COVID-19 pandemic in South Dakota

On June 4, Noem announced that Mount Rushmore's Independence Day festivities on July 3 would go on as originally scheduled and planned, with no additional reduction in ticketed capacity (beyond the number of tickets having already been lowered to 7,500, in a decision that was made prior to the pandemic) or "enforcement" of social distancing, and with President Donald Trump expected to attend. Secretary of Tourism Jim Hagen stated that "we're doing everything we can to work diligently to make this a safe and fun event for all attendees." Noem downplayed the possibility that the event could lead to new outbreaks, arguing that the state "[hasn't] even come close to reaching the capacity of the amount of people that we can take care of."[8] The majority of the audience did not practice social distancing or wear face masks.[9]

After the event, it was reported that Noem had interacted with Kimberly Guilfoyle—a Trump aide who later tested positive for COVID-19, and flew back to Washington, D.C. on Air Force One. On July 7, Noem stated that she had tested negative, stated that Guilfoyle was asymptomatic, and claimed that "the science of the virus tells us that it's very, very difficult to spread the virus when you're asymptomatic". Noem added that it was "incredibly important that we do what we can to mitigate the spread of this virus, but we also know that we can't stop it."[10][11]

On August 3, 96 out of 328 people who attended Camp Judson, a Christian summer camp near Keystone, tested positive for COVID-19, with an average age of 15 years old.[12]

The Sturgis Motorcycle Rally was held as scheduled from August 7–16, with an estimated 250,000 expected to attend.[13] Although the rally itself was classified by infectious disease professor Carlos del Rio as being of a relatively lower risk due to it being an outdoor event, concerns were raised that attendees would engage in indoor gatherings at bars and restaurants, and that travelers could potentially export COVID-19 cases back to their home states. Mayor of Sturgis Mark Carstensen questioned why the event still went on, admitting that "we cannot stop people from coming."[14][15] Attendees were encouraged, but not required, to wear a mask.[13][14] A week after the rally, three days of mass testing were scheduled in Sturgis for local residents.[16]

Footage of a concert at Buffalo Chip Campground as part of the festivities showed wide defiance of mask-wearing and social distancing, and Smash Mouth lead singer Steve Harwell telling the audience to "fuck that COVID shit".[17][18] Public health notices were issued regarding possible exposures at a bar and a tattoo parlor in Sturgis, and a restaurant in Hill City, recommending that visitors monitor for symptoms.[19][20][21] By August 26, the number of cases attributed to the rally had reached 70, including 35 cases in Minnesota, 17 in North Dakota, and seven cases in the Nebraska Panhandle.[22] By September 2, the number had increased to 260, and Minnesota reported the first known COVID-19 death among an attendee.[23][24]

The Sturgis Rally and other public events, including concerts at the Sioux Empire Fair, the return to school, and exposures at local businesses, resulted in a surge of new COVID-19 cases in South Dakota. A single-day record of 623 new cases were reported on August 27.[1] On August 30, it was reported that there had been over 2,000 new cases over the past seven days.[25][21][26] The next day, Governor Noem downplayed the surge, arguing that "none of this was a surprise", hospitalizations were low in comparison to models, and deaths had trended downward. She also claimed that most of the new cases were among younger residents with a higher chance of recovery, despite cases in people over 70 having increased since the 27th.[27]

In September, a non-peer-reviewed study was released by San Diego State University's Center for Health Economics and Policy Studies, which projected that up to 260,000 COVID-19 cases were tied to the rally nationwide. The estimate was based on case trends following the event in the regions from which its attendees originated, as determined by cellphone data, rather than contact tracing — which an author of the study considered unfeasible due to the scale of the event.[28]

The study was criticized by state officials, including Governor Noem, Secretary of Health Kim Malsam-Rysdon, and state epidemiologist Josh Clayton, who felt it was an overestimate in comparison to case totals reported locally and by the Associated Press (which, by then, had projected 124 in-state cases tied to Sturgis, and 290 across multiple states), and noted that the study was not peer-reviewed. Noem also criticized media outlets for reporting on the study, describing it as a "fiction" based on "incredibly faulty assumptions that do not reflect the actual facts and data here in South Dakota."[28]

From August 16 to September 26, 2020, the seven-day moving average quadrupled from an average of 95.6 cases per-day to 384 cases per-day.[1] On September 16, a single-day record of eight new deaths was reported.[1] By September 23, the state's number of new, active, and hospitalized cases reached new peaks.[29] Along with North Dakota, South Dakota saw the largest per-capita increases in new cases nationwide.[30] On October 1, the state set a single-day record for new deaths, with 13.[31][1]

On October 7, the South Dakota Department of Health (SDDoH) began to identify test positives on antigen tests (which are faster, but less-accurate than PCR tests)[32] in its statistics as "probable" cases.[33] For health care and contact tracing purposes, they are handled the same as those that are confirmed via PCR test. If a probable case is tested via PCR as a follow-up by a clinician, they will be reclassified as a "confirmed" case. However, probable cases might not necessarily be retested.[33]

On October 13, Noem attributed the present spike in cases as "expected" due to increased testing, despite a case positivity rate of over 10%.[34] On October 15, the state set a single-day record for new cases, at 876, surpassing previous peaks experienced throughout the month.[35]

Cases continued to rapidly increase into November; on November 5, the state surpassed 51,000 cases, with the South Dakota Department of Health (SDDoH) reporting that the state's test positivity percentage had increased to nearly 17%, and its 14-day rolling average was at 19.5%.[36] Test positivity increased to nearly 24% by November 10, with the SDDoH reporting a rolling average of 19.9%.[37] By mid-November, the state's 7-day rolling average per-capita peaked at 165 cases per-100,000.[38] On December 1, the number of active cases in South Dakota fell to its lowest total since early-November, after the state reported a single-day record of 3,542 newly-inactive cases.[39] During the first week of December 2020, South Dakota had the highest mortality rate per-capita among all U.S. states.[38]

By December 7, the state's seven-day average had begun to decline, with South Dakota ranking third behind Rhode Island and Minnesota in new cases per-capita nationwide.[40] On December 21, Avera Health reported that South Dakota had the highest mortality rate of all U.S. states over the past week, second-highest test positivity, and was 14th in new hospitalizations.[41] On February 22, 2021, the state recorded its fewest new daily cases since July 2020.[42]

It has been suggested that personal impacts of the pandemic on residents had led to increased use of masks in South Dakota. Both of the Dakotas had seen noticeable declines in the rate of new cases since December.

Noem has faced criticism from residents, as well as other city and county leaders, for her lack of state-wide actions to control local spread of COVID-19. The resistance forced municipalities to implement their own ordinances to enforce social distancing, including Sioux Falls—which enacted a "no lingering" ordinance on March 26 to restrict all non-essential businesses to only serving a maximum of 10 customers at a time.[63][64]

Mayor of Sioux Falls Paul TenHaken introduced a proposal for a municipal stay-at-home order on April 14,[65] but it was rejected by city council.[66][48][7][49] On May 8, the "no lingering" ordinance was eased ("no mingling") to allow restaurants to expand to capacity (subject to six-foot social distancing between patrons), and fitness, entertainment, and recreation facilities to expand to half of their licensed capacity, or 10, whichever is greater.[67] On May 19, TenHaken tabled a proposal to sunset the ordinance, citing a slowing in new cases in the city since the new ordinance was implemented. City Health Director Jill Franken also reported that the number of hospitalizations in the area was lower than projected. On May 26, Sioux Falls City Council voted in favor, with the ordinance officially repealed on May 29.[68][69]

Medical responses to the pandemic have largely been coordinated by South Dakota's Avera Health, Monument Health, and Sanford Health systems, including testing, vaccination, and public awareness.[70]

On September 8, the city of Brookings became the first in the state to mandate the wearing of face masks in public spaces.[71] The mandate has been credited with lowering the rate of new cases in Brookings County; by late-November, it had the lowest number of cases per-100,000 among South Dakota's 10 most populous counties, at 74.[72][73]

The Cheyenne River and Pine Ridge Sioux reservations have established highway checkpoints to regulate access to their territory.[74][75] On May 8, Governor Noem sent letters to the two tribes' leaders, declaring the checkpoints illegal for "interfering with or regulating traffic on US and state highways" without permission, and threatening a federal lawsuit if not removed.[76][77] The Oglala and Cheyenne River Sioux tribes maintained their checkpoints due to safety concerns.[78]

On May 12, Noem sent a second letter to the leader of the Cheyenne River reservation, clarifying that it was within their rights of tribal sovereignty to establish checkpoints on roads leading into their reservation (rather than the highway itself) to help protect their populations, as long as they provide "reasonable access" for essential goods, emergency services, and access to private property situated on the land.[79] On May 20, after the tribes continued the checkpoints, Noem sought assistance from the federal government in resolving the dispute.[80] On June 24, the Cheyenne River Sioux filed a lawsuit against the federal government.[81]

The Indian Health Service has worked with local tribes on vaccine distribution.[70]

On August 25, it was reported that the University of South Dakota had 61 active COVID-19 cases, and 300 students self-quarantining.[82]

Since August 26, the South Dakota Department of Health has released case numbers for universities on a weekly basis, including data for individual schools.[83]