The rates of coronavirus infection and COVID-19 cases have increased substantially as the reopening of businesses and social activities has progressed. These distressing trends have emphasized the critical importance of implementing an effective economic reopening strategy that minimizes the risks to health. Under the current plan, 89 of the 95 Tennessee counties that do not have locally run health departments operate under a single set of guidelines developed by state government, whereas each of the other six counties with local health departments is tasked with developing its own approach. This approach is perilous from a health perspective.