As COVID-19 Cases Rise, Some Governors Resist Lockdowns, Mask Mandates

With coronavirus spiking in the Great Plains and parts of the Midwest, South Dakota – often promoted as a success story by its high-profile Republican Gov. Kristi Noem – has emerged as a major U.S. hotspot, with one of the worst rates of new infections in the country.

Cases have climbed from a daily average of about 220 in mid-September to more than 430 as of this week, and the number of people currently hospitalized for COVID has risen by more than 50% over the last two weeks. But Noem has resisted taking more aggressive measures to curb the outbreak, like a statewide facemask mandate or restrictions on businesses.

On Twitter last week, she claimed that South Dakota was proof that "you don't need lockdowns to be responsible and flatten the curve."

In North Dakota, where daily cases also shot up in the last month, Republican Gov. Doug Burgum has also tried to rein in the virus without resorting to lockdowns or mask mandates.

Last week, Wisconsin Gov. Tony Evers, a Democrat, declared a public health emergency and extended his state's mask mandate, after an alarming rise in cases that has led to record-high new infections and hospitalizations. Cases have climbed by about 75% in the past two weeks.

The Dakotas and other more rural states in the country's interior were somewhat insulated from the coronavirus early in the pandemic compared to coastal cities, says professor Carrie Henning-Smith who studies rural health at the University of Minnesota.

"Residents there may not have clearly gotten the message that this could impact them, too," she says.

After tamping down on a huge outbreak at a meat processing plant, South Dakota kept coronavirus in check for much of the summer, with new infections consistently in the double digits.

Gov. Noem has frequently touted the state's success and encouraged people to visit, including welcoming nearly half a million bikers who gathered in Sturgis for a 10-day motorcycle rally in August.

"We gave people their freedom, by letting businesses stay open," Noem said during a Fox News interview in July.

More recently, in a widely shared video, Noem stands in a corn field wearing hunting gear and holding a shotgun.

"This is how we do social distancing in South Dakota," she declares, before turning around and shooting a pheasant that flies by.

Henning-Smith says there is an inaccurate perception among some politicians and members of the public that places such as the Dakotas do not have to take the same kind of public health measures as other parts of the country.

"Not every person in South Dakota has the luxury of choosing to spend their time out hunting by themselves in an isolated location," she says. "You can't look at the numbers and say what's happening there is working."

Even with the increase in cases, South Dakota hospitals are not overwhelmed with COVID-19 patients.

"We do have plenty of beds, we have plenty of ventilators, we have staff that we've cross-trained," says Dr. Allison Suttle, the chief medical officer at Sanford Health, a major health care system headquartered in Sioux Falls.

"So we feel pretty confident as we're watching these numbers that we're going to be able to manage anyone with COVID that comes through our doors," she says.

But there are signs that could change in the coming weeks as infections spread to more vulnerable populations, said Bonny Specker, a professor and epidemiologist at South Dakota State University.

"We're seeing a much higher number of cases in the 60-plus age group" she says. "The hospitalizations are going to increase, so I don't think it's under control at all."

Most concerning for South Dakota is the number of tests coming back positive, which has now climbed to around 25% – an indication that the state is not testing nearly enough people.

In North Dakota, the positivity rate is only about 7%.

Specker says there continues to be too much of a disconnect between the urgency of the situation and the public view of how the pandemic is affecting her state.

"I can get pretty discouraged about this whole thing," she said. "I have to keep thinking that if we educate people they'll listen to the science and not the politics and misinformation."

In the absence of a statewide mask requirement, Brookings – the fourth largest city in South Dakota and home to the state university – passed its own citywide facemask mandate in early September.

Nick Wendell, who is on the Brookings city council, supported the measure, which he acknowledges came up against some very loud opposition.

"You really can't make public health policy in the midst of a crisis by a straw poll," Wendell says. "You've really got to rely on medical experts and the public health experts."

But the councilman says he appreciates how his governor has approached the pandemic and left decisions up to local lawmakers.

"Certainly the growth of the virus in South Dakota is concerning, but I'm not opposed to the way our state has handled this virus," he said.

The day after the city passed the mandate, Michael Johnson, a chef and general manager of the Pheasant Restaurant and Lounge in Brookings, says his phone started ringing non-stop.

"With people saying 'like, oh my gosh I feel safe to come out now. I was a little leery before,'" he says. "We started seeing faces of people we hadn't seen."

Johnson believes the mask mandate has made a big difference. His restaurant is busier because people are more comfortable being in public and know there are rules in places to help protect them from the virus.

But Johnson said the decision divided Brookings in a way that he'd never seen before.

"The public dialogue just got kind of angry and divisive, it turned into a reflection of what we see on a national level with these screaming matches." he says. "I thought that was very uncharacteristic of our community."

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