SUBSCRIBE NOW AND SAVE 3 months just 99¢/month



Governor, top doctors warn of North Dakota hospitals at 'redline' capacity for weeks ahead

“Right now, stepping into a hospital in North Dakota is like stepping into an alternate reality,” Hettinger physician Joshua Ranum said in a joint statement released with Gov. Doug Burgum on Friday.

North Dakota Gov. Doug Burgum holds a COVID-19 news conference on Oct. 23, 2020, in Bismarck. Kyle Martin / The Forum

BISMARCK — Gov. Doug Burgum and top North Dakota doctors on Friday, Oct. 1, urged residents to take public health precautions to ameliorate strain on the state's hospital system, which has continued to operate near its breaking point for weeks.

This week, North Dakota reported the most hospitalizations the state has seen since its last COVID-19 case surge one year ago. Virus hospitalizations in North Dakota increased to 161 on Friday for the first time since December, climbing by 28% over the month of September.

In a statement, the governor's office said North Dakota's six largest hospitals had to deflect 43 patients to other facilities on Friday, while a total of 29 patients were waiting for admission to health care centers in emergency wings. Dr. Chris Meeker, chief medical officer for Sanford Health in Bismarck, noted that major hospitals have been unable to accommodate the requests of small rural facilities.

“Right now, stepping into a hospital in North Dakota is like stepping into an alternate reality,” said Dr. Joshua Ranum, a physician at West River Health Services in Hettinger, who called on residents to get vaccinated. “Our hospitals are at a redline capacity and will likely be that way for several more weeks. In stark contrast, one can move about the community almost normally, unaware of the chaos inside the hospital blocks away."

“The health care systems in our state and across the region are at the point of being overwhelmed,” added Dr. Jeffrey Sather, chief of medical staff at Trinity Health in Minot, emphasizing the need for residents to make healthy decisions to avoid additional strain on the hospital system. “We are above our capacity to provide the normal care we all expect."


The state is also reporting more COVID-19 hospitalizations now compared to exactly one year ago. On Oct. 1, 2020, there were 135 hospitalizations, meaning there are about 20% more hospitalizations now compared to last year, according to state health department data. The vast majority of people hospitalized are not fully vaccinated.

"It still does remain a pandemic primarily of the unvaccinated," said Dr. Paul Carson, an infectious disease specialist who teaches at North Dakota State University, in a virtual town hall on Thursday.

The health department said Friday that it's acquired four more ambulances to assist in a growing number of hospital transfers, while the state has purchased 1,000 monoclonal antibody treatments in addition to its federal ration.

State Health Officer Dr. Nizar Wehbi extended the waiver for temporary nurse aid registration in North Dakota to the end of the year. Currently, 65 North Dakota National Guard troops are on duty to help health care staff.

North Dakota's health care system is stressed largely because of staffing shortages, and an increasing number of COVID-19 hospitalizations, on top of other medical emergencies such as strokes and heart attacks, is putting pressure on providers. Health care providers are also concerned that the onset of flu season will further strain hospitals, and have encouraged residents to get vaccinated against the flu in addition to COVID-19. As of Friday, fewer than 10% of staffed hospital beds were available statewide.

People who are vaccinated may still become infected with COVID-19 and require hospitalization. However, in the vast majority of cases, those who are fully vaccinated experience less severe symptoms and don't need to be hospitalized. Only about 0.0714% of fully vaccinated people in North Dakota have been hospitalized due to COVID-19 since December 2020.

“The pressure on hospitals and clinics in both our urban and rural areas is reaching critical levels, and we all need to do our part to avoid hospitalization and prevent further strain on these facilities and their staff as we work through this incredibly challenging time,” said Burgum in the statement.

Statewide case rates

  • ACTIVE CASES: 4,334

Children under age 12 accounted for 645 of North Dakota's active cases. Nearly 30% of the state's active cases are residents under 20 years old.
Burleigh County, which includes Bismarck, had the most known active cases on Friday with 913 cases. Cass County, which encompasses Fargo, had 837 active cases, and Ward County, which includes Minot, had 318.


The state's 14-day rolling average positivity rate increased to 7.43% — the highest since December 2020.

Hospitalizations, deaths


  • DEATHS: 0

  • TOTAL DEATHS: 1,611

Hospitalizations increased by six over the previous day with 155. Three of these hospitalizations were children up to age 5 and two adolescents between ages 12 and 19 were hospitalized.
A total of 15 staffed ICU beds were available statewide as of Thursday, according to a state health department database. Bismarck's two hospitals had two available staffed beds, and Fargo had seven among its three hospitals.


  • FIRST DOSE ADMINISTERED: 366,776 (55.3% of population ages 12 and up)

  • FULL VACCINE COVERAGE: 340,161 (51.3% of population ages 12 and up)

On Thursday, the health department said about 8,000 North Dakotans have received a Pfizer COVID-19 vaccine booster dose.
Only people who have received the Pfizer vaccine are eligible for a third dose. The Centers for Disease Control and Prevention approved booster doses for those 65 and older, residents of long-term care facilities, adults with underlying conditions and people in high-risk occupations such as health care, teachers and grocery store employees.

About 80,000 North Dakotans are currently eligible for a booster dose, said Molly Howell, state immunization manager.

The Department of Health encourages individuals to get information about vaccines at .

As a public service, we’ve opened this article to everyone regardless of subscription status. If this coverage is important to you, please consider supporting local journalism by clicking on the subscribe button in the upper righthand corner of the homepage.

Readers can reach reporter Michelle Griffith, a Report for America corps member, at

What to read next
"We see through the data that when we have a high vaccination rate in facilities, absolutely we have less infection there," said North Dakota Long Term Care Association President Shelly Peterson. "It really does work. It really does make a difference."
They say the surging pandemic is stressing health systems by not only sending more people to the hospital, but also by taking staff away who are either sick with COVID-19, recovering, or have to stay home as caregivers because the virus has closed child care centers.
For the second day in a row, North Dakota reported more than 3,000 new coronavirus cases, a single-day threshold it had not met at any point during the pandemic prior to this week. Virus hospitalizations have climbed from 122 in the first week of January to 170 on Thursday.
The seven-day rolling average positive test rate reached 23.7%.