SIOUX FALLS, S.D. (KELO) — It was a short five months ago when Gov. Kristi Noem said the state was “very, very close” to herd immunity and the state was a national leader in COVID-19 vaccinations.
But over the past several weeks, the Delta variant started coursing through South Dakota like a horse on a track.
“Herd immunity, also known as ‘population immunity’, is the indirect protection from an infectious disease that happens when a population is immune either through vaccination or immunity developed through previous infection,” according to the World Health Organization.
On May 5, during a tourism news conference in Sioux Falls, Noem said the state “was very, very close” to herd immunity with COVID-19. At that point, about 47% of the state’s 16 and older population were fully vaccinated. As of Sept. 27, 58% of the state’s 12 and older population are fully vaccinated. The FDA approved vaccines for those 12 and older in mid-May.
In early January 2021, health officials and Noem were praising the state for its leadership in vaccination rates.
The state hasn’t been a leader in vaccinations for a while. And based on the incremental increases in the number of vaccinations, those who aren’t vaccinated are preventing the return of the state to a leader role.
Sioux Falls public health director Dr. Charles Chima said in a Sept. 1 news conference the current surge in COVID-19 cases is now a pandemic of the unvaccinated.
Dr. Mike Wilde of Sanford said in the same joint news conference that projections showed the Sioux Falls area was three to four weeks away from another COVID-19 peak in cases and hospitalizations.
From Sept. 1 through Sept. 27, cases increased by 10,346.
From Sept. 1 through Sept. 27, the number of fully-vaccinated individuals increased by 14,155.
The number of hospitalizations has often been a point of emphasis for the Department of Health and Noem.
Back on April 17, 2020, Secretary of Health Kim Malsam-Rysdon said the “curve flattening” the state was discussing wasn’t about reducing the number of people who get COVID-19, but reducing the number of hospital beds needed. The state has gone from projecting a need of 10,000 hospital beds to 2,500 beds in the middle of June 2020. It was also preparing for the possibility of 5,000 beds.
The state was “preparing for the worst case scenario,” Malsam-Rysdon said about projections and modeling on Aug. 20, 2020. “That work has been completed.”
Although the state has never needed 10,000 or 5,000 or 2,500 beds at one time during a COVID-19 peak, based on how health systems in the state have had to respond since March of 2020, the question might be: How could the state ever handle a need for 5,000 beds for COVID-19 patients and others?
On Sept. 1, Wilde and Dr. David Basel of Avera McKennan said their hospitals were being stretched with COVID-19 patients. Most of the patients in hospital beds and ICU beds were unvaccinated COVID-19 patients.
“We are in a true crisis setting,” Dr. Shankar Kurra, Monument Health’s Vice President of Medical Affairs in Rapid City said in a Sept. 22 KELOLAND News story. “It’s putting immense stress, not just on the health system but on our health care workers. It is not sustainable if we continue on this path.”
As of Aug. 27, Monument announced it had 78 hospitalized COVID-19 patients across its five hospitals in the Black Hills region. It planned to add more ICU beds.
Even the additions filled quickly as the hospital announced on September 14 that all ICU beds were full.
A pandemic without masks, mandates?
The state is weathering this phase of the pandemic with few mask mandates in schools or in cities.
In the fall and winter of 2020, a number of schools and cities had mask mandates.
The city of Sioux Falls had a mask mandate from approximately mid-November 2020 through March 2021. Cities such as Huron and Brookings also had mask mandates.
The Sioux Falls School District had a clearly defined indoor mask policy for staff and students during the 2020-2021. It is encouraging masks for staff and students this year.
The Sioux Falls City Council, for example, emphasized the importance of vaccinations at a Sept. 14 informational meeting but few who attended the meeting were wearing masks, even as Chima said during the same meeting that mask wearing was important.
Entertainment venues, including the PREMIER Center, are operating with few or no COVID-19 restrictions.
While Mitchell, Huron and Yankton schools have mask mandates, there were more in 2020-2021.
Reaching the peak?
The recent 2021 COVID-19 peak may be near or may have been reached, depending on which data point is emphasized.
The state reached 19,240 active cases on Nov. 19, 2020. But highs of deaths and hospitalizations were reached at different points.
The state hit 1,033 total deaths on Dec. 3, 2020, and on Dec. 31, there were 1,488 total deaths. Daily reported deaths included 22 men and 17 women on Dec. 16 and 41 total reported deaths on Dec. 24.
There were 437 total deaths on Nov. 1, 2020. Deaths increased by more than 1,000 from that 437 on Nov. 1 to 1,488 on Dec. 31.
Active hospitalizations hit 607 on Nov. 10, 2020.
The state had 7,132 active cases on Oct. 14, 2020, which was weeks before the state hit its peak in cases and hospitalizations. There were 304 people in the hospital on that day.
The 2021 surge has included 60 deaths reported from September 21 to September 27. The death toll was 2,069 on Sept. 21 and 2,129 on Sept. 27.
The September 2021 high for active cases was 7,927 cases on Sept. 20. The highest hospitalization day was 236 on Sept. 21.
Although the S.D. DOH’s 2020 COVID-19 modeling was to predict a worst-case scenario, other models and projections did not have as high death totals as the 2,109 dead as of Sept. 22.
KELOLAND News reported on Aug. 21, 2020, that a study by the Institute for Health Metrics and Evaluation said South Dakota would have reached its COVID-19 peak in December 2020 if the current situation continued with no additional restrictions such as a mask mandate. The study projected about 254 people would die. If the state had a mask mandate, an estimated 183.4 people would have died from COVID-19, according to the study.
The study projected that 33.45 of the 74 available ICU beds in the state would be needed on Dec. 1, 2020. Another 125 of all available hospital beds would be needed.
The state outperformed some of the health model projections for deaths and other data in the fall and winter of 2020 round of the pandemic.
What could be ahead
The Institute for Health Metrics and Evaluation projects that the state will have continued deaths and cases well into the winter.
Daily deaths will climb to four per day by the end of December 2021.
As of Sept. 27, the Institute for Health Metrics and Evaluation projected 2,399 will have died by Dec. 1, 2021, in the worst-case scenario. The projected number of deaths based on current conditions continuing is 2,264. By mid-December, the state will have 1,400 cases of COVID-19 both confirmed and not confirmed.
Current conditions include the pace of vaccinations, participation in social distancing and mask wearing including any mandates.
A younger element to the pandemic
Health experts within the state and outside of South Dakota have said the Delta variant is impacting a younger segment of the population than the strain experienced in 2020.
Multiple state health agencies are reporting an increasing number of COVID-19 deaths and cases in residents under 60.
As of Sept. 27, there were 17,399 cases in the 10 to 19 age range and 7,236 cases in the 0 to 9 range. The 20 to 29 range has the most cases with 25,183. Also, the state has 23,667 cases in the 30 to 39 range, 20,162 in the 40 to 49 age range and 19,469 cases in the 50 to 59 age range.
As of Sept. 27, 496 individuals under 30 have ever been hospitalized.
South Dakota has 227 deaths in those under 60 including nine in the 20 to 29 range.
The Centers for Disease Control said cases in the 18 to 29 age range has accounted for the largest cumulative number of COVID-19 cases compared to other age groups but still has a lower death rate than other age categories.
The deaths in the 18 to 29 age range in the U.S. represent .6% of all deaths. The deaths in age categories under 17 do not represent more than .1% of all COVID-19 deaths.
The rate of death in the 30 to 39 range is four times higher than the 18 to 29 range, according to the CDC.