If North Dakota was a country, it would have the world's worst confirmed COVID-19 outbreak, one analysis shows

3D print of a SARS-CoV-2—also known as 2019-nCoV, the virus that causes COVID-19—virus particle. The virus surface (blue) is covered with spike proteins (red) that enable the virus to enter and infect human cells. (Submitted / National Institutes of Health)
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BISMARCK — The Czech Republic currently has the most confirmed COVID-19 cases per million people worldwide. But if North Dakota was its own nation, it would surpass the per capita COVID-19 case count of the central European country, according to a Financial Times database.

The database, which tallies COVID-19 cases in each country using data from the European Centre for Disease Prevention and Control, Johns Hopkins COVID-19 Tracking Project and other governmental agencies, shows the seven-day rolling average for the number of confirmed COVID-19 cases in the Czech Republic, when broken down per million, totals 810 per million. However, North Dakota surpasses that at almost 919 COVID-19 cases per million for its seven-day rolling average.

The Financial Times database points out that, "Governments’ stark daily figures on the spread of coronavirus are difficult to compare across countries," as many countries do not conduct rigorous testing. The number of cases in some countries may be undercounted, as they do not have the resources to do regular COVID-19 screenings.

In contrast, North Dakota conducts some of the most rigorous testing in the United States.

North Dakota's exceedingly high number of cases per capita was pointed out on Twitter and MSNBC after physician Eric Topol highlighted that the state outranked the Czech Republic in the Financial Times database.


When asked about the analysis, Mike Nowatzki, spokesperson for Gov. Doug Burgum, said it was important to note that North Dakota is conducting COVID-19 testing at nearly four times the rate of testing that is being done in the Czech Republic, citing information from the publication Our World in Data. Nowatzki said that since North Dakota conducts thorough testing which finds many asymptomatic positive cases, it drive's the state's per capita rate higher.

With the prevalence of COVID-19 increasing, North Dakotans should do what they can to help curb the spread of COVID-19 like wear face masks, wash hands, physically distance from one another and avoid large gatherings, said North Dakota Department of Health spokesperson Nicole Peske.

"The numbers are certainly not going in the direction we would like them to, but the increased mitigation efforts taking place in communities and by individuals across the state is promising," Peske said in a statement. "Now is the time for all North Dakotans to really be aware of the efforts they are personally taking to slow the spread."

On Wednesday, Oct. 21, the Department of Health reported another 516 cases as active cases dipped slightly to 5,974.

The state announced Tuesday evening that it is now asking residents to conduct their own contact tracing as the state's operation is overwhelmed by the number of cases.

An additional 10 deaths were reported on Wednesday, including two residents of Burleigh County, two residents of McLean County, two residents of Ward County, and one each from Emmons, Kidder, Oliver and Stutsman. All were in their 60s to 90s and had underlying health conditions.

The U.S. Centers for Disease Control and Prevention says older adults and people with HIV, diabetes, asthma, liver disease or other conditions that compromise one's immune system are at a greater risk of serious illness or death from COVID-19.

The state's total COVID-19 death toll is now 422, of which 152 deaths have occurred in October, according to the state.


At least 258 of the state's deaths have come in nursing homes and other long-term care facilities, many of which have seen skyrocketing cases among residents and employees in the last month.

North Dakota reported the most COVID-19 cases and deaths per capita in the nation over the last week, according to The New York Times .

Hospital beds in North Dakota continued to remain tight with only 17 ICU beds and 224 in-patient beds available as of Wednesday.

Cass County, which includes Fargo and West Fargo, has 1,351 residents known to be infected with the illness — the most of the state's 53 counties. It announced an additional 97 cases Wednesday.

Ward County, which encompasses Minot, announced an additional 90 positive cases on Wednesday which now brings the county's active cases to 586.

About 8% of the 6,176 residents tested as part of the latest batch received a positive result, but 20% of residents tested for the first time got a positive result.


North Dakota does not report a seven-day rolling average for positivity rate, but Forum News Service calculated the rate to be almost 11% for all residents tested and about 18% for tests taken on previously untested residents.

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

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Michelle (she/her, English speaker) is a Bismarck-based journalist for The Forum of Fargo-Moorhead and Report for America, a national service organization that places journalists in local newsrooms to report on under-covered topics and communities.
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