North Dakota Physicians Plead for State and Local Leaders to Mandate Masks

How widespread are daily coronavirus infections in the Dakotas? If they were countries, North Dakota would claim the number one spot and South Dakota would be tied with Czechia for number two, according to The Washington Post's U.S. and global coronavirus trackers on Oct. 20, with 7-day rolling averages of 103 and 81 per 100,000 residents, respectively. The U.S. and Europe/Russia daily case incidence rates were 18 and 19 per 100k people, respectively, the world's highest.

North Dakota Gov. Doug Burgum (R), who has made emotional pleas to encourage mask-wearing, is one of 17 governors who are resistant to issuing statewide mask-wearing mandates.

"Sixty-five pediatricians in the state signed an open letter sent to Gov. Doug Burgum on Tuesday, Oct. 13, asking him to institute a mask mandate," report Jeremy Turley and Adam Willis for The Grand Forks Herald (source article – the letter from the North Dakota Chapter of the American Academy of Pediatrics is embedded in it).

They warned that “until there is an effective and safe vaccination, masking is all that stands in the way of North Dakota and a public health disaster this winter.” 

"The refusal to endorse a mask mandate is no longer an act of strong leadership; the refusal ignores sound science and the recommendations of medical experts at local, state, and national levels," they write.

"A separate group of more than 100 doctors published a letter last week urging residents to comply with mask guidelines, but they stopped short of calling for a statewide mask requirement," add Turley and Willis.

Burgum's opposition to mask mandates and his opponent

"The governor is constantly asked about masks but Burgum says personal responsibility and education are keys to slowing the spread of the virus," wrote Doug Barrett for KNOX News last month. [See related post on the state's mask-wearing campaign.]

He says states that have a high compliance are those with a majority of residents who support a mask mandates. Burgum says the majority of residents in North Dakota do not support a mandate.

James MacPherson of the Associated Press provides some helpful insight into the first-term governor who is on the ballot next month for reelection.

“He’s overwhelmed and is freezing in a crisis," said his Democratic opponent, Shelley Lenz, a veterinarian in her first statewide campaign. Her COVID-19 Crisis Management Plan includes a statewide mask mandate.

How widespread are infections in the state?

All but five of the state's 53 counties are "in the red," meaning that daily new cases exceed 25 per 100k daily, according to the Harvard/Brown Covid Risk Levels Dashboard.

Three of the state's metropolitan and micropolitan statistical areas are listed by The New York Times COVID metro tracker among the nation's top 20 metro areas in the category, "Where the Outbreak Is Worst Now," as of Oct. 18. Bismarck was ranked #2 after Rexburg, Idaho. Fargo and Minot were #15 and #16, respectively.

The list is dominated by Wisconsin, which claims six of the top 10 metros; eight total. The Peace Garden State has the second most regions on the list.

Local leadership?

Turley and Willis add that Burgum "has also said the state is relying on local leaders to make decisions." On Oct. 14, Burgum met with with 14 mayors from the state’s largest cities to discuss local pandemic responses a day after leaders from the five largest: Fargo, Bismarck, Grand Forks, Minot, and West Fargo, signed onto an open letter imploring residents to wear masks and socially distance.

Grand Forks Mayor Brandon Bochenski, who personally opposes a mask mandate, said there was no consensus in the meeting about issuing a requirement. Burgum noted Wednesday that some mayors have lobbied for a statewide mandate, though he declined to name them.

Fargo Mayor Tim Mahoney [a physician], who did not directly answer whether he favors a mandate, said the city would "push hard" to encourage mask use among residents and businesses.

There was a hint in the letter that the mayors would resort to stronger action if businesses don't adhere to state guidance.

We ask for increased diligence from our business community when it comes to NDSmart Restart Recommendations to include occupant capacity in particular. Further disregard may lead to the necessity of enforcement.

The article goes into much greater depth about the alarms sounded by the medical and public health community. 

The last word goes to Dr. Jeffrey Sather, a member of the state’s Physicians Advisory Group, who "lamented that state leaders have prioritized political expediency over the recommendations of medical experts, noting that the doctors group pushed the health department to install a statewide mask mandate months ago."

"We have a government — starting out with our president, all the way down — that does not want to impose that on the public,” he said. “It seems to become much more political than science-based. And rather than doing what’s best for the overall population, we seem to be doing what’s politically popular at the moment, and it certainly is popular to defy reason and push for just individual rights.”

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