In a stark assessment of the ongoing coronavirus pandemic, Tennessee Gov. Bill Lee and members of his administration told lawmakers Wednesday the state will see hospital bed shortages and need to utilize space in college dormitories, convention centers and hotels all while dealing with a "crush" of new patients.

The virus could could kill thousands of Tennesseans in the coming months, according to some projections, and the dire picture was presented by Lee and and other top state officials, including director of the state's COVID-19 unified command Stuart McWhorter, during a roughly 30-minute phone call with lawmakers.

According to audio obtained by The Tennessean, McWhorter said college dormitories, convention centers and hotels would need to be utilized in order to prepare for an anticipated bed shortage.

"We’re working with hospital providers and other providers to help build out — identify assets around the state and this includes convention centers, rural hospitals, (unclear), college dorms, hotels, hotel ballrooms, anything that we can find that’s existing assets that we can get into quickly," he said.

"We know based on modeling that we’re looking at that we will have a bed shortage both with hospital beds as well as ICU beds," McWhorter added. "We’re taking that very seriously.”

As the virus has spread throughout the country and subsequently overwhelmed health care systems, other states and cities are looking to add space in similar places. In New York, the city placed makeshift tents with beds in Central Park and turned a convention center into a 1,000-bed hospital. Officials in Ohio and Louisiana have also looked at utilizing hotels and dorms to meet demand.

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Dr. William Schaffner, a leading expert in infectious diseases at Vanderbilt University Medical Center, said hotels and conference centers would be best used to house patients who didn’t have the coronavirus, allowing hospitals to focus almost exclusively on patients who were acutely ill or had the virus.

The strategy would be similar to what is being done on the USNS Comfort, a 1,000-bed hospital ship docked in Manhattan, Schaffner said. It may be risky to keep coronavirus patients in non-medical facilities like hotels because of the highly contagious nature of the virus, he said.

“We wouldn’t want a hotel to be turned into another cruise ship, where there is widespread transmission, which is exactly what happened, because they couldn’t contain the virus — no big surprise — among the cruise ship personnel," he said.

Lee: 'Biggest crisis' in next two to four weeks

McWhorter's remarks come as state officials have said Tennessee is prepared to handle the ongoing pandemic that as of Wednesday had killed 24 residents and infected 2,683.

He was one of several state officials, including the governor and Department of Health Commissioner Dr. Lisa Piercey, to address both Democrats and Republicans during Wednesday's phone call.

Lee said the purpose of the phone call was to "give you information and give you the opportunity to answer the questions of your constituents."

Like McWhorter, Lee offered a stark assessment of the ongoing pandemic.

“We have a tremendous challenge coming in the next few weeks and we want to be prepared to meet it," he said. "We want to challenge Tennesseans to play their part to address it and at the same time we want to make decisions that protect the liberties of our citizens while calling them to be responsible for having that liberty. Those are the fine lines that we’re drawing and the hard decisions that we’re making.”

Later in the call, while fielding written questions from lawmakers, Lee said the state is concerned about ventilator capacity.

During a Tuesday news conference, officials offered assurances about the availability of beds and ventilators. The governor's office presented a slide Wednesday showing the state had 32% of available floor beds, 32% of available ICU beds and 69% of available ventilators.

McWhorter and Lee's comments come as public health officials, including in President Donald Trump's administration, have similarly alluded to difficult weeks ahead while combating COVID-19. On Tuesday, federal public health officials said between 100,000 and 240,000 Americans could die from COVID-19 by the end of the year.

Despite the federal government's projections, Tennessee has yet to publicly release similar information.

On Monday, the Department of Health declined to respond to a question about projections from the University of Washington's Institute for Health Metrics and Evaluations, which currently indicates as many as 3,200 Tennesseans could die by August.

Although the department declined to comment on the projections, which change daily — Tuesday's projection showed 5,000 deaths in Tennessee — the governor said Wednesday the state is looking at the IHME data.

"We’re working off a particular model from Washington state," Lee said, noting Vanderbilt University is working on its own projections, which are expected any day now.

Once the data from Vanderbilt is released, Lee said the state would combine the two models.

At one point Lee said several lawmakers had asked what the "crush" is going to look like.

“We’re going to have our biggest crisis somewhere between the next two to four weeks,” Lee said. “And that’s why we are working to build out thousands of additional beds and capacity in our state over the next three to four weeks so that we can meet that.”

Speaking to reporters Wednesday afternoon during his daily briefing, Lee said Tennessee is working with the U.S. Army Corps of Engineers to assess locations in major cities that could hold thousands of beds. The governor said as many as 7,000 additional beds could be needed when the pandemic peaks, which he estimated around April 19 or April 20.

Data from the Department of Health indicates that as of Monday, Tennessee had more than 11,900 total beds throughout the state.

In addition to Lee and McWhorter, lawmakers also heard from Piercey, the health commissioner, who said while Tennessee is "ahead of the curve" on personal protective equipment, there is some concern.

"I'm not here to mislead you and say we have tons of it," she said. "But we are ahead of that curve."

Patrick Sheehan, director of the Tennessee Emergency Management Agency, said in anticipation of the state's future needs, officials have bought more than 18 million items of personal protective equipment and other medical equipment.

Sheehan said his agency is also having twice weekly calls with counties across Tennessee in an effort to coordinate to prepare for “when the curve peaks.”

“In a couple of weeks we could see some pretty strong demands,” he said.

Current hospital capacity could get 'washed away' with spike in cases

In Nashville, Dr. Alex Jahangir, the city’s coronavirus task force chair, says he monitors hospital capacity every day. On Wednesday, that was 30% to 35% of possible hospital beds available in the city. But that number varies day to day.

“So when I think we're fine, it is true that this moment in time we are fine. But any day, if we spiked up in the number of patients that need hospitalization, that can quickly get washed away,” Jahangir said.

Dr. Tufik Assad, a critical care physician at Williamson County Medical Center, said the repurposing of hotels and conference centers is an expected step in combating the virus, but questioned why — if the outbreak was on pace to overwhelm hospitals — the governor had not mandated residents to stay home.

On Monday, Lee issued an executive order that closes non-essential businesses and “strongly urges” residents to stay at home. Assad is one of a growing number of doctors who have publicly pressured the governor to take more forceful steps by ordering Tennesseans to shelter at home.

“I’m happy that they are preparing in a way they deem necessary for an overflow of our hospitals beds and our hospital capacity,” Assad said. “But to me that is an extraordinarily dire situation, and I’m not necessarily seeing that language matched by the words out of our governor’s office.”

Beyond the need for additional personal protective equipment, tests, beds and ventilators, the Lee administration said Wednesday it would soon launch a workforce website in an effort to recruit health care workers. The website would help utilize workers who have been furloughed or those not currently in the workforce to help with the pandemic.

Yihyun Jeong contributed to this report.

Reach Joel Ebert at jebert@tennessean.com or 615-772-1681 and on Twitter @joelebert29.