PHOENIX (AP) — Under increasing pressure to take a harder line against the spread of the coronavirus, Gov. Doug Ducey stayed the course Thursday, recommending people avoid crowds but stopping short of a statewide mandate for businesses to close or people to stay home.

The Republican governor has taken a restrained approach for statewide rules as a growing number of Arizona mayors impose emergency restrictions on businesses. Tempe — a nightlife hotspot — on Thursday joined cities including Phoenix, Tucson, Flagstaff and Sedona that have ordered bars and gyms to close while restaurants offer only takeout or drive-thru service.

The White House and Centers for Disease Control and Prevention urge Americans to avoid groups of more than 10 people, avoid bars and restaurants, work from home whenever possible and skip discretionary shopping trips. The mayors, and governors in several other states, have ordered business owners and residents to follow that guidance.

“Maybe today is the day we can convince @dougducey to take action and enforce the new WH/CDC guidelines to keep Arizonans safe and save lives. Please help,” Democratic Sen. Kyrsten Sinema wrote on Twitter Thursday morning.

Ducey insists he's following the guidance from the state and federal health authorities and will “make the appropriate announcements as circumstances change.”

“I'm going to be guided by the facts and the situation on the ground in the state of Arizona,” Ducey told reporters in a news conference Thursday.

Earlier this week, he said Arizona is a large state and his guidance recognizes “things are different in Tombstone than they are in Tucson. They're different in Gilbert than they are in Globe." He said he respects the decisions that mayors are making for their own jurisdictions.

Public health officials said there were 44 people known to have COVID-19 in Arizona, up from 30 on Wednesday as the availability of tests slowly ramps up. State officials say the numbers will increase quickly as authorities boost their ability to confirm that people have the disease.

Several of the new cases were found in Maricopa County, while Coconino County on Wednesday saw its first case.

For most people, COVID-19 causes only mild or moderate symptoms, such as fever and cough. For some, older adults and people with health problems, it can cause more severe illness, including pneumonia.

Dr. Cara Christ, head of the Arizona Department of Health Services, said some of the patients known to have the disease are elderly and she knew of three people whose symptoms were severe enough to require hospitalization.

The vast majority of people recover from the virus. According to the World Health Organization, people with mild illness recover in about two weeks, while those with more severe illness may take three to six weeks to recover.

The fight to limit the spread of the virus has led to increasingly restrictive attempts to cut down on unnecessary interactions between people. Public health authorities hope aggressive action now will prevent the health care system from being overwhelmed with more sick people than can be effectively treated at once.

That fear has driven the pressure on Ducey to act more forcefully, much of it from Democrats.

“I think our governor’s been way too slow-footed,” said Dr. Randall Friese, a Democratic Arizona House lawmaker who is a trauma surgeon. “We need bold leadership to save lives. And we need to look back on this time and say we did too much. We don’t want to look back on this time and say we didn’t do enough.”

U.S. Rep. Greg Stanton, a Democrat and former Phoenix mayor, said this week Ducey should mobilize the National Guard.

“If we need the National Guard, I'll call the National Guard up,” Ducey said.

On Thursday, Ducey and state schools chief Kathy Hoffman passed out food to families driving through a west Phoenix school to draw attention to the meals available for children. With schools closed until at least March 27 and workers in many industries losing wages, school districts are ramping up their food distribution to families in need.

"We want to ensure that every child in Arizona, who needs meals during mandatory school closure has access to nutritional assistance," Hoffman, a Democrat, told reporters.

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Associated Press writer Bob Christie contributed.