BISMARCK — Three months after North Dakota found itself at the peak of a Matterhorn-shaped infection curve, the state is riding the downslope of the COVID-19 pandemic — at least for now.

North Dakota had the second-lowest number of new cases per capita in the country over the last week, behind only naturally isolated Hawaii, according to the Centers for Disease Control and Prevention. It's a quick reversal of fortune for a state that hung around the other end of the infection spectrum for some two months at the end of last year.

The virus's grip on the state may have loosened, but officials continue to urge diligence and patience as the nation crawls closer to herd immunity and an end to the plague.

State epidemiologist Grace Njau said it's unclear how close the state is to the all-important, much-debated herd immunity threshold. Many experts believe at least 70% of the population needs to gain immunity from the virus to reach the target, but Njau noted there's no firm scientific consensus on where the line is drawn.

Available vaccinations from pharmaceutical giants Pfizer and Moderna are thought to ensure immunity in about 95% of those who get the jab. More than 46,000 North Dakotans have received the two required doses, and another 49,000 have gotten a first dose.

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Medical experts also think contracting COVID-19 grants survivors at least temporary immunity. Officially, about 97,000 living North Dakotans have tested positive for the virus, but researchers from Columbia University believe more than 60% of residents may have already been infected with COVID-19.

Njau acknowledged that some North Dakotans have beaten the virus without testing positive, but she said the Columbia analysis may be failing to account for risk-averse residents who followed all of the health protocols for nearly a year. It's hard to know how many persistent mask wearers and social distancers have minimized their potential exposure to the virus, which puts an unknown variable into the herd immunity equation, Njau noted.

"I think that's a group we have not really been paying attention to, so I'm very wary about talking about herd immunity when that group has not been quantified," Njau said.

North Dakota Department of Health epidemiologist Grace Njau. Photo provided
North Dakota Department of Health epidemiologist Grace Njau. Photo provided

At the moment, Njau said, the low percentage of residents testing positive suggests the virus is not very prevalent in the state, but she isn't ruling out flare-ups in the future.

With the recent emergence of more infectious virus strains, it's tricky business predicting how the next outbreak might look, she said, but it would likely have a lower apex than the one late last year. Many health care workers and vulnerable residents have gotten vaccinated, and better treatments are available for those who get sick, so it's reasonable to assume the state's hospitals wouldn't be in the same kind of bind.

Njau said residents should continue masking and refraining from social gatherings to keep the state's virus numbers under control.

From hardest hit to virus-free

No slice of North Dakota's population has experienced a starker turnaround than nursing home residents.

On Nov. 12, 699 long-term care residents and 851 staff were infected with COVID-19. Three months later to the day, just five residents and 25 employees have the virus.

Njau said the disease's near-total disappearance from nursing homes is "good news, but it also comes at a cost." Of the 1,431 North Dakotans who have died, more than 60% were residents of long-term care facilities.

Shelly Peterson, president of the North Dakota Long Term Care Association, said the worst of the pandemic was "tremendously difficult" for nursing homes, adding the industry has "never seen such tragedy and sadness." But, she said, "brighter days are definitely ahead" for the recently battered facilities.

The arrival of vaccines was a major factor in reducing the viral spread in nursing homes — more than 80% of residents and 45% of employees have gotten at least their first dose, said state vaccination coordinator Molly Howell. Peterson said she hoped nursing homes would be insulated from any future COVID-19 outbreaks due to the high rate of vaccination.

The current lack of infection in the facilities is "absolutely amazing" and means better quality of life for those living in nursing homes, Peterson said.

About 80% of skilled nursing homes and all basic care and assisted-living facilities are open for limited visitation, Gov. Doug Burgum said on Wednesday, Feb. 10. In most cases, one masked family member or friend is allowed to visit a resident during designated hours, Peterson said.

Jim Steckler, a resident of Woodside Village nursing home in Grand Forks, received his second dose of the vaccine last month and has since been visited by his sister for the first time in months. He said it's been great to resume socially distanced meals and activities with his fellow residents — the staff planned a Valentine's Day party on Friday, Feb. 12.

Steckler said the pandemic will never leave the minds of long-term care residents, but he's hoping to return to some sense of normalcy this summer. His nursing home used to put on a small outdoor festival every July, and "it would be really nice" to host it this year.