FARGO — North Dakota ranks near the top of states in cumulative COVID-19 infections per capita as the omicron wave rages, near the bottom in vaccination rates and last in mask usage.
Why is North Dakota such a laggard in taking precautions against a virus that has killed more than 2,000 residents and hospitalized thousands more in less than two years?
Public health officials have grappled with ways to increase vaccination rates. One major reason for residents’ indifference, according to surveys by the Census Bureau compiled by QuoteWizard , is skepticism that the coronavirus poses a major threat.
In surveys exploring vaccine hesitancy, 45% of respondents in North Dakota didn't view COVID-19 as a big threat. That ranked second only to Maine, where 50% of residents did not view the virus as a big risk — but 76% of the population in Maine is fully vaccinated, compared to 53.1% in North Dakota.
Neighboring states with higher vaccination rates than North Dakota also were more skeptical than the 25% in the United States who didn’t see the virus as a big threat; 33% in Minnesota and 39% in South Dakota didn’t see the virus as a major risk.
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What lies behind that skepticism?
“You could call it political, you could call it downplaying the pandemic early on,” said Kylie Hall, operations director of the Center for Immunization Research and Education at North Dakota State University, which works to increase vaccine participation.
Although the omicron variant now surging has a reputation for being milder than the delta variant, it remains deadly for those who are vulnerable, especially the unvaccinated, she said. Because it is so contagious, it also threatens to overwhelm hospitals.
Largely because of misinformation, there has been a failure to communicate the continuing threat posed by the coronavirus, Hall said.
“There are people dying every day from omicron,” she said. “People are still dying from omicron and they’re vulnerable.”
North Dakota ranked second among the states with 24,857 cumulative infections per 100,000 people, second only to Rhode Island, which had 27,435 in a ranking by the Centers for Disease Control and Prevention on Wednesday, Jan. 12. North Dakota leaders have often pointed to the state's testing efforts as a reason for its high count of confirmed cases.
By comparison, neighboring South Dakota ranked sixth with 22,372 cases per 100,000 and Minnesota ranked 26th with 19,774.
Despite having one of the highest COVID-19 infection rates in the country, and one of the lowest vaccination rates, North Dakota ranked in the middle of states in the rate of deaths from the disease caused by the coronavirus. North Dakota, with 273 deaths per 100,000, ranked 25th. South Dakota ranked 20th with 286 and Minnesota ranked 37th with 195 in a ranking compiled by Statista as of Wednesday.
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But North Dakota could have saved hundreds of lives if it had acted earlier to take steps, including a statewide mask mandate earlier in the pandemic, and done more to promote vaccination, said Dr. Stephen McDonough, a retired pediatrician and former senior health department official.
Now, with mask requirements phasing out even in Fargo public schools and absent in most districts, “You can expect a lot of cases in elementary schools and middle schools and high schools,” McDonough said.
“We should see an explosion of cases in the next month,” he said.
Cases have skyrocketed in North Dakota, which is on the front end of the omicron wave. Active cases in Cass County have surpassed the previous record peak in November 2020, before vaccines were available, and are pushing toward peak levels statewide.
After almost two years of pleas by public health officials to take precautions, people have become more reluctant, McDonough said. “People I think are just getting worn down,” he said.
Still, Gov. Doug Burgum and top state officials could be doing more to stress the importance of getting vaccinated and taking other mitigating measures, McDonough said.
“The public messaging has been weak,” he said. “They don’t seem to care anymore or lack the will to do anything.”
A spokesman for Burgum said the governor has repeatedly stressed the importance of vaccines, even allowing himself to be photographed by news photographers while getting vaccinated. The governor appeared last October with hospital administrators to plead with people to take precautions to ease the strains on health systems.
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“North Dakota has made vaccines readily available to residents in every corner of the state,” Burgum spokesman Mike Nowatzki said. “The governor strongly supports vaccination and believes it is a personal choice that should be made in consultation with one’s trusted medical provider.”
When the omicron variant was first confirmed in North Dakota on Dec. 20, Burgum used his social media channels to amplify state health officials’ announcement of the cases and to stress the importance of vaccines and boosters as the best defense against serious illness from the virus, Nowatzki said.
To address vaccine hesitancy, the North Dakota Department of Health is working with health care providers and others to improve confidence in the COVID-19 vaccines, he said, adding that last week more than 2,500 North Dakotans received their first dose.
North Dakota ranks near the bottom of states in the percentage of the population that is immunized against the coronavirus. Nine states ranked below North Dakota’s 53.1% vaccination rate, while neighboring Minnesota ranked 16th, with 66.1% fully vaccinated, and South Dakota ranked 26th, with 57.8%.
Public health experts have repeatedly said vaccination offers the best protection against infection from the coronavirus, and have said the vaccines are highly effective in preventing hospitalization or death.
McDonough has pointed out that nine of the 10 counties in North Dakota with the highest death rates from COVID-19 — all in the western part of the state — had immunization rates below the state average.
