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While making endless decisions as he steers a state through a life-or-death crisis, Gov. Bill Lee has come face to face with his own ideology.

A global pandemic can prompt that.

Traveling across Tennessee in a campaign RV and in speeches during his 14 months in office, Lee touted his long-held belief that government is often not the solution to a problem.

But now, government intervention is what — at least in the short term — will sustain many Tennesseans financially through an unprecedented crisis, and, according to medical experts, save some of their lives.

“I certainly have had to think about that in a way that I’ve never had to think about it before,” Lee said Monday from his office in the Tennessee Capitol.

He taps on his desk, fidgeting with a pen as he thinks about his words.

With no respect to political party, the coronavirus outbreak has left hundreds of thousands in the state without paychecks and has infected several thousand, some of whom have not and will not survive.

The government, at his command, will buy much-needed medical equipment, open temporary hospitals, conduct testing, provide cash assistance and attempt to reimburse providers who care for the uninsured.

And each afternoon, Tennesseans tune in through livestream to look to the leader of the state for answers about what they should be doing and what’s to come.

Lee reflects on how to reconcile his reluctance toward government intervention with the need to keep the state afloat.

“And this will give me a good experience to think about it and go, ‘You know, how much should government be involved?’” he said.

Make no mistake: Lee is confident that he will come away from this crisis with his small-government inclinations intact. But they will likely be stretched.

“When you never have to deal with that, it’s easy to say how you feel about that,” Lee said.

His decision to issue a statewide stay-at-home order, to close businesses that pose a particular health risk to customers and to encourage local law enforcement to take reasonable action to enforce the order, among others, was one he held off on for as long as he could possibly justify.

When other governors were quick to impose shelter-in-place orders — and despite mayors and the medical community in Tennessee asking Lee to do so — Lee was reticent to use the full power of the state.

As the crisis grew, that changed.

‘Urged’ to ‘required’

The night of March 4, Tennessee was still in the throes of its immediate response to a series of deadly tornadoes that devastated thousands of homes and businesses the day before and killed 25 people.

President Donald Trump would be coming two days later to assess damage.

Butch Eley, Lee’s chief operating officer, was working on a disaster declaration letter to Trump with chief counsel Lang Wiseman and his deputy, Clark Milner, when he got a text from the state health commissioner asking him to call.

Tennessee had its first case of the coronavirus, said Dr. Lisa Piercey, a pediatrician who is tasked with leading the state Department of Health through the ongoing crisis.

Eley would get word to the governor, and the next day the state would announce the news.

A week and a half later, Lee had urged all schools in the state to shut down by March 20.

Lee moved to stop dine-in service at restaurants and close gyms. But despite mayors in Nashville, Memphis and Knoxville doing so, Lee over the following weeks held off on enacting wider-ranging orders, insisting that Tennesseans would voluntarily follow guidance to stay home and avoid crowds.

By March 30, Lee enacted his own “safer at home” executive order urging more Tennessee businesses to close and asking residents to stay home, though spelling out hundreds of businesses and activities deemed “essential” under the order. Lee stopped short of compelling residents to stay put in order to protect personal liberties, he said.

Then, on April 2, there was another shift.

In what amounted to a change of a single word in his earlier executive order — “urged” to “required” — Lee announced that his guidelines were now a mandate. After more than two weeks of resisting calls by a group of Tennessee doctors to enact stricter restrictions, Lee told reporters he had finally seen data convincing him it was time to lay down the law.

The state released traffic data collected by the Department of Transportation, along with cellphone movement data posted publicly by a private company, that showed Tennesseans, specifically in rural parts of the state, had hardly reduced their traveling.

It’s what finally “tipped the scale,” Lee recalled.

“I just kept saying, no one has shown me anything,” he said of the weeks leading up to his April 2 decree. “There isn’t a state in this country that has proven that a particular method is working for them. Of course they haven’t. This thing has been going on for four weeks.”

The only thing he knew was that physically distancing people from one another could stop the spread of the virus. Lee said up until then, he had remained conflicted about the most effective way to convince people to do that.

While the governor was being criticized in national media for his response — repeatedly being compared to Democratic Kentucky Gov. Andy Beshear, whose state had fewer cases and instituted an emergency declaration before Tennessee — he doubled down on needing to take a measured approach.

Since then, the picture has changed somewhat. Tennessee has far outpaced Kentucky on testing. The state has conducted about 884 tests per 100,000 people, compared to Kentucky’s rate of 518 per 100,000 residents. As of Thursday, 77 people have died in Kentucky and 94 in Tennessee.

Lee had talked to other governors on the phone, both on conference calls with the National Governors Association and Republican Governors Association, but also one on one.

He had been calling about a half-dozen epidemiologists from the state and from Vanderbilt University.

He had talked with former U.S. Sens. Bob Corker and Bill Frist, two Tennessee Republicans whose positions had somewhat differed on the coronavirus discussion: Corker’s on the importance of preserving the economy and working to quickly open up the country on a regional basis, and Frist’s on the need to take further action to keep people at home.

Frist, a surgeon whose family founded HCA Healthcare, the nation’s largest hospital company, has spoken out about the importance of maintaining physical distancing.

“I just called him one day and said, ‘I could use your help,'" Lee said.

The governor sat by the road near his farm a couple of weeks ago and talked to Frist for an hour.

By the time Frist on April 2 had added his name to a petition of doctors urging Lee to take more action and implement a stay at home mandate, Lee said he had already seen the travel data and made up his mind to do so.

“He has been a great encouragement,” Lee said.

Tom Ingram, a longtime Republican political strategist who was chief of staff for Lamar Alexander as both governor and U.S. senator, emphasized the importance of sending a clear message about the crisis and how seriously people should have been taking it.

"It’s understandable for a governor to need to accommodate multiple perspectives," Ingram said. "But in an unprecedented life or death situation, decisive — and likely highly controversial — measures must be taken."

That means decisions, even early on, may fly in the face of members of the state's conservative, small-business owning community, he suggested.

“To some extent, it was inevitable that the governor was going to continue to get pushed to more and more shelter in place, more and more distance, more and more restrictions,” Ingram said.

“And to the extent that that was put off, I think it very well may have created some confusion and lack of clear direction that we may look back on and think should have been clarified sooner.”

‘Consoler in chief’

On Saturday, April 4, the governor woke at 5:30 a.m.

It was the opening day of turkey hunting season in Tennessee.

He shot one during his early morning session in time to get back to his house for the daily 8:30 a.m. COVID-19 Unified Command call.

Lee rode his four-wheeler across the family property to visit his grandchildren.

He returned to the house for another phone call.

It’s how Lee is trying to spend his weekends, staying focused on the mountain of work there is to do and decisions left to make, while still taking off what he refers to as “chunks of time” on Saturday and Sunday to reflect and recharge.

His rural Fernvale home in Williamson County — the one he designed at age 27, on the family farm where Lee has spent nearly his entire life — is a respite for part of the weekend, a 40-minute escape from the Tennessee governor’s residence in Nashville’s Oak Hill area.

On the farm, he can walk down the road and think about points in his life.

Memories playing as a kid.

The period just after the birth of his first daughter.

When his dad died.

The devastating season when his first wife, Carol Ann, died.

Updating things when he and Maria Lee got married to make the house feel like theirs.

“It puts into perspective where I am right now in my life,” Lee said, sitting at his four-person kitchen table at the governor’s residence, shoveling down a concoction of oatmeal and Greek yogurt as he paused to think.

He sipped a juice of carrots, beets and kale, a drink he makes himself every morning and reserves extra in a small glass — covered in plastic wrap in the refrigerator — for Maria.

It’s the same breakfast the small business owner turned governor has eaten for years. The juice component started even earlier, 17 or 18 years ago, when he felt as if his life was unraveling and he needed to make a change.

Carol Ann had died in a horseback riding accident a few years earlier, and Lee was trying to raise their four children on his own. Lee Company, his HVAC, plumbing and electrical services business, was going broke.

He called his doctor about severe heartburn.

It was around 2003 or 2004, and Lee thought he might die.

He started juicing at the urging of a woman at church, and he vows it changed his life.

“And I’m an old man, right?” Lee continues as he sits at the table. “I’m 60 years old, and I’ve lived in the same place all my life, and I’ve seen joy and tragedy and fun times and really hard times all on that road.

“And you have to put it into perspective, otherwise it would overwhelm you.”

He has gotten criticized for, particularly early on, not speaking as directly of the bleak forecasts of the coronavirus, though the governor and advisers at news briefings have since issued starker warnings to Tennesseans.

Lee has borrowed the phrase "the storm is passing over," a line from a 1905 hymn by Charles Albert Tindley, an African-American preacher and musician.

He repeats it at news conferences. He ended an op-ed with it late last month. A narrator reads the hymn's lyrics in a video Lee's office recently put out about rebuilding from the tornadoes.

“I say things in the midst of press conferences sometimes that people might wonder, ‘Why would he say that?’ or ‘that’s not important here’ or ‘that shouldn’t fit into a press conference,’” Lee said, beginning to list some of the comments he frequently makes.

“Pray for our state, pray for the people that are sick, pray for your leaders that have to make decisions. Discernment. Wisdom. But I think for the vast number of people, those are things that they want to find hope in.

“If I can be a consoler in chief at the same time I’m making the right decisions from the executive branch standpoint, I want to be both of those things.”

Lee's day of coronavirus crisis management

Lee begins his weekdays at the headquarters of the Tennessee Emergency Management Agency in South Nashville.

At 8:30 a.m. on Monday, just after finishing a phone interview in the car with a Cookeville radio station, he is surrounded by members of his COVID-19 Unified Command team, which includes leaders of the health, military and emergency management departments.

They're spread apart at a large table.

Laine Arnold, the communications director, and Lee's chief of staff Blake Harris joined the group.

The governor opens the meeting with prayer before receiving updates on progress with an outbreak at a Gallatin nursing home — the state hadn't found it to be at fault — and on positive tests among an outside food worker and a corrections counselor at a prison in Bledsoe County.

They talk about anticipated locations for where the U.S. Army Corps of Engineers will set up temporary hospitals.

By 9:55 a.m., Lee is seated with his senior staff: Harris, Arnold, Eley, Wiseman, senior adviser Brandon Gibson, legislative counsel Liz Alvey and policy director Tony Niknejad.

They're the same team that has surrounded the governor daily for the last year, long before the virus overshadowed Lee's policy goals.

It's in those daily meetings where they talk about decisions Lee may need to make to adjust state government operations during the pandemic: extending the expiration date of driver's licenses; closing down state parks; requiring appointments rather than allowing walk-ins to apply for government assistance.

Lee steps out early to join an hour-long video call with Vice President Mike Pence and other governors, a virtual conference he watches on a large television wheeled in front of his desk. His personal aide, Alec Richardson, stands over Lee's right shoulder and takes notes for the governor.

When it ends, his executive assistant brings him a stack of photos and letters needing his signature. Lee then gets on a call with Cookeville Mayor Ricky Shelton and Putnam County Mayor Randy Porter to talk about ongoing tornado relief.

By 12:15 p.m., his executive leadership team — largely the same roster as his senior staff — returns to his conference room to meet over a lunch of food from Chick-fil-A.

They talk about how, given new, less severe projections and after confirming capacity, many hospitals could likely handle coronavirus surges within their own buildings, and may not need off-site beds.

They'll continue planning to construct them anyway.

In light of rosier updates from the University of Washington's Institute for Health Metrics and Evaluation's modeling for the state, Lee's team discusses swapping out some of the previously identified temporary hospital sites at convention and expo centers for vacant buildings. It would allow the larger commercial spaces geared toward tourism to be able to reopen sooner, should the state of the virus and the economy permit.

They discuss implementing widespread blood testing for antibodies to determine who has already caught the virus and is immune.

After the meeting, he moves to spending an extended period of time with Arnold and Harris to prepare for his daily 3 p.m. news briefing.

'Bad news doesn't get better with time'

There are a lot of factors to weigh when navigating a crisis.

Alan Levine, president and CEO of Ballad Health in Northeast Tennessee, is familiar with the tension. He previously served as health secretary in Florida through 10 major hurricanes and in Louisiana for two more.

While Levine was working in former Louisiana Gov. Bobby Jindal’s Cabinet, the state weathered the H1N1 pandemic of 2009 and the Deepwater Horizon oil spill.

Levine, whom Lee appointed earlier this year as a member of the state’s charter school authorization board, said he understands that regardless of planning, unexpected outcomes will occur. Critics won’t usually see the full scope of information a governor must process before coming to a decision.

He gives Lee a lot of credit for that. He remembers, as a health official in Louisiana, forcing a nursing home to evacuate to the northern part of the state ahead of a hurricane. The plan fell apart.

“The nursing home that they evacuated did not flood, did not lose power,” Levine said. “The nursing home they evacuated to caught fire. Every decision you make has consequences.”

But in phone calls over the past couple weeks with Lee’s advisers, Levine, like others from the health care industry around the state, cautioned them that a stay-at-home order was important. A few days before Lee made the decision, Levine spoke again with the governor’s chief of staff.

Levine’s advice: “Bad news doesn’t get better with time.”

He and Harris both seemed to agree, Levine said, that if the state didn’t do something different than it had been to keep the spread from continuing unchecked, Tennessee could get in over its head.

“I don’t know what was in the governor’s head when he made the decision,” Levine said. “I can only surmise that the governor believed the stay-at-home order was like slinging a sledgehammer, and before he swung the sledgehammer, he wanted to make sure there was nothing more surgical he could do.”

Michele Johnson, executive director of the Tennessee Justice Center, the state's leading advocacy group for Medicaid expansion, says she doesn't believe Lee was under the impression that bleak evidence about the coronavirus was a hoax.

"When he spoke, it was clear this was weighing heavily on his heart," Johnson said.

But for weeks, the governor was not quick to take sweeping action to mandate residents to stay at home.

Johnson said it appeared Lee was being "haunted" by a segment of his base who had their doubts about the seriousness of the virus and concerns about the ramifications of closing down businesses.

"I understand it’s a weighty decision that involves a balancing of health and economy, and when I look at other Republican governors who took those same challenges and came out saying, 'We're going to shut it down,' it's disappointing that Gov. Lee didn’t do that," she said.

Senate Minority Leader Jeff Yarbro, D-Nashville, has a draft folder on Twitter these days full of unpublished criticisms about the government's coronavirus response.

But now is not the time for partisan bickering in the state just for the sake of disagreement, Yarbro said.

"It's a time when the minority party has to find ways of working with the other side without shying away from their responsibility to push the executive to do the best job possible," he said.

He, too, noted that the governor has not appeared to be in denial or cavalier about the threat of coronavirus.

But Yarbro believes that the state's leader must "be capable of getting to the best decision as quickly as humanly possible," in the midst of such a life-or-death situation.

"There still hasn’t been a briefing that lays out a coherent strategy for the state, and when you can't see the strategy, you can't help but worry there isn’t one," Yarbro said.

'Who gets to be in this spot?'

It's hard for anyone to see clearly what's next.

Projections have rapidly changed in the course of days. Plans made a week earlier have been reconsidered as more data has emerged.

A state like Kentucky, lauded for its early performance, is hardly better off than Tennessee as it has seen its own number of deaths rise.

But much of Lee's hope now is in the ability of widespread testing to help manage the spread of the coronavirus, both to determine who has the virus and, as an antibody test becomes widely available, who may be immune.

Not only does Lee want to continue to increase current testing, the governor is envisioning a point in which anybody who wants to take an antibody test will be able to easily in order to better understand how the virus has or has not spread.

He does not have any intentions of mandating it.

"There's some evidence that maybe this has been around for longer than three or four weeks, and that maybe people are walking around who have had it and now are beyond it," Lee said. "That would be really helpful."

Lee knows that other facets of life will change, as well.

The role of technology in everyday life.

People's priorities in life, which have a way of shifting during tragedy.

The decisions that Lee has made have been "grueling," he said.

"But in spite of all that, who gets to be in this spot?" Lee asks.

The governor continues to tap on the surface of his desk as he thinks. It's almost 6 p.m., when he'll have another conference call.

"I'm really glad to be able to do it. I will be really glad when it's over, when this pandemic has subsided," he said. "But I'm glad to be in this spot."

Reach Natalie Allison at nallison@tennessean.com. Follow her on Twitter at @natalie_allison.