Virus Outbreak North Dakota (ASSOCIATED PRESS)

North and South Dakota are in the midst of a coronavirus outbreak that experts have said is “as bad as it gets anywhere in the world,” prompting the states to take drastic action, including considering common public health actions they have long resisted.

“Our situation has changed, and we must change with it,” said North Dakota governor Doug Burgum, a Republican, in a video address on Friday, which included announcing a mask mandate. Mr Burgum had previously resisted imposing mask rules in the state, and his Republican colleague, South Dakota governor Kristi Noem, still does.

As our COVID-19 situation changes, we must change with it. Tonight, we announced four measures designed to reduce the rampant spread of infections in our communities, protect our vulnerable, ensure hospital capacity and keep schools & the economy open.

— Gov. Doug Burgum (@DougBurgum) November 14, 2020

Now South Dakotans must wear masks inside businesses and outdoors when distancing isn’t possible. Bars and restaurants have also had their capacities restricted, and asymptomatic health workers in the state who tested positive were given the clear to keep working to meet staffing needs.

Both states, which never entered full lockdowns to begin with, are consumed with history-making outbreaks, with hospitals approaching capacity and the most new cases per capita of anywhere in the US this week. 

In the Dakotas, according to Dr William Haseltine, president of health consultancy ACCESS Health International, it is “as bad as it gets anywhere in the world.” The stats put them on par with some of the countries hardest hit in the world like Belgium, Czech Republic, and Slovenia.

South Dakota, under governor Noem’s leadership, has taken an even more hands-off approach, not requiring masks and declining to cancel the large events like the state fair and the massive Sturgis motorbike rally, later linked to thousands of cases. Governor Noem has railed against mask-wearing and dismissed “so-called experts” on Covid, plus disparaged lockdowns as “herd mentality.” 

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Dr Doug Griffin, chief medical officer at Sanford Medical Center in Fargo, ND, told NPR on Thursday  he expected things to get bad, but not this bad.

“We had fully expected it would get worse,” Mr Griffin said. “I think what has surprised me is that really just in a matter of days, it’s like we opened up a spigot and a huge number of patients influx to us.”

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