STEVE INSKEEP, HOST:
Tracking the progress of the coronavirus - over the summer, the pandemic hammered the Sunbelt, states like Texas and Arizona. Cases have gone down again there. And now parts of the Midwest have trouble. North Dakota had the highest per capita infection rate in the nation last week. Until recently, North Dakota was receiving praise for controlling the pandemic. NPR's Will Stone reports.
WILL STONE, BYLINE: With coronavirus advancing rapidly in North Dakota, Sister Kathleen Atkinson (ph) says there's still a sense of disbelief, even denial, that she hears in her hometown of Bismarck.
KATHLEEN ATKINSON: People saying, well, wait. What happened? I think that's one of the struggles that the general community is having.
STONE: Atkinson runs a food pantry and sits on a government committee helping with the local COVID response. She's also a nun who's consoled families who've lost people to COVID. And yet, she believes many people aren't taking it seriously enough even in church.
ATKINSON: Because I've had people who have called me and said, do you know of any parish that primarily had people wearing masks? And I say, no, I don't.
STONE: North Dakota was holding up well. The state invested heavily in contact tracing to suppress outbreaks. Heading into the summer, it was averaging only about 30 cases a day. Then in mid-July, cases spiked and started rising even more steeply late last month. Now the average is around 260 new infections a day.
ATKINSON: I think we need to acknowledge what the statistics tell us. Unfortunately, we're not going to change behaviors until we are mandated to do that.
STONE: But North Dakota's governor, Doug Burgum, has avoided doing that. There is no statewide mask mandate, no limit on large gatherings. Businesses are open. And until the end of last week, Burgum kept the entire state's COVID risk level at low. He compared the pandemic to North Dakota's floods.
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DOUG BURGUM: There's no law that said tens of thousands of people had to show up and fill millions of sandbags. There's no law that mandated that people come out and try to help save their community.
STONE: And Burgum pointed out that while the state has one of the highest rates of new infections, it is testing anywhere from three to 10 times as much as other nearby states. Renae Moch, director of the Bismarck-Burleigh Public Health Department, says many of the infections appear to be linked to lax behavior and social gatherings.
RENAE MOCH: People have had, I think, a little bit of COVID fatigue and getting back together with friends and family and kind of reigniting that again. And it's kind of been an increase, an uphill battle.
STONE: The greatest share of cases are turning up mostly among people in their 20s. Dr. Joshua Wynne, dean of the University of North Dakota School of Medicine, says many students got tested as they headed back to classes two weeks ago.
JOSHUA WYNNE: Even though we had widespread testing available and did identify literally hundreds of students, we clearly did not reach all students. And therefore, I think that community spread among the young people clearly is occurring.
STONE: In fact, Grand Forks, home to the university, now has the most cases in the state. One population that has not seen quite as steep a jump is the Standing Rock Sioux Tribe, whose reservation spans both North and South Dakota. Tasha Peltier is the COVID-19 case manager there.
TASHA PELTIER: People are respecting this virus and that it can cause harm to our communities.
STONE: Peltier says, on the reservation, school is being done remotely. There's a curfew and a limit on gatherings. But...
PELTIER: We are not isolated from everybody else. When their cases are increasing, we know that that's going to impact us as well.
STONE: So too goes for the entire state of North Dakota as cases now climb across the Midwest.
Will Stone, NPR News.
(SOUNDBITE OF MOONCAKE'S "MANDARIN") Transcript provided by NPR, Copyright NPR.