SIOUX FALLS | South Dakota Gov. Kristi Noem on Wednesday doubled-down on her hands-off approach to the coronavirus pandemic by pointing to the state's low hospitalization numbers and cast doubt on key recommendations from public health officials like wearing a mask.
The Republican governor's reluctance to endorse mask-wearing and the state's relatively low amount of testing have some health experts in the state worrying the early success in managing the pandemic could yet be undone.
Noem's refusal to issue statewide lockdown orders has earned praise from conservative pundits, with Newsmax magazine recently dubbing her the "Iron Lady of the Prairie." They point to the state's relatively low COVID-19 numbers as evidence her approach is working. But a closer look shows that South Dakota is currently testing residents less frequently than nearly any other state, leading doctors to worry the state won't be able to catch clusters of infections before they get out of control.
Noem has said repeatedly that "science, facts and data" lead her decisions but that appears to come down to a single metric for determining the state's success in fighting the coronavirus: hospitalizations.
"We weren't going to focus on the amount of positive cases versus negative cases, we were just going to focus on how many people we had in the hospital because we knew that this virus would come. We also know that we can't stop it," she said in a conference call with Center of the American Experiment, a conservative think-tank based in Minnesota.
So far, the number of hospitalizations has remained far from overwhelming the state's hospitals. 54 people are currently hospitalized with COVID-19, according to the Department of Health.
But that's just one piece of the puzzle, said Dr. Jawad Nazir, an infectious disease expert and clinical professor at the University of South Dakota medical school.
"If we don't bring testing up, we are probably contributing to the spread of infection," he said. "If we don't identify sources of spread in our community, then we will end up with compromised hospitals and health care workers."
Over the last seven days, the state has conducted the second-lowest number of tests per person in the country, beating only Hawaii, according to The COVID Tracking Project.
South Dakota's testing has lagged behind most of its neighbors throughout the pandemic, with 9.7% of the population receiving a test. Of the six states that share a border with South Dakota, only Wyoming has tested a lower percentage of its population.
Meanwhile, North Dakota has held regular mass testing events, free to anyone who shows up. In South Dakota, the state's largest health care providers still vet whether people need a test, usually limiting them to people with symptoms
Dr. David Basel, vice president of Clinical Quality at Avera Medical, said health care providers are looking to expand testing but need to make sure they don't run out of supplies.
"Today, we would still describe our supply chain as adequate but still fragile," he said.
Aggressive testing is crucial to containing the virus, Nazir said. While recent infections have come from people in their 20s and 30s, he worried they could spread it to people at higher risk to the virus.
He said mixed messaging on wearing masks is not helpful, either. The Centers for Disease Control and Prevention recommends people wear masks while in public or around people outside their household.
Noem said she refers people to that guidance but went on to call the science on masks "very mixed."
"There's not good science using them or not using them," she said.
An analysis published in the leading medical journal The Lancet found, however, that masks and social distancing can help control the coronavirus, though hand washing and other measures are still needed.
Noem made another claim that defies recommendations from many public health experts, saying that "asymptomatic people very rarely spread the virus."
An official from the World Health Organization said last month that it appears to be rare asymptomatic people transmit the virus. But many other scientists have said there's plenty of evidence that people can spread the disease before suffering symptoms.
Noem appears determined to avoid government lockdown orders or other mandates, often emphasizing the need for businesses to continue operating.
"If you come into a crisis, and you have a leader use more authority than what they really are granted or allowed to, that's how you lose this country," she said.
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