The Shelby County Health Department Wednesday added teeth to the stay-at-home order. Those who continue to ignore it and social-distancing directives can face misdemeanor charges.

“I want to be very clear, this is not just a recommendation but a requirement supported in law. It is necessary that we move in this direction because our numbers are climbing,” said Dr. Bruce Randolph, health department medical officer.

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Offenders will first receive verbal warnings, followed by written notice. Those who continue to defy will face charges and risk having their business shut down, including places of worship.

The health department receives calls all day long, Randolph said, of gatherings of people and lack of social distancing, including in workplaces.

“We are not going to have 100% compliance,” Shelby County Mayor Lee Harris told reporters Wednesday afternoon. “But the vast majority of our residents, or your neighbors, are committed to putting their shoulder to the wheel and helping.”

The misdemeanor charge exists for those who refuse, but people will be warned first.

“We’ll be talking first to see if we can get them to make changes. I think that will work in nearly all the cases,” Harris said. “We live in the real world. And that is the reality, but we’re going to do what we can to have compliance.”

The threat of enforcement comes as jurisdictions around Shelby County step up their efforts.

Mississippi Gov. Tate Reeves issued a statewide shelter-in-place order Wednesday afternoon after pressure from physicians and elected officials, including U.S. Rep. Steve Cohen of Memphis.

Leaders from Crittenden and DeSoto counties have joined the Shelby County task force, which meets every morning.

“I do think we really are looking at things from a regional perspective, not just the Shelby County, Tennessee, perspective,” Shelby County Health Department director Alisa Haushalter said.

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West Memphis has followed through with a curfew, Harris said.

“I think there’s some really great signs, early on, that coordination with some of our regional partners is going to go well,” Harris said.

Hospital leaders in the task force report in some cases that up to half of the patients hospitalized are requiring ICU care, an increase noted this week.

“So, we know there’s a trend toward more severity of illness,” Haushalter said.

The vast majority of cases here are among people under age 60, but as testing increases, the ages are rising also.

“We are beginning to see more at 60 and above. That’s our most vulnerable population,” she said.

The number of people hospitalized in the 22-hospital Baptist Memorial Health Care system are manageable now.

“The numbers are not by any stretch staggering or stretching us at the moment,” said Dr. Stephen Threlkeld, who is treating COVID-19 patients at Baptist Hospital-Memphis.

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On Wednesday, Baptist-Memphis had nine people in regular acute beds and 12 in ICU. Tuesday, there were 10 in acute beds and 11 in ICU, he said.

“We hope the surge never comes, but we are certainly continuing to prepare for that,” he said.

“The percentage of people we are testing is slightly lower today than it was a few days ago,” Threlkeld said. “If you really are getting into a surge, you would expect the rate of detection of cases to be increasing.”

When two employees in a Baptist facility in Mississippi tested positive, hospital administrators ordered every employee on the property be tested. More than 200 were tested, and none were positive.

“That is encouraging, although it should not lead to overconfidence,” Threlkeld said.

Baptist is conducting targeted tests in asymptomatic people, both employees and non-employees, to see what the positive rates are among people not showing symptoms.

“We think that is missing as a piece of how we can serve the community and make informed decisions about social distancing,” Threlkeld said.

“It’s very difficult to make those decisions if you don’t know how much there is in the community and where it is.”

And to further deplete the people in county jail at 201 Poplar, Criminal Court Judge John Campbell has suspended all bench warrants in General Sessions Court.

People who are served bench warrants missed their court dates and are picked by law enforcement to wait in jail for the disposition of their cases. They are now being allowed to miss them.

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“That means we will see a rapid decline in our jail population,” Harris said.

As of this week, inmate population at 201 Poplar is 1,900, down from 2,700 late last year.

The county Wednesday alerted employees that free mental health counseling is available through face-to-face meetings or teletherapy. The number to make an appointment is (901) 458-4000.

“We have in-person therapy, but we’re really pushing and promoting the teletherapy,” Harris said, “which is a new benefit we’ve been able to put together in the last few weeks.

“We know that we are in a very tough environment where there’s a lot of fear and anxiety around contracting COVID-19 or spreading it to members of your family and all sorts of unique stressors related to this public health event. We want to let our employees know, and I want to encourage other employers to let their employees know, that it is OK to protect your mental health, and counseling is one way to do it.”

COVID-19 in Memphis and Shelby County: April

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