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As Democrats bashed the state’s response to the coronavirus, Republican Gov. Bill Lee considered declaring a state of emergency Monday, March 9, after Tennessee confirmed its fourth case, according to Health Commissioner Lisa Piercey.

“Obviously, that is on his radar, and he’s working through that and right now we’re working toward what is the threshold to declare that. We don’t feel like we’re there yet,” Piercey said.

Coronavirus daily blog, March 9: Baptist patient improving

A spokesman for the governor said he doesn’t have a number of cases in mind to declare a state of emergency, giving him unique powers to deal with the spread of the disease, and noted the declaration of an emergency would be based on a number of variables.

Meanwhile, the Department of Health is preparing to make a request for increased funding to cope with the outbreak and federal funds will be sought as well, Piercey said after the Tennessee Coronavirus Task Force held its first meeting at the State Capitol.

And two Southwest Tennessee Community College students in Memphis are under quarantine.

The Shelby County Health Department directed two students to self-quarantine following rotations at Baptist Memorial Hospital-Memphis last week, the college announced Monday.

The students were unknowingly exposed to the patient with a confirmed case of COVID-19 and then attended classes in the Allied Health Building Wednesday, Thursday and Friday. The students' last exposure with the patient was March 4, and the two were asked to remain in quarantine until March 18 as long as they remain symptom free, according to the college.

The school says the chances of exposure to other students is low, but is closing the Allied Health Building through March 18 to allow for extra cleaning measures.

To protect the identity of COVID-19 patients in rural areas, the state will not identify the counties of confirmed patients if they live outside one of the state’s urban centers. The fourth patient confirmed Monday was identified only as living in Middle Tennessee, and the state declined to release more information about the patient in Shelby County.

As of Monday evening, the state still had only one COVID-19 case listed on its website. Four cases of COVID-19 have been reported across the state, according to the Tennessee Department of Health, including one in Shelby County, one in Nashville and one in Williamson County.

But Piercey said the site would be updated with more cases started Tuesday at 2 p.m. She also noted the state will be putting more people on its hotline to handle heavy call volume after people across the state got busy signals Monday.

Democratic leaders criticized the reaction and the decision not to release information to protect other Tennesseans.

“I heard a business-as-usual meeting as if we’re planning the building of a municipal library, not a team that is focused on our health department responding to this in a dynamic and day-to-day way to bring this matter under control and protect Tennesseans,” said state Rep. Mike Stewart of Nashville, who chairs the House Democratic Caucus.

For instance, Stewart said he understood the state didn’t question the people who flew on a plane with a Williamson County man who tested positive for the virus because he wasn’t showing the symptoms at the time. The man made a flight to Boston for a conference before returning home and testing positive last week.

“That’s not reasonable. You can get this disease from people who are asymptomatic. That’s on the Centers of Disease Control website, or CDC website. (It) says it’s extremely spreadable and people don’t know where they got it,” Stewart said, contending the state’s response is not consistent with guidance from the CDC.

Democrats are pushing for the expansion of Medicaid to treat some 300,000 uninsured and underinsured Tennesseans who might go to work because they can’t afford a trip to the doctor for treatment of the coronavirus.

House Minority Leader Karen Camper said Monday she hopes to meet with Lee to urge his support for expansion of healthcare coverage to uninsured Tennesseans as coronavirus cases spread.

“This is a time for us — our colleagues across the aisle to join us, really — the governor to join us today, to say Tennessee cares. Tennessee cares about the health of our citizens. Tennessee cares about a … world-class health system,” said Camper, a Memphis Democrat. “We have got to come together on this issue, and I think the time is right now.”

Republicans have declined to expand Medicaid as part of the Affordable Care Act, even though two Republicans are sponsoring legislation to widen coverage this year. It has not been heard in committee.

Piercey, though, said uninsured patients across the state will continue to be treated through safety net hospitals and charitable care as is done under current procedures.

A bill filed Monday — after the Legislature’s deadline — authorized the governor to start negotiating immediately with the federal Centers for Medicare and Medicaid Services and President Donald Trump for waivers to provide primary to all uninsured residents in Tennessee “relative to the prevention and treatment of coronavirus.”

The legislation would have to come out of a committee for late legislation and go to the House floor for consideration, further complicating the potential for its passage, considering Republicans hold a supermajority and are not enthused about expanding Medicaid. The state already is seeking permission from the federal government to receive $7.9 billion in a block grant for most of the TennCare program.

In addition to pushing the legislation, Democrats accused the state of being unprepared to deal with the virus, which started in China and spread into Europe, to the West Coast and into Tennessee.

Stewart said the Department of Health needs to answer numerous questions, including the number of test kits available in the state, the numbers of kits maintained by private healthcare providers, the guidelines for who should be tested, whether an inventory has been done on ventilators to treat the elderly, a plan to care for COVID-19 patients without infecting other patients and staff, an inventory on negative pressure control rooms in cities statewide, long-term facilities, capacity in rural communities including those where hospitals have close and a detailed response to the public.

Piercey, though, said the state has a tracking system that details the capabilities of every hospital in the state, including intensive care unit beds, ventilators and negative pressure rooms where people would be isolated.