Updated 12:54 p.m. Tuesday

BISMARCK — North Dakota's hospitals have reached their limit, and the coming weeks could push them past their capabilities, Gov. Doug Burgum said at a news conference on Monday, Nov. 9.

Due to a major shortage of health care staffing, the state's hospitals have a severe lack of available beds. Rising COVID-19 hospitalizations and high noncoronavirus admissions, some resulting from residents who deferred health care earlier in the pandemic, have caused the crunch on medical centers.

Burgum said hospitals are implementing their "surge" plans, and some will be voluntarily stopping elective surgeries to free up staff. He added that the state will coordinate with hospitals to move nurses to medical centers in most dire need of staff.

In an attempt to alleviate some of the staffing concerns, Burgum announced that interim State Health Officer Dirk Wilke has amended an order that will allow health care workers with asymptomatic cases of COVID-19 to continue working in COVID-19 units at hospitals and nursing homes.

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The move aligns with "crisis" guidelines from the Centers for Disease Control and Prevention. Since only patients with COVID-19 could receive care from doctors and nurses with the virus, Burgum said he believes there will be little risk of more spread. He added that health care workers in COVID-19 units already wear protective gear to prevent them from contracting the virus.

The Republican governor said health care providers asked the state to take the extraordinary step, adding that "apparently some (providers) had the ability to do this in other states."

RELATED: ND nurses reject policy allowing COVID-positive medical workers to stay on job, call for mask mandate

Burgum spokesman Mike Nowatzki said he didn't have information on other states that have allowed nurses with COVID-19 to return to work and referred Forum News Service to the state Health Department and hospitals who asked for the measure.

Department of Health spokeswoman Nicole Peske and Sanford Bismarck spokesman Jon Berg both said they were unaware of any other states that have taken the extreme step.

Scattered news reports from around the country suggest that some nursing homes have allowed workers with asymptomatic cases of COVID-19 to stay on the job, but Forum News Service could find no evidence of a defined policy exception put in place by a state government.

Burgum also announced that the state would be sending out new-age rapid tests to hospitals, nursing homes, schools and colleges. He said the tests that can produce results in as little as 15 minutes could free up health care workers who might have been relegated to the sidelines while waiting for test results.

The governor added that the state is looking to hire emergency medical technicians and paramedics to run COVID-19 testing operations, which would allow nurses who are currently administering tests to begin working in hospitals.

Watch Burgum's Monday, Nov. 9, news conference below:

In a reflection of the stress on hospitals, Burgum moved every county in the state to the orange-coded "high risk" level on the state's official COVID-19 gauge. All of the state's most populous counties were already at the risk level, which comes with recommendations for restaurants, bars and event venues to limit capacity to 25%.

Many counties in state, including Cass and Grand Forks, meet two of the three main criteria for the "critical risk" level, but Burgum has never moved a county to the red-coded status. The highest risk level would come with mandatory business closures and a stay-at-home order. Burgum directly contradicted a recent medical study published by the CDC, saying that "shutting down the economy doesn't necessarily slow the spread" of the virus.

The color-coded key for North Dakota's COVID-19 risk level system is seen. Screenshot via North Dakota Response website
The color-coded key for North Dakota's COVID-19 risk level system is seen. Screenshot via North Dakota Response website

Burgum said mask-wearing, social distancing and hand-washing are the most important actions North Dakotans can take to relieve some of the pressure on hospitals. He also echoed hospital administrators in saying that residents should continue to seek routine outpatient care to avoid a further build-up of hospitalizations from neglected health issues.

The governor said the next few weeks could make the strain on hospitals even worse as the spread of COVID-19 spirals out of control. Only about 20% of those hospitalized in North Dakota have COVID-19, but patients with the virus put a greater strain on staffing than normal patients because hospitals must employ nurses to support their peers in full protective gear who cannot easily leave the COVID-19 unit.

COVID-19 cases, deaths continue to climb

As the pandemic continues to rage in North Dakota, the state Department of Health reported five deaths from COVID-19 and a record-high number of active cases.

The deaths came from all over the state with one each in Burleigh, Stutsman, McKenzie, Walsh and Mountrail counties.

The department says 644 North Dakotans have succumbed to the illness since March, and deaths have been climbing at a rapid pace over the last three months. The state has averaged nearly 10 COVID-19 deaths per day in October and November.

At least 383 of the state's deaths have come in nursing homes and other long-term care facilities. Eleven facilities have more than 15 active cases in residents, including Lutheran Sunset Homes in Grafton, which has 55 infected residents.

There are now a record 10,865 North Dakotans known to be infected with the virus.

North Dakota has reported the most COVID-19 cases and deaths per capita in the nation over the last week, according to the Centers for Disease Control and Prevention. The whole region is experiencing a surge in cases, with South Dakota, Wisconsin, Iowa, Montana and Minnesota all seeing increasing cases.

RELATED: Read the latest local, regional and national health stories from NewsMD here

The number of hospitalized residents due to the COVID-19 rose to 254 on Monday. Another 129 patients were initially hospitalized with some other ailment but later tested positive for COVID-19. Forty-eight residents with the virus are in intensive care.

Burgum has faced increasingly louder calls from doctors and political opponents to issue a statewide mask mandate, but the first-term Republican has so far rejected the measure in favor of relying on the "personal responsibility" of residents. However, Burgum has recently begun supporting mask requirements enacted at a local and county level.

Williston Mayor Howard Klug signed a citywide mask order into law on Monday, Nov. 9, joining local leaders in Fargo, Grand Forks and Bismarck. Most of the mask mandates passed by cities, counties and American Indian reservations in North Dakota do not come with penalties for residents who refuse to wear masks.

The Health Department reported 1,160 new cases of COVID-19 on Monday. All but seven of the state's 53 counties reported at least one new case.

Cass County, which includes Fargo, reported 216 new cases of COVID-19 on Monday. The state's most populous county has 1,542 infected residents.

Burleigh County, which encompasses Bismarck, reported 214 new cases Monday. The county again has the most active cases in the state with 1,586. Morton County, which sits just west of Burleigh County and includes Mandan, reported 61 new cases and has 533 active cases.

Grand Forks County reported 166 new cases, bringing its active case count up to 1,350.

Ward County, which includes Minot, reported 93 new cases, bringing the number of infected residents to 1,527.

About 15.6% of the 7,455 residents tested as part of the latest batch received a positive result, but 25.6% 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 16.1% for all residents tested and 24.3% for tests taken on previously untested residents.

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