Deborah Birx, the White House Coronavirus Task Force coordinator, listened during a phone call Friday morning as Mississippi Health Officer Thomas Dobbs walked her through the details he and Gov. Tate Reeves planned to announce later that day that would relax parts of Mississippi’s previous statewide shelter-in-place order.

Birx, who has been in close contact with Mississippi officials, expressed support for the plan and optimism about the state’s pandemic outlook, according to a source with direct knowledge of the call.

A few hours later, as hundreds of thousands of Mississippians watched and listened live, Reeves announced he would allow most retail businesses in the state to reopen, but not close-contact establishments such as hair and nail salons, barbershops, spas, gyms, casinos and entertainment venues.

“This weighs very, very heavily on me,” Reeves told Mississippi Today in a phone interview on Thursday, the day before he announced his new order. “We’re doing this methodically and cautiously. Obviously the health and safety of Mississippians is my top priority, but part of that conversation has to be about whether to reopen the economy. It’s a difficult balance to strike.”

In the days leading up to the Friday announcement, government officials across the state had considered it to be an inflection point in the state’s response to the pandemic. State agency heads and even administrators at the University of Mississippi Medical Center, the largest medical center in the state, prepared for the governor to completely reverse his previous decision to order many Mississippians to stay at home.

Reeves, Dobbs and several people close to the two officials spoke several times last week with Mississippi Today to provide insight into the deliberations that would culminate in Reeves’ Friday announcement. The governor’s chief consideration last week: weighing the state’s health data and newly issued reopening guidance from the White House versus the political and economic effects of relaxing or extending his earlier shelter-in-place order.

The state’s COVID-19 data available to Reeves and Dobbs on Friday morning, paired with the White House’s guidance on how states should start to reopen, showed it was too soon to fully roll back shelter-in-place restrictions. Mississippi Today analyzed the data available to the two officials on Friday shortly before they announced the decision. (Data have since changed and spiked in some cases.)

Cases will never flatten or decrease until the disease is eradicated. But metrics such as the number of new cases, when folks become ill and total tests completed, when analyzed both daily and weekly, paint a picture of the state’s progress in flattening or plateauing the curve of cases.

Before moving to lift shelter-in-place orders and reopening state economies, the White House guidelines issued April 16 generally suggest that states should see three things over a two-week period before beginning to roll back shelter-in-place orders:

• Flu- and COVID-like symptoms should trend down.

• Number of new daily cases should decrease or represent a smaller proportion of all tests, while test volume increases or flattens.

• Hospitals are able to treat patients without crisis care, while also ensuring health care workers can access tests.

By Friday, Mississippi had not met the first two White House thresholds. And while total tests run have consistently increased and continue to outpace most other states per capita, the average daily tests run and weekly total tests have started to decline. As of Friday, looking back a week, total weekly new cases grew by 25 percent and total weekly tests decreased by 27 percent.

Tracking new and total cases is dependent upon testing — the more tests completed, the more cases are identified, traced and, ideally, isolated. Last week saw the most and second-most new cases ever last week, at 300 and 281, though officials have reiterated that testing delays and reporting lags — even when operating efficiently — can lead to varied peaks and valleys in new cases reported any given day.

As for the health care system’s capacity, Mississippi officials have said the state successfully thwarted capacity issues and avoided extreme projections, meaning Mississippi’s data satisfied the third White House guideline. However, while intensive care unit and ventilator usage remain relatively stable, the number of patients hospitalized with confirmed and suspected COVID-19 is still growing.

By most metrics, Mississippi’s new cases have not leveled or declined – and appear to still be climbing. Over the last two weeks, chronological new cases over a rolling seven-day period averaged 159 daily cases two weeks ago, 189 daily cases one week ago, and 234 daily cases Friday. (Averaged daily cases over a week reached a new peak over the weekend at 249 new cases Saturday.)

The burden of cases and deaths is disproportionately carried by African Americans. As of Friday, black Mississippians comprised 53 percent of cases and 61 percent of deaths despite accounting for less than 40 percent of the state’s populations. Limited data suggest this is echoed nationally.

Though the state’s COVID-19 data failed to satisfy all the White House guidelines, political pressure to reopen the state crescendoed last week as Reeves was weighing his decision.

Last week, Republican governors in other Southern states ignored those guidelines and loosely reversed their previous shelter-in-place restrictions. Georgia Gov. Brian Kemp, a Republican whom Reeves has contacted regularly in recent days, received sharp criticism from both sides of the political aisle — including from President Donald Trump — after drastically reversing his previous shelter-in-place order.

When asked last week if Trump’s suggestions were playing a role in his decision-making, Reeves replied: “What (Trump) has said to me is to open up Mississippi as soon as it’s safe to do so.”

As the influence of national and regional politics crept into the state, Reeves and his political advisers were also strapped with the reality that the central pillars of his successful 2019 gubernatorial campaign — a steady state economy and positive trends in public education — are breaking down.

After Reeves had issued stay at home restrictions and the virus continues to spread, small businesses across the state are struggling to survive or are closing outright, and unemployment filings are at a record high. Public education advocates fear the state’s testing gains will be erased as schools have been closed since spring break and many students and districts have inconsistent access to virtual learning options.

Voters like Jessica Cobb, a self-described conservative Republican in Gulfport who said she voted for Reeves last year, have lost faith in the governor’s ability to lead.

“I know people who are hurting and wondering where their next meal is going to come from,” Cobb, who is unemployed and looking for work, told Mississippi Today. “They’re not getting the help they were promised, they don’t qualify for unemployment because they were self-employed. This is just insanity. It’s people’s livelihoods at stake. This state is a working class state, these people are working class people. He needs to open the state.”

In a Thursday phone interview with Mississippi Today, Reeves acknowledged that small business owners are struggling and called his late March defining of essential businesses “a mistake.”

“Defining any business as essential or not doesn’t take into consideration that any business is essential for many Mississippians,” Reeves said. “So many people have invested everything they have into building their small businesses, and they’re looking at this as the moment when they could lose everything they’ve worked their entire lives for. Government cannot be the reason that happens, and I’m doing everything I can to make sure it doesn’t.”

But through the growing political pressures and criticisms from unemployed Mississippians and small business owners, Reeves has leaned into Dobbs as his closest adviser during the pandemic, several people close to the two leaders told Mississippi Today. Dobbs, an epidemiologist by training, is the head of the Mississippi State Department of Health, a state agency independent of the governor’s office. Dobbs reports to an appointed Board of Health, not Reeves.

Dobbs himself ratcheted up his cautionary rhetoric last week, conceding that it appears the curve is flattening but going out of his way to publicly use phrasing like “still very, very concerned about outbreaks in places where people are close together,” “big box stores are still pretty crowded, it makes me very nervous,” and “I’m not seeing a lot of people wearing masks in the community.”

“The governor has been very thoughtful,” Dobbs told Mississippi Today in a phone interview on Tuesday. “He’s got a lot to balance and I certainly don’t envy certain decisions he has to make. He is extremely attentive to the health implications of this.”

Response to Reeves’ decision has varied, with critics believing that even the slight relaxation of the shelter-in-place order is irresponsible, and proponents believing that the decision was appropriate and measured.

Reeves clarified on Friday that though his new order is statewide, it will not preclude local governments from implementing tighter restrictions on their residents. For instance, if a municipality wants to close restaurants, that option would be available.

“I respect Governor Reeves safer-at-home order, and I appreciate him reopening our state’s economy slowly versus wide open as I feel that is a safer approach to slow the spread of COVID-19 and prevent a relapse in the future,” said Greenwood Mayor Carolyn McAdams. “Leflore County’s numbers are not leveling off but climbing, which tells me we need more time to slow the spread even though strict measures have been put into place and enforced.”

This article was written by Adam Ganucheau and Erica Hensley with MississippiToday.org. Anna Wolfe and Bobby Harrison contributed to this report. The article is republished with permission.