BISMARCK — A top doctor in the nation's fight against COVID-19 broke with North Dakota Gov. Doug Burgum on the controversial topic of mask mandates during a visit to the state's capital city on Monday, Oct. 26.

Dr. Deborah Birx, the White House coronavirus response coordinator, said there's evidence that statewide and local mask requirements have aided in slowing the spread of COVID-19 where they've been put in place. She cited specific examples — the state of Mississippi and the cities of Baton Rouge, La., and Phoenix, Ariz. — where the rate of infection and COVID-19 deaths declined just a few weeks after leaders implemented mask mandates.

"There is not only an evidence that masks work," Birx said. "There is an evidence that masks utilized as a public health mitigation effort work."

North Dakota is one of 17 mostly Republican-led states that does not have a statewide mask mandate, according to AARP.

Dr. Deborah Birx, the White House coronavirus response coordinator, speaks Monday, Oct. 26, at a press conference at Bismarck State College. Kyle Martin / Forum News Service
Dr. Deborah Birx, the White House coronavirus response coordinator, speaks Monday, Oct. 26, at a press conference at Bismarck State College. Kyle Martin / Forum News Service

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Burgum has repeatedly dismissed the idea of issuing a statewide mask mandate, instead advocating that residents take "personal responsibility." The Republican governor has said implementing a face covering requirement could even decrease mask-wearing, though he has offered no evidence for the claim.

On Monday, Burgum reiterated that mask-wearing is effective in slowing the virus's spread, but added that individual residents should make the right decision to wear masks in public.

In the last month, Burgum has faced increasingly louder calls from political opponents and medical professionals to issue a mask mandate, but Republican leaders in the state Legislature have made clear they oppose the measure.

Fargo and Minot issued citywide mask mandates last week that do not include penalties for violators, and Devils Lake and Grand Forks did so Monday. Two of the state's tribal nations have also implemented mask requirements.

Bismarck Mayor Steve Bakken said he's not in favor of issuing a mask mandate at a local level, but that a statewide face covering requirement would be "more effectual." He said North Dakotans move from one community to the next all the time, so a patchwork of local mandates wouldn't be productive.

Bakken said he has had discussions with the governor's staff about a statewide mandate, but hasn't lobbied for the measure. He added that many of his interactions with Burgum's office have been to oppose the idea of local requirements.

Bismarck Mayor Steve Bakken takes questions from members of the press at Bismarck State College on Monday, Oct. 26. Kyle Martin / Forum News Service
Bismarck Mayor Steve Bakken takes questions from members of the press at Bismarck State College on Monday, Oct. 26. Kyle Martin / Forum News Service

Burgum and Birx agreed that a crucial next step will be testing and isolating more asymptomatic residents, or "silent spreaders," before they further aggravate the state's already precarious situation. North Dakota, which performs more tests per capita than any other state, must continue to expand its testing operation and target residents between 20 and 40 years old, the governor said.

The U.S. Department of Health and Human Services announced it is sending 220,000 rapid COVID-19 tests to North Dakota. The newly developed tests return results in as little as 15 minutes. Burgum has talked in the past about using the tests at nursing homes, many of which have been decimated by the virus in the last two months.

Birx's visit comes as the state weathers one of the most severe COVID-19 outbreaks in the country. North Dakota has reported the most COVID-19 cases and deaths per capita in the nation over the last week, according to the Centers for Disease Control and Prevention.

Over the last week, Birx has been touring the region, which is experiencing the nation's highest rate of spread. The doctor visited Rochester, Minn., on Sunday, where she spoke about community transmission in rural areas.

Birx said Monday she observed Bismarck hotels, restaurants and grocery stores, and found residents in the city were the worst she has seen at mask-wearing and social distancing during her prolonged 38-state tour of the country. She noted that she observed more public mask-wearing when she visited Fargo two months ago.

The doctor said residents who chose not to wear masks need to think about others in their community before deciding to compromise public health.

"Together we're deciding not to mitigate against this community spread," Birx said. "We're making a choice to keep North Dakota children out of the schools by deciding that my personal freedom is more important than that child's education, or my personal freedom is more important ... than caring for a North Dakotan in a long-term care facility."

Prior to answering questions from the press, Birx participated in a large discussion with local, state and tribal leaders.

Renae Moch, director of Burleigh-Bismarck Public Health, said she hopes Birx's visit will push businesses and residents to be more responsible in wearing masks and refrain from large gatherings. Moch, who has been one of the few vocal local officials in favor of harsher mitigation measures, said Birx did not push blame onto any group of officials for the state's outbreak during the meeting.

Birx said if residents don't make some serious behavioral changes, the rate of infection in North Dakota could get even worse, which in turn, would drive up COVID-19 deaths and hospitalizations.

The doctor noted that the Upper Midwest is experiencing a similar phenomenon with the incoming colder weather that Southern states battled over the summer when many social functions moved inside because of the heat. Winter in North Dakota means more interactions indoors and more spread of the virus, she said.