SIOUX FALLS, S.D. — In the space of a month, South Dakota has gone from a summer simmer of COVID-19 cases to a new pandemic surge rivaling those in other states. Why?
The Black Hills in western South Dakota is the epicenter of the state's COVID-19 surge, according to a Forum News Service analysis of federal and state COVID-19 data.
The virus is likely surging in the Black Hills for two reasons: Relatively few people in the area have gotten vaccinated against COVID-19, making them a relatively easy target for the more contagious delta variant of the virus, and the Sturgis Motorcycle Rally, which brought hundreds of thousands of people from around the country into close contact.
Think of it as a lit match touching dry tinder.
Since the end of the 10-day Sturgis rally on Aug. 15, about 4,000 people have been newly diagnosed with COVID-19 in the state. That means the state has logged about 330 new case a day, 10 times higher than in July, with local hospitals struggling to keep up with the flood of severe cases.
South Dakota Department of Health spokesman Daniel Bucheli declined to specifically link the Sturgis rally to the rising virus surge, noting on Thursday, Aug. 26, only 39 COVID-19 cases have been directly attributed to the rally.
"COVID-19 case spikes are following a national trend being experienced in every state, not just South Dakota," he said.
But the spread of a virus is not inevitable, or unstoppable. Its spread, and reach, are sped or contained by the choices people make.
State and local officials have chosen to not restrict gatherings such as Sturgis or require easy mitigation strategies such as masking. And in the Black Hills, they choose to avoid vaccinations and to welcome in hundreds of thousands of people for a motorcycle rally.
Tinder and match
The Black Hills region was ripe for a new surge of COVID-19. Despite widespread availability of COVID-19 vaccines for months, a majority have declined to get vaccinated, even as the more contagious delta variant began fueling renewed surges elsewhere in the country.
About 49% of South Dakotans are fully vaccinated against COVID-19, according to the Centers for Disease Control and Prevention. But in the Black Hills area, most county vaccination rates range from 26-39%.
"It is important to mention that Meade County currently has a lower vaccination rate than other counties in the state," Bucheli said.
It's perhaps not surprising those who call the Black Hills area home are less inclined to get vaccinated against COVID-19. Polls have shown Republicans are less likely to take the vaccine. Black Hills voters are deep red, politically, in an already red state, and tend to have a libertarian streak not uncommon in the American West.
The Black Hills are something of a topographical island among the plains. But COVID-19 doesn't care about the landscape. It spreads between people.
In that respect, the Black Hills is about as well connected as it gets. It's the pulsing heart of the state's tourism industry.
The biggest South Dakota tourism event of them all? The Sturgis Motorcycle Rally.
The Sturgis rally regularly draws hundreds of thousands of bikers and fans from across the nation and world to the town, population 6,800. On the menu: races, rock shows, parties and tours of the area via motorcycle.
This year at least half a million people flocked to the rally, according to preliminary tallies. The City of Sturgis partnered with regional health system Monument Health to offer visitors free COVID-19 self-test kits.
But the virus-friendly events were legion. People stood shoulder to shoulder, no masks in sight, to watch a show in Outlaw Square in Deadwood. They drank shoulder to shoulder in Sturgis bars such as The Knuckle Saloon and the Loud American Roadhouse.
At the Buffalo Chip campground and venue, thousands partied with Kid Rock, ZZ Top and Corey Taylor of the band Slipknot (Taylor tested positive for COVID-19 shortly afterward).
July in South Dakota was so quiet in pandemic terms, state officials stopped reporting daily statistics, releasing data weekly instead.
Then came August. The number of new cases a week more than doubled, then more than doubled that number two weeks later.
COVID-19 is surging again, and the Black Hills is ground zero. Of the 10 South Dakota counties with the most new COVID-19 cases per capita, six are in the Black Hills or just adjacent. The remainder are elsewhere in the western half of the state.
Meade County, home to Sturgis, was No. 1 in per capita new cases and hospitalizations, but other counties in the area weren't far behind.
The number of people with severe cases of COVID-19 began to swamp local hospitals. On Friday, Rapid City based Monument Health said it was "extremely busy" with virus patients and was setting up makeshift ICU rooms and shifting around staff to handle demand.
"The vast majority of these patients are unvaccinated," it said.
Monument, which has yet to require its staff get vaccinated against COVID-19, posted dozens of staff needs on travel nurse staffing websites — mostly ICU, emergency room and other critical care positions. It was willing to pay up to $6,018 a week for critical response nurses to staff its ICU, it said.
Despite the worsening surge, Sturgis city officials on Thursday issued a defiant statement in the face of negative state and national media coverage. They partially blamed the higher case counts on expanded testing, and said new South Dakota cases had peaked on Aug. 16, the day after the rally concluded, an inaccurate claim easily debunked by easily available state data.
"There are individuals in the national media who are determined to mischaracterize the event," they said in their statement. "The safety of the event was best illustrated through the smiles on the faces of national press who enjoyed the event."