BISMARCK — Gov. Doug Burgum said hospital capacity has not been an issue in North Dakota during the COVID-19 pandemic despite a statewide shortage of intensive care beds and evidence that some patients are being transported several hours from their homes to receive medical care.

"It is an accurate statement that capacity today has not been a problem in the state of North Dakota... It could be a problem if we don't turn our numbers around," Burgum said at a press conference Thursday, Oct. 1.

Earlier this week, Forum News Service reported that the state's major hospitals are struggling to find available beds for patients due to a confluence of staffing strains, the pandemic and increased non-coronavirus admissions. The latest internal tally from the state Department of Health shows that just 29 ICU beds and 244 regular inpatient beds are available statewide. That's up from just 14 ICU beds and 233 inpatient beds on Sunday.

Grand Forks' only hospital, Altru Health, reported zero available beds of any kind on Sunday, though it now reports 4 open ICU beds and 16 inpatient beds. Bismarck's two hospitals reported a combined three open ICU beds on Wednesday, while Fargo's three hospitals reported 13 among them.

DeeAnna Opstedahl, the vice president of patient care at CHI St. Alexius Dickinson, told The Forum that the hospital has had to transfer patients as far as Fargo and Billings, Mont. because of capacity concerns.

The scarcity of beds in major medical hubs — Fargo, Bismarck, Grand Forks and Minot — has been so severe that rural hospitals like the Mountrail County Medical Center in Stanley are preparing to receive low-acuity patients, if called upon.

The number of available beds reported to the Department of Health differs from those reflected on the state's public-facing COVID-19 dashboard .

The dashboard on Thursday showed 147 available ICU beds — five times the actual amount. That's because the department reports publicly reports the number of licensed beds at hospitals, rather than the number of beds staffed by medical professionals, according to spokeswoman Nicole Peske. Strangely, the dashboard also reports just 216 available inpatient beds, which is lower than the actual amount.

Burgum took responsibility for the misleading information on the website, saying "the buck stops here," but he rejected that the oversight was intentional in any way.

"When you say the word 'misrepresentation,' it makes it sound like there was some artificial effort to overstate capacity or understate the issue, and I would take a challenge with that because the effort has always been to be transparent around the availability of hospital capacity that we have," Burgum said.

The Republican governor noted that the state will be updating what it reports on the dashboard next week to better reflect the actual hospital capacity in the state. Burgum noted that reporting staffed beds will be among the changes.

Change in quarantine recommendations

Kirby Kruger, the director of the state Division of Disease Control, announced Thursday a change to the state's recommendations for when close contacts of known COVID-19 cases should quarantine.

Residents identified as close contacts will no longer be recommended a two-week quarantine period if they and the positive case to whom they were exposed wore masks when they were together.

Last week, the state rescinded an order requiring close contacts to quarantine just a day after it was expanded. Burgum and other Republican leaders faced intense backlash for the order's punishment mechanism, which meant violators could be charge with a Class B misdemeanor. The episode led Dr. Paul Mariani to resign as state health officer just 11 days into the job.

The rescinded order means there is no legal requirement that household or close contacts quarantine, but Kruger and Burgum said they hoped Thursday's action will incentivize more residents to wear masks. Burgum has repeatedly rejected a statewide mask mandate, saying it would be unpopular with residents and might actually decrease mask-wearing.

The change in recommendations is mostly geared toward K-12 and university students who may have previously been required to quarantine for two weeks after being identified as close contacts. The new recommendation does not apply in health care or residential settings.

Deaths from COVID-19 continue to mount

Earlier in the day, the North Dakota Department of Health reported nine deaths from COVID-19, a record high number of hospitalizations and 373 new infections.

Health officials confirmed the deaths of three Morton County women, two Morton County men, a Burleigh County woman, a Divide County man, a Richland County man and a Stutsman County man. All of the residents had underlying conditions, and only one was younger than 60 years old, according to the department.

The department says 256 North Dakotans have succumbed to the illness, and deaths have been mounting at rapid pace over the last three weeks. The nine deaths reported Thursday have been included in September's death toll of 109 — by far North Dakota's deadliest month of the pandemic.

At least 153 of the state's deaths have come in nursing homes and other long-term care facilities, many of which have been decimated by the virus in the last month. Five facilities in the state — two in Dickinson, one in Mandan, one in Velva and one in Bottineau — have more than 15 infected residents.

There are now 3,690 residents known to be infected with the virus, a slight rise from Wednesday.

North Dakota leads the nation in new COVID-19 cases per capita over the last week, according to the New York Times . The whole region is experiencing a surge in cases, with South Dakota, Wisconsin, Iowa, Montana and Minnesota all identified by the publication as states where infections are "high and staying high."

The number of hospitalized residents with the illness rose from Wednesday to 106 — a new pandemic high. Twenty-two patients are in intensive care.

Thirty-seven counties reported at least one case Thursday, including many small, rural counties. Every county in the state except for Steele has at least one active case.

Eighty-one of the new cases reported Thursday came from Cass County, which includes Fargo. The state's most populous county has 606 active cases. North Dakota State University has reported 71 cases of COVID-19 in the last two weeks.

Williams County, which includes Williston, reported 51 new cases. The county now has 276 active infections.

Burleigh County, which encompasses Bismarck, reported 44 new cases Thursday. The county has the most active cases in the state with 684. Morton County, which sits just west of Burleigh County and includes Mandan, reported 14 new cases and has 245 active cases.

Thirty-eight new cases came from Dickey County, which lies in southeastern North Dakota. The county now has 59 active cases and looks to be emerging as a rural hotspot, along with nearby Emmons County.

About 6.4% of the 5,853 residents tested as part of the latest batch received a positive result, but 12.7% of residents tested for the first time got a positive result.

North Dakota does not report a seven-day rolling average for positivity rate, but Forum News Service calculated the rate to be 7.4% for all residents tested and 13.2% for tests taken on previously untested residents.

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