generates 13-page weekly reports for every state on the situation of COVID-19. The reports provide extensive detail on the states, recommendations and how they compare to national averages.

For this story, the Times-Gazette obtained copies of the Tennessee reports from Tennessee Governor Bill Lee's office, from Nov. 1 through mid-December . To view the reports go to the Tines-Gazette website, www.t-g.com/files/2020-12-28-public-records-response.pdf

**Summaries

In the Nov. 1 report, the White House Task Force wrote "Tennessee had 263 new cases per 100,000 population, compared to the national average of 165 per 100,000." By Dec. 13, Tennessee had 639 new cases per 100,000 population, compared with the national average of 451 per 100,000. Tennessee remained in the Red Zone (more than 100 new cases per 100,000 population) for all seven weeks reviewed for this story.

In the Nov. 29 report, the White House task force was blunt in its assessment of the situation. "If state and local policies do not reflect the the seriousness of the current situation, all public health officials must alert the population directly," the task force wrote. "It must be made clear that if you are over age 65 or have significant health conditions you should not enter any indoor public spaces where anyone is unmasked due to the immediate risk to your health; you should have your groceries and medications delivered. If you are under age 40, you need to assume you became infected during the Thanksgiving period if you gathered beyond your immediate household. Most likely, you will not have symptoms; however you are dangerous to others and you must isolate away from anyone at increased risk for severe disease and get tested immediately."

Also in the Nov. 29 report, the task force wrote, "The depth of viral spread across Tennessee remains significant and without public health orders in place compelling Tennesseans to act differently, the spread will remain unyielding with significant impact on the healthcare system."

**Hospital case loads

In the Nov. 1 report, the task force reported " Between Oct 24 - Oct. 30, on average, 178 patients with confirmed COVID-19 and 105 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Tennessee."

In the Dec. 13 report, the task force reported " Between Dec. 5 - Dec. 11, on average, 319 patients with confirmed COVID-19 and 140 patients with suspected COVID-19 were reported as newly admitted each day to hospitals in Tennessee."

**Recommendations, testing

On Nov. 1: The task force stressed the importance of increased testing to better identify people who are infected with the virus but are not exhibiting symptoms and are unknowingly spreading the infection - asymptomatic transmission. "Must focus testing to find asymptomatic transmission," said the report. "With cases and new hospitalizations at high levels, transmission must be reduced."

Nov. 15: The task force by this time was increasingly concerned about the situation in Tennessee. "Over the past month, the spread in Tennessee has become deeper and unyielding. Week over week increases in hospitalizations, reported limited bed availability, and increasing deaths correlate with Halloween and related activities. With Thanksgiving and upcoming holidays, Tennesseans must understand the situation the COVID-19 situation statewide. Serious messaging and action is needed from state leadership; recommending Tennesseans wear masks in public settings communicates the current risk level and identify actions all Tennesseans need to take."

In the Nov. 15 report, the task force continued to stress the importance of a rigorous testing program. "As previously noted," the report said, "proactive testing must be part of the mitigation efforts inclusive of mask wearing, physical distancing, hand hygiene, and immediate isolation, contact tracing, and quarantine." The task force continued to emphasize the need to identify "silent spreaders, those who have the virus, feel fine, and are unknowingly spreading it. The task force recommended offering incentives for people under age 40 to get tested.

The task force suggested continuous "monitoring of testing and contact tracing capacity in all counties to ensure rapid turnaround of test results (within 48 hours). The task force said "full contact tracing" is completed within 72 hours of a positive test. The state has never implemented a comprehensive contact tracing program.

Nov. 22: The task force continued to stress the importance of "proactive, focused testing" to find the silent spreaders, the community that "precedes and continues to drive these surges."

On Dec. 14, Tennessee announced it was cutting back on its testing program in order to prepare for distribution of vaccines. Tennessee had contracted for its contact tracing program with a medical billing company with no experience in epidemiology. The state spent tens of millions of dollars with the company but no reports on the company's success or lack thereof have been produced.

The state's testing program did pick up some over time. For example, in the first 15 days of October, the state reported conducting 38,230 tests. In the first 15 days of December, the state reported conducting 541,335 tests. However, during the first 15 days of October, the testing uncovered 26,688 cases - a positivity rate of 7 percent. In the first 15 days of December, the testing resulted in 98,112 positives - a positivity rate of 18.1 percent. According to Johns Hopkins, "The rate of positivity is an important indicator because it can provide insights into whether a community is conducting enough testing to find cases. If a community's positivity is high, it suggests that that community may largely be testing the sickest patients and possibly missing milder or asymptomatic cases." Positivity rates of above 5 percent are considered too high to accurately gauge the extent of the virus.

As of Dec. 28, Tennessee had the eighth highest positivity rate in the U.S. The highest positivity rates in the U.S. on Dec. 28 were Idaho at 56.7 percent followed by Pennsylvania and Alabama both at 38.7 percent, South Dakota at 35.5 percent, Iowa at 34.1 percent, Kansas at 29.5 percent, Mississippi at 20.1 percent and Tennessee at 19.7 percent. The top 10 was rounded out with Arkansas at 18.5 percent and Utah at 18.1 percent.

**Masks, hand washing, separation

Nov. 1: "With the daily new hospital admissions at high levels, there must be clear messaging to Tennesseans to act now:

- Do not gather without a mask with individuals living outside of your household.

- Always wear a mask in public places.

- Stop gathering beyond immediate household until cases and test positivity decrease significantly."

The White House task force repeated the same recommendations in every weekly report through Dec. 13. The task force cautioned that without increased testing and "significant behavior change of all Americans" uncontrolled spread of the virus will not be interrupted."

**Alert

In its Dec. 13 report, during what has been identified as the post-Thanksgiving surge, the White House task force provided "Pandemic Alerts."

"Despite the severity of this surge and the threat to hospital systems, many state and local governments are not implementing the same mitigation policies that stemmed the tide of the summer surge," the task force wrote. "Many Americans continue to gather indoors, creating private spreading events outside of public spaces. Mitigation efforts must increase, including key state and local policies; increase physical distancing through significant reduction in capacity closure in public and private indoor spaces, including restaurants and bars. Focus on uniform behavioral change, including masking, physical distancing, hand hygiene, no indoor gatherings outside of immediate households, and ensuring that every American understands the clear risks of ANY family or friend interactions outside of their immediate household indoors without mask."

-To view the full 88 pages of the seven weeks of the White House Coronavirus Task Force reports from Nov. 1 through Dec. 13 go online to www.t-g.com/files/2020-12-28-public-records-response.pdf