PROVIDENCE, R.I. (AP) — A confidential government report obtained by The Boston Globe shows that while Rhode Island Gov. Dan McKee was saying the state was “ramping down” its testing and vaccination efforts because of lower demand in November, he was warned that COVID-19 was spreading rapidly.

The newspaper obtained an internal memo prepared by the state’s medical advisers dated Nov. 16 that warned of rising hospitalizations and deaths in the state into December. The memo said new cases had risen 56%, hospital admissions by 15% and the test positivity rate had gone from 2.1% to 3.4%, the newspaper reported.

Models contained in the memo warned of an increase of cases in December, predicting a peak of “4,000 cases a week, and noted that the trend might actually lose steam,” the newspaper reported.

According to Johns Hopkins University, over the past two weeks, the rolling average number of daily new cases in Rhode Island has increased by 2,080.4, an increase of 165.9%.

The same day as the internal memo is dated, Nov. 16, the Health Department director, Dr. Nicole Alexander-Scott, warned of rising cases at a news conference, the newspaper reported.

“Now is the time, get your masks ready, your high-grade, quality masks, and make sure you’re wearing them, particularly indoors,” she said.

Speaking on Dec. 30, McKee answered a question about why the state didn’t increase testing sooner, saying, “We always can look in the rear-view mirror on things, and perhaps if you had a crystal ball you could have done that. But remember, coming up on Thanksgiving, this issue was not on the table. Infection rates increased on Dec. 4 and did again on Dec. 11 and Dec. 18, and we’ve been working on this for a couple of weeks.”

In a response to the newspaper, McKee’s administration said the memo was, “only one set of data in a weekly and daily data set that is used to track and respond to the COVID-19 pandemic.”

The administration added, “Fortunately, Rhode Island’s COVID-19 response system is agile enough to ramp up within hours to respond to changing circumstances,” saying that it had increased the number of daily testing appointments available from 10,000 to 16,000 in three weeks.

The administration said that only 60% of testing capacity was being used in October and “that recommendations by the Department of Health to ramp down certain activities are carefully examined and considered for weeks, and often take months to complete.”