North to south: How COVID-19 in North Dakota compares to South Dakota

Jack Williams
Devils Lake Journal
In this Thursday April, 9, 2020 photo, employees at a new hand sanitizer factory work to load and manufacture product at the facility in Bismarck, N.D. A number of North Dakota businesses have switched gears amid the coronavirus outbreak to make products in short supply.

The upper midwest has been one of the regions hardest hit by COVID-19 in the United States. 

According to the New York Times, North Dakota has the worst outbreak per capita in the country with 109.8 cases per 100,000 people. South Dakota has the third-worst outbreak with 106.8 cases per 100,000 people.  

Each state poses different situations to different populations, but there are similarities as well. 


South Dakota and North Dakota follow a similar pattern, with their populations being separated by 122,000 people, with population concentrations coming from the eastern borders of the states in Fargo (105,549) and Sioux Falls (153,088). It makes sense that Cass and Minnehaha counties are seeing more cases of COVID-19.

Despite larger cities having more cases, it's the smaller counties that are seeing worse outbreaks per-capita. Sioux County, which is just north of the Standing Rock Reservation, currently has the worst outbreak of COVID-19 in North Dakota with 263.4 cases per 100,000 people. In South Dakota, Dewey County in the central part of the state currently has the worst outbreak with 410.2 cases per 100,000 people. Both counties have populations under 6,000. 

The majority of severe COVID-19 outbreaks in both states are occurring in areas with smaller populations. The five worst outbreaks in North Dakota are occurring in counties with populations less than 5,000 people, and in South Dakota, the four worst outbreaks are occurring in places with populations less than 5,000 people as well.  

Both states' largest counties fall lower on the list to COVID-19 numbers per-capita as Cass County is listed as the 28th worst outbreak in North Dakota while Minnehaha County is listed as the 21st worst outbreak in South Dakota. 

While it may be harder to compare the populations of the biggest cities in each state, there are cities around all three states that offer a similar perspective population-wise. Ramsey County would be comparable to Butte County in South Dakota. 

Butte County and Ramsey County hold similar numbers, holding around 100 active cases in the county, however, Butte County does hold a smaller population of around 1,100 people. NDDOH does not have Ramsey County's numbers available, but Butte county's numbers of overall cases fall at 635. 

North Dakota has begun to see numbers slow down a bit as Ramsey County's positivity rate dropped to eight percent, but rates continue to rise in Butte County as they reported an 11.4 percent positivity rate on Tuesday. 

Population trends around neighboring states tend to remain the same from county to county. Ramsey County does have a higher concentrated population center in Devils Lake than the two other counties but still maintain similar numbers. 

Government action

Both North Dakota and South Dakota have seen action taken at the local levels, but have split when it has come to state action. Multiple cities across both states have seen mandates involving group gatherings and masks come into action. 

Devils Lake was one of the first cities in North Dakota to issue a mask mandate on Oct. 26 and went into action on Oct. 29. The mandate was later supported and extended to the rest of Ramsey County by the Ramsey County Commission on Nov. 9. The state's largest city, Fargo, enacted the state's first government-issued mandate on Oct. 19. Larger cities like Grand Forks, Bismarck, and Minot would follow suit. 

In South Dakota, Aberdeen would come out as one of the earlier cities to approve a mask mandate, with the resolution going into action on Nov. 11. Sioux Falls would pass a mandate that went into effect on Nov. 21. The most recent city to approve a mask mandate in the state was Rapid City, who approved a mandate on Nov. 30 after multiple rounds of debate. 

There has also been action taken by various reservations across both states. The Cheyenne River Sioux Tribe in the northwest corner of South Dakota installed COVID-19 checkpoints, which fell into dispute with South Dakota's governor Kristi Noem in April. In late July, the Spirit Lake Tribe enacted a mask mandate along with a curfew. 

At the state level, North Dakota was the only one out of the two to take statewide action. On Nov. 13, North Dakota governor Doug Burgum issued an executive order enacting a state-wide mask mandate, new business restrictions, and the postponement of winter sports for a month. Since the mandate, the state has seen a slow decrease in active cases and test positivity rate, while testing rates have remained the same. 

South Dakota has not enacted any sort of statewide mask mandate, but the South Dakota Department of Health has recommended the usage of a face-covering in public spaces when you cannot social distance. Noem has also come forward saying that if president-elect Joe Biden would enact a nationwide mask mandate, she would not enforce it. South Dakota has seen a decrease in positive cases reported after it peaked at 1,819 in early November. 

Public reaction 

Both states have seen groups of citizens protesting for more government action related to COVID- 19 and less government action related to COVID-19.

A small group of people marched from the state capitol building to the governor mansion in Bismarck in response to the governor's order to postpone winter sports until Dec. 14. A similar situation happened in Brookings, South Dakota when hundreds of citizens showed up to a city town hall meeting to protest a possible city-wide mask mandate. 

In a similar light, citizens in Sioux Falls also gathered to support the city-wide mandate that was put in place. Government officials in South Dakota have also asked Noem to enact a statewide mandate as well. 

Jack Williams covers Lake Region sports and general news for The Devils Lake Journal. Contact him via email at, on Twitter @jackgwilliams, or phone at 701-662-2127.