“It sucks that people die, but they do, we can’t stop that,” said Allison Atkinson, 44, of Clark County, Kentucky, during a protest against the governor’s stay-at-home order at the state capitol on April 15. On April 19, Kentucky Governor Andy Beshear (D) announced that the state had seen its single largest one-day increase in confirmed COVID-19 cases, with 155 deaths currently being reported.

Despite warnings from public health experts that early stay-at-home and social distancing orders could have prevented 90 percent of all U.S. COVID-19 deaths, citizens and governors from a handful of states are pushing back against these common-sense safety measures — and are now seeing spikes in infection rates.

According to data released by Johns Hopkins, non-stay-at-home states Arkansas, Nebraska, and Iowa saw their number of confirmed cases jump 60, 74, and 82 percent, respectively, in one week.

During this same period, South Dakota reported a 205 percent increase in cases after South Dakota Governor Kristi Noem’s (R) repeated refusal to issue mandatory stay-at-home orders for South Dakota or individual municipalities. Noem seems to believe that somehow the state’s rural nature and “resilient” citizenry make this basic safety precaution unnecessary for most residents.

For Native American communities, the elderly, and the immunocompromised, Noem’s refusal to act is an act of governmental negligence. You can send an email to Governor Noem and tell her to stop putting lives at risk; it’s time to issue a shelter-in-place mandate and shut down nonessential businesses — including Keystone XL pipeline construction.

Governors in similar states cite low population densities as justification for only implementing less stringent public safety measures like closing schools and having employees work from home. However, low-density cities like New Orleans and Detroit and low-density countries like Spain and Sweden have all become hotspots for the illness, undermining the assumption that low density prevents outbreaks. Compounding the risk, Utah, Arkansas, Oklahoma, and South Dakota have high to moderate levels of housing crowding, which can rapidly increase the spread of disease throughout a community not practicing stay-at-home policies.

Number of COVID-19 cases per state or territory. Source: CDC

Where we see inadequate measures taken, we see spikes in the virus. As of Thursday, April 16, Sioux Falls, SD was the center of the largest COVID-19 hotspot in the nation (since surpassed by an Ohio prison outbreak). The Sioux Falls outbreak has been largely concentrated to workers at a single pork processing facility owned by Smithfield Foods, a Virginia-based conglomerate with operations across North America and Europe that is a wholly-owned subsidiary of the world’s largest pork company, WH Group of China. Of the 1,311 cases positively confirmed throughout the state, 733 have been linked to Smithfield workers or those they have come into contact with, resulting in at least one fatality. Smithfield has since closed two other plants in Cudahy, Wisconsin and Martin City, Missouri on Wednesday, April 15 after cases were confirmed at both, raising concerns about the impact on national pork supplies.

South Dakota is one of a dwindling number of states without a mandatory stay-at-home order, interstate travel restrictions, or any form of eviction or utility shut-off protections. The governor has instead responded to the crisis by offering up to 10,000 of its citizens as the first state-backed test patients for President Trump’s hydroxychloroquine trials. However, similar hydroxychloroquine trials in Brazil and involving US veterans have shown higher patient mortality in those receiving the experimental drug after they developed deadly heart arrhythmias — meaning sick Smithfield workers, many of who are immigrants to the United States, will be used as test subjects for a drug with known lethality being pushed on the public without evidence that it is effective in treating COVID-19.

"What do you have to lose?" said President Trump at a press conference in which he promoted hydroxychloroquine in early April.

As of Wednesday, April 15, 95 percent of South Dakota’s cases were in Minnehaha and Lincoln Counties, in which the City of Sioux Falls is located. Gov. Noem has rejected multiple appeals from Sioux City mayor Paul TenHaken to issue a citywide stay-at-home order due to the outbreak, prompting the Sioux Falls city council to vote 8-0 in favor of passing a stay-at-home ordinance for non-essential workers; the item goes into a second reading next week. If approved, it would go into effect on April 24.

“There are people struggling,” said Lakota People’s Law Project lead counsel Chase Iron Eyes. “And Governor Noem is failing the people.”

Noem claims that issuing a stay-at-home order would not have prevented the outbreak in Sioux Falls, as ongoing work at the pork processing plant would have been permitted as an essential service. This implicitly dismisses the possibility that such an order could have prevented the first plant worker who fell ill from contracting the virus and spreading it — which it very well may have — and highlights the lack of action on the part of both the state and Smithfield to ensure safer working conditions. South Dakota health officials were aware of substantial community spreading of the virus within Minnehaha and Lincoln Counties as far back as March 26, giving them weeks to implement more stringent safety measures at high-risk facilities like the Smithfield plant. Their failure to do so is a clear dereliction of their duty to protect the lives and well-being of South Dakota residents.

Number of confirmed COVID-19 cases in South Dakota by county. Source: South Dakota Department of Health

Smithfield workers have described unsafe conditions in the plant, which provides nearly 5 percent of the nation’s pork, at 130 million servings of food per week or about 18 million servings per day. The plant employed 3,700 people prior to its indefinite closing on Sunday, April 12. The physically demanding and repetitive tasks, tightly-packed production lines under intense pressure to operate at top speed, and overcrowded locker rooms that made up business as usual at the Sioux City plant were compounded by inadequate personal protective equipment and washing facilities, as well as by pressure from management to hide symptoms of illness and continue working while sick. There are also reports of management ignoring union requests for more protective equipment and safer working conditions.

Noem’s continued refusal to shut down South Dakota is resulting in the sickness and death of workers and residents, and increasing the risk of outbreaks in vulnerable communities like the state’s nine Native American tribal nations. Current and historical racial injustices have created conditions that make the state’s nearly 72,000 Native Americans (out of a total population of 880,000) uniquely susceptible to illnesses like COVID-19. The state’s tribal nations suffer disproportionately high rates of poverty, respiratory illnesses, diabetes, cancer, and heart disease, overcrowded and often inadequate housing, and a lack of access to healthy food and top-flight medical care. All of the crises that Native Americans face on a daily basis pave the way for infectious disease to spread at a devastating speed.

“I am really greatly disappointed in the South Dakota governor’s leadership,” said Standing Rock Sioux Tribe councilwoman Avis Little Eagle in a tribal council meeting on Tuesday. “As of yesterday, South Dakota ranks no. 1 as the state where the virus is growing rapidly. That’s what they get to be noted for; that South Dakota is the state where this virus is so out of hand that there is no hope of controlling it. It's gonna just grow in that state because [Gov. Noem] didn’t act.”

This nightmare scenario is already playing out in New Mexico’s Diné population of the Navajo Nation, with more than a third of the state’s cases occurring in Navajo residents despite the fact that they comprise just ten percent of the total population. South Dakota Gov. Noem must act immediately in order to prevent her state’s systemic discrimination against Native Americans from turning into a complete human rights disaster — a new genocide of the Oceti Sakowin.

You can help slow the spread of COVID-19 by urging South Dakota’s leadership to act like leaders in this pandemic and issue the appropriate orders now.