By Carrie Moritz, Gazette
Since the first death from COVID-19 in South Dakota was recorded on March 10, 2020, much of the state has waited with bated breath for the effects of the virus to hit the state as hard as it did New York, California, and Washington.
However, South Dakota appeared to sidestep most of its effects, even after a hotspot happened at Smithfield Foods in April. Overall, from March until August, the South Dakota Department of Health reported a confirmed daily case count that hovered around 50-100 new cases per day, and relatively few deaths. By August 1st, only 8,867 people out of a population of around 885,000 people had been diagnosed with Sars-COV-2, the virus that causes COVID-19. A few counties in the state hadn’t had a single case, and several didn’t have a single active case at the time. Due to mitigation measures taken early on, precautions that were still occurring, and a small, rural population, until August 1, the virus was slow to spread. In the past six weeks, that has changed.
According to the South Dakota Department of Health, of those relatively few cumulative cases, 134 people, or 2%, had died as a result of the virus, either from its effects of creating a cytokine storm (an overreaction of the immune system) or from the side effects such as pneumonia, heart attacks, or stroke, which have been listed by the CDC. A majority of the deaths have been in people older than 65. Across the United States, over 200,000 people have died as a result of having COVID-19.
Each of those deaths meant a loved one was lost, and each positive case meant another person had the possibility of suffering from a severe shortness of breath, fatigue, cough, loss of taste or smell, or other side effects that are often compared to the worst of the flu. Scientists are finding that up to 30% of those who acquire the virus still have symptoms several months later, and according to the National Institutes of Health (NIH), many are showing lung damage that was not present prior to the virus. The NIH also notes that a higher tendency towards blood clotting is also being discovered. Since this is a novel virus, scientists, epidemiologists, and public health officials are still learning whether these side effects will continue and for how long.
Despite that, South Dakota, as a whole, considered itself to be very lucky, and at the behest and blessing of Governor Kristi Noem, plunged ahead with Sturgis, college openings, and school openings.
A Fourth of July event at Mount Rushmore, which was attended by President Donald Trump, and the continuation of the Sturgis motorcycle rally, were panned across the United States, with many worried these events could be superspreaders.
The Fourth of July event didn’t lead to a surge in cases, but many across the state continued to apply mitigation measures, with communities (including Garretson) canceling summer celebrations and events and encouraging outdoor activities.
With so few cases, the pressure continued to build to keep reducing precautions. According to the Black Hills Pioneer, 62.9% of Sturgis residents stated they were against holding the motorcycle rally, but in June the city council opted to move ahead with the event. Approximately 450,000 people attended, coming from all over the United States, and polarization between those convinced it would lead to far more infections and those who didn’t want any precautions grew wider.
As of September 8, the South Dakota Department of Health reported that 124 people in South Dakota were confirmed to be positive and directly linked to the Sturgis rally. According to the Associated Press, 290 people across 12 other states had been diagnosed positive, and one person had died. Each of those cases was directly linked to attending the rally. These numbers appeared exceedingly low, leading many to believe the superspreader event didn’t happen.
But after that, the positive case numbers linked to Sturgis became less distinct. Symptoms can appear up to two weeks later, and asymptomatic spread could mean that contact links were broken.
A study conducted by the Center for Health Economics and Policy Studies at San Diego State University estimated much higher numbers by utilizing cellphone data and extrapolating from other superspreader events, and estimated that over 250,000 positive cases were due to the rally, according to one of its lead authors, Andrew Friedson. They estimated public health costs of the rally to be 12 billion dollars.
Governor Noem and the South Dakota Department of Heath immediately refuted the study, calling it fiction and an attack on personal freedoms to attend the rally.
Pennington County, which houses Rapid City, had daily active case numbers that averaged around 135 active cases from July to August. It shot to 428 active cases on September 1, and as of September 22, were still at 299. Meade County, where Sturgis is located, went from 16 active cases on August 5 to 158 on September 1, and as of September 22, were at 97.
Epidemiologists and public health officials are still studying COVID’s viral spread. A wedding in Maine attended by just over 100 people was directly linked to 170 cases after attendees spread the virus to a nursing home and a county jail. In April, an outbreak at Sioux Falls’ Smithfield Foods was linked to 1,300 cases, with 929 employees and an additional 210 contacts being diagnosed with the virus. Four people died as a direct result of that outbreak. In the past week, 116 residents and staff of the South Dakota women’s prison were diagnosed positive. The jail houses 140 women.
Public health officials continue to put the R0 (pronounced R-naught) of the virus above 1, even as high as 2 or 3, according to ABC News. This means that the virus passes easily. While using R0 can be problematic due to limitations, it means that for every one person who gets sick, they are likely to infect 1-3 more people. Part of why this occurs is because up to 40% of all people could be asymptomatic, which means they get the virus but don’t present symptoms. Among those who do get sick, most are highly contagious in the day or two before they do have symptoms.
The opening of colleges and schools after the rally, along with a resumption of indoor activities and precaution reductions around the state, have likely contributed to South Dakota’s cases more than doubling. Those 8,867 cases have turned into 19,189 confirmed cases in less than two months. Hypothetically, if South Dakota had followed the same trajectory it had maintained until August 1, there would only have been around 13,000 new cases by mid-September (using an average of 2,000 new cases per month).
Hospitalizations, which lag behind increases in positive cases by up to four weeks, went from an average 60 people per day throughout the entirety of the pandemic so far, to 110 people on September 14, and 178 people on Tuesday, September 22.
It can be easy to pretend that by living in a small community such as Garretson, especially when case numbers by ZIP code are not released, that it will continue to remain relatively unaffected. Many of the cases in Minnehaha County are attributed to Sioux Falls. This may cause residents to let down their guard, believing that they will not become infected, or if they do, that they won’t be badly affected.
Unfortunately, this may change all too soon. As numbers increase throughout South Dakota, the likelihood of it spreading through Garretson and impacting the residents increases substantially. Extrapolating from the data already shown, of those who do get infected, approximately 6% will be hospitalized, and 1% are not likely to survive it. An older population such as Garretson’s may be impacted even more heavily.
To reduce the spread, the community can work together. Taking precautions such as masking, handwashing, distancing, and staying home will help, even if it feels burdensome. In this way, residents can help reduce the possibility that they’ll give their neighbor a virus that has been described by many as “something you don’t want to get.”
Sources: South Dakota Department of Health, CDC, John Hopkins University, National Institutes of Health, Center for Health Economics and Policy Studies at San Diego State University, KELOLAND News, ABC News, The Guardian, USA Today, Black Hills Pioneer, Argus Leader.
