BISMARCK — North Dakota Gov. Doug Burgum and top hospital officials assembled at a news conference on Wednesday, Sept. 1, to deliver a uniform message: If residents don’t seek COVID-19 vaccines, wear masks and resume social distancing at greater rates, the state's health care system could become overwhelmed in the weeks ahead.

States like Mississippi, where hospitals have reached their breaking point, should provide North Dakotans with a cautionary tale, Burgum said.

“It could happen here because we have some of the same characteristics of limited (hospital) capacity and low vaccination rates,” Burgum said.

Leaders from health care giants Sanford, Essentia, Altru, CHI St. Alexius and Trinity said hospitals in the state’s biggest cities are already pushing up against their limits as staffing issues abound and COVID-19 hospitalizations shoot up.

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Fueled by the highly contagious delta variant, North Dakota’s COVID-19 infections increased fivefold in August, and hospital officials like Sanford Bismarck CEO and President Dr. Michael LeBeau project the state's peak in cases won't come until at least late September.

The virus is taking away options from the health care field and patients, said Dr. Jeffrey Sather, Trinity Minot's chief of medical staff. Slammed hospitals are having to postpone surgeries and other scheduled procedures, while patients might have to travel hundreds of miles to get medical care if their local providers are short on staff, space or resources, he said.

Though none of the major hospitals have suspended elective surgeries altogether, LeBeau and Sather said their hospitals reevaluate capacity on a daily basis and frequently put off procedures if dedicating resources to them would be too straining. LeBeau said Sanford Fargo has already put a plan in place to cut down on surgeries by 30% to free up capacity.

If the alarming rise in COVID-19 hospitalizations continues, Sather said short-staffed hospitals may stretch nurses very thin and have unskilled workers looking after patients. When hospitals can’t do “regular business,” everyone requiring medical attention suffers.

LeBeau said he thinks the state’s health care system will flex to take on the challenge of high admissions and hampered capacity, but it comes at a cost: Frontline health care workers will have to pick up the slack and people seeking medical care will suffer and sometimes die from otherwise preventable ailments.

Burgum noted that “Not only is this (surge) not the same as a year ago because we have better tools, but we’ve also got more constraints.”

The vaccine is proven to prevent many COVID-19 hospitalizations and deaths — roughly 90% of those hospitalized with the virus in North Dakota are not fully vaccinated. Residents who are fully immunized, including most older residents, will largely avoid serious illness from COVID-19 and have a better chance of staying out of the hospital during the imminent surge.

However, traveling nurses are not available like they were last year because many are helping in the hard-hit southern U.S., Burgum said. That means there’s less relief for hospitals suffering from low staffing.

Unvaccinated residents have a choice, and if they choose to forgo the shot, they risk being hospitalized and negatively impacting their loved ones and people they don’t even know who might need the hospital bed they’re occupying, Burgum said.

Statewide case rates

  • NEW CASES REPORTED WEDNESDAY, SEPT. 1: 463

  • ACTIVE CASES*: 2,442

  • DAILY POSITIVITY RATE: 5.91%

  • TOTAL KNOWN CASES THROUGHOUT PANDEMIC: 117,955

  • TOTAL RECOVERED THROUGHOUT PANDEMIC: 113,952

*The Department of Health often amends the number of active cases after they are first reported.

Nearly 20% of active COVID-19 cases in North Dakota are among adolescents under 15 years of age, according to data from the North Dakota Department of Health.

More young people are becoming infected with COVID-19 and needing hospitalization in North Dakota and nationwide compared to a year ago, health officials said on Wednesday. The rise is largely due to the highly contagious delta variant, which is the source of most COVID-19 cases across the U.S. and in North Dakota.

Four children under 15 years of age were hospitalized due to COVID-19 in North Dakota as of Wednesday, according to the state.

Almost 20% of the new positive cases reported were among youth under 15, according to Department of Health data.

Cass County, which encompasses Fargo, has the most known active cases in the state with 474. Burleigh County had 451 known cases as of Wednesday, and Ward County, which encompasses Minot, had 204.

The state's 14-day rolling average positivity rate was 6.54% as of Tuesday, and since June 27, there have been 184 cases of reinfection.

Hospitalizations, deaths

  • ACTIVE HOSPITALIZATIONS: 135

  • DEATHS: 1

  • TOTAL DEATHS: 1,561

North Dakota had 16 staffed ICU beds available throughout the state as of Tuesday, along with 199 staffed inpatient beds. There was one available staffed ICU bed among Bismarck's two hospitals as of Tuesday, 10 staffed ICU beds available among Fargo’s three hospitals and two available in Grand Forks.

The Department of Health began releasing data about breakthrough cases last week. A breakthrough case occurs when a person tests COVID-19 positive after they are fully vaccinated. During the week of Aug. 22, the state reported 12 hospitalizations where the person was fully vaccinated and 77 hospitalizations where the person was not fully vaccinated.

Vaccinations

  • FIRST DOSE ADMINISTERED*: 348,119 (52.6% of population ages 12 and up)

  • FULL VACCINE COVERAGE*: 320,773 (48.1% of population ages 12 and up)

*These figures come from the state's vaccine dashboard, though the Centers for Disease Control and Prevention, which includes vaccinations performed at federal sites, reports slightly higher vaccination rates.

North Dakota’s vaccination rate is among the lowest in the United States, ranking 42 out of 50, Burgum said on Wednesday. Even though about 48% of all North Dakotans are fully vaccinated, the rate among residents ages 12 to 18 is only about 25%.

Even though a person can be infected with COVID-19 after they are fully vaccinated, health officials emphasize that those who are inoculated often experience less severe symptoms and have a less likely chance of being hospitalized.

More than 320,000 North Dakotans are fully vaccinated and 0.0405% of them were hospitalized due to COVID-19, according to the Department of Health. The chance of infection also decreases when a person is vaccinated.

In North Dakota, one in 175 fully vaccinated people have tested COVID-19 positive, compared to one in 15 unvaccinated individuals, according to the Department of Health. More information about vaccines can be found at www.health.nd.gov/covidvaccinelocator.

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Readers can reach reporter Michelle Griffith, a Report for America corps member, at mgriffith@forumcomm.com.