North Dakota is leading the nation in coronavirus deaths per 100,000 people. New COVID-19 cases were at 200 per day or less through the middle of August.
Since the middle of August, the trend of new has been upward rapidly with just under 1,500 daily on the average with some daily spikes around 2,000 per day. (https://www.worldometers.info/coronavirus/usa/north-dakota/) Daily deaths remained below five per day until just after the middle of September.
Since the middle of September, the average is around ten per day with occasionally surges to near 20 a day and a few beyond 25 daily deaths. The alarm that has North Dakota leaders concerned is the mortality rate of over 100 per 100,000 population. (https://www.health.nd.gov/diseases-conditions/coronavirus/north-dakota-coronavirus-cases)
Why North Dakota?
https://www.healthline.com/health-news/north-dakota-has-one-of-the-worst-covid-19-mortality-rates-in-u-s-heres-why There are several reasons – non-mandatory face mask usage, delayed diagnosis and treatment, vulnerable population, shortage of nurses, super-spreader events, risk mitigation measures, pandemic fatigue, and misinformation. There are others, but these are probably the biggest causes.
Face Masks Mandatory
https://www.governor.nd.gov/news/burgum-announces-new-requirements-businesses-gatherings-and-masks-delays-winter-activities The governor never set a firm policy of mandatory face masks. Rather, personal responsibility was left to the individuals. It does not take many people ignoring safety measures to put others in jeopardy.
Delayed Diagnosis & Treatment
https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2020/10/20/covid-19-patients-swamp-rural-hospitals Rural areas tend to smaller populations. However, when a pandemic erupts, the ability to handle larger crowds inside hospitals becomes difficult. North Dakota has few ICU beds for the entire state. Critically ill patients may have to be moved to another state for treatment.
https://med.und.edu/research/vulnerable-populations.html Vulnerable in this context means low socio-economic status, disability risk, and elderly. The Native American population has a higher susceptibility risk for many diseases compared to the rest of the state.
The total hospitalized as of today (https://www.health.nd.gov/diseases-conditions/coronavirus/north-dakota-coronavirus-cases) is 238 patients due to COVID-19 over the age of 60, and 77 below the age of 60. The number of deaths due to COVID-19 is 780 over the age of 60, and 60 under the age of 60 years of age.
Shortage of Nurses
https://www.registerednursing.org/largest-nursing-shortages/ It is not about the total number of nurses. North Dakota has a few more nurses than is needed. It is the location of those nurses. In rural areas, the demand is great, and the availability of skilled professionals is lacking.
https://www.washingtonpost.com/health/2020/10/17/sturgis-rally-spread/ A superspreader event is one in which an infectious disease is spread more than usual. Almost one-half million people attended the August Sturgis Motorcycle Rally in South Dakota that observed no coronavirus restrictions.
Tracing cases from the motorcycle rally showed an onset of coronavirus symptoms within 14 days of that event in multiple states surrounding South Dakota. https://abcnews.go.com/US/80-covid-19-cases-minnesota-traced-sturgis-rally/story?id=74336914 North Dakota, Wyoming, Minnesota, and Montana showed remarkable increases in new confirmed cases of COVID-19.
https://www.nbcnews.com/news/us-news/north-dakota-lets-healthcare-workers-covid-stay-job-record-surge-n1247487 and https://www.health.nd.gov/sites/www/files/documents/Files/MSS/coronavirus/State%20Health%20Officer%20Orders/2020-05.2_isolation_health_care_excemption.pdf
Normally healthcare workers are adequately protected to ensure that they or other patients are not contaminated or infected with the coronavirus. Less than two weeks ago, the North Dakota interim State Health Officer officially declared that healthcare workers with asymptomatic infections could continue to work treating COVID-19 patients in hospitals and nursing homes.
It is felt there are not enough trained workers to handle the current demand and protective equipment can minimize the risk of infecting others. The issue of asymptomatic cases infecting others has been in discussion for months.
Some coronavirus asymptomatic people will never see symptoms and are most likely a non-threat to others. However, the asymptomatic person who does come down with symptoms (usually mild) are carriers who can infect others during their asymptomatic phase.
https://www.cnn.com/2020/11/12/health/pandemic-fatigue-wellness-partner/index.html Relapse is common in many situations. We live our lives a certain way and then change is forced upon us. We accommodate the change and adhere to the restrictions for months. After several months, some of us begin to fatigue from those restrictions.
Most of us are not exercising like we were a year ago. We may be eating less healthy and nutritious foods because of convenience. Alcohol usage, smoking, drugs, and other unhealthy habits increase. These and other factors tweak our minds to rationalize that everything is OK around me. Maybe it is better to relax rather than strengthen the resolve to fight on?
It does not matter what the individual’s reason is for wanting to revert to the good old days. Pandemic fatigue is real.
https://www.valleynewslive.com/2020/10/12/covid-misinformation-and-the-health-risks-of-wearing-masks/ Where do you get information? Public news broadcasts, social media, CDC, or WHO websites? Headlines are attention grabbers. Many times, fear is the reason to capture a person’s attention.
How many times have you seen ‘record-breaking new COVID-19 cases being set daily’ in this state or another? Dig into the data and you may find that there are twice as many new cases than three months ago. More testing is ongoing. However, the hospitalizations have not increased, nor have the daily death rates.
We hear something from a national health authority and a month later we hear the exact opposite from that same person. Testimonial advice is sometimes taken as gospel. What works for your best friend’s uncle may not be the best advice for you to take.
Misinformation and disinformation have been rampant since early March when it comes to COVID-19. I research health headlines daily and have seen complete reversals of ‘facts’ as this pandemic continues.
Is North Dakota unique in geography, demographics, and other factors that made it one of the worst states currently for coronavirus trends? No, there are some unique aspects about North Dakota that could have been mitigated a bit, but we will never know.
House arrest or home quarantines will not stop the virus. There is no current cure or prevention for coronavirus. That being the situation, the simple rules of social distance, hand washing, face masks, etc. do provide a minimum level of protection.
Live Longer & Enjoy Life! – Red O’Laughlin – RedOLaughlin.com