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At-home COVID tests aren't counted by states, so how many North Dakotans and Minnesotans are getting sick?

The illness is making about the same number or more people sick compared to last year, but far fewer are going to the hospital, doctor says.

Covid test kits
Jamie Bunnis sorts through a box of take home COVID-19 test kits at Fargo Cass Public Health on Friday, Aug. 5, 2022.
David Samson / The Forum
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FARGO — It’s hard to know exactly how much the coronavirus is spreading in North Dakota, because the state doesn’t track at-home tests.

With the help of surveys, experts have estimated that while COVID-19 may be as infectious as last summer, it is causing far fewer hospitalizations, one doctor said.

Like the Centers for Disease Control and Prevention, North Dakota, Minnesota and South Dakota don’t track at-home tests. A positive case of the coronavirus can be confirmed if a person goes to a doctor, seeks treatment or goes to a testing site, said Brenton Nesemeier, a North Dakota Department of Health field epidemiologist.

“The home tests are more of a screening test,” he said.

Fargo Cass Public Health doesn’t track how many at-home tests are distributed. They are given to residents for free, and a number of places in North Dakota distribute the them.


Not counting at-home tests has become a national practice. Those tests are still reliable, Nesemeier said, but they aren’t done under the supervision of medical professionals. Officials don’t know the conditions in which the test was taken or if directions were fully followed, he said.

That means the coronavirus count is underreported, Dr. Tracie Newman acknowledged.

“I would say that is true for a lot of reportable conditions,” she said. “It’s not just COVID … but it is also true of conditions like flu and even chickenpox. People might not necessarily go in and get a positive diagnosis for it to be counted in state counts.”

The BA.5 subvariant of omicron, a variation of the coronavirus, is spreading faster than others and has become the dominant strain, according to the CDC. It makes up 85% of cases.

Newman, who is a health officer for Fargo Cass Public Health, also said the variant is causing fewer hospitalizations than before. It’s a trend Dr. Avish Nagpal, an infectious disease specialist for Sanford Health in Fargo, has noticed, as well.

“It’s not leading to too many hospitalizations, which is a blessing,” he said.

As far as how many people are being infected, surveys suggest the same number, if not more, people are getting sick from the virus than last year around this time, Nagpal said.

Most people struggle the first couple of days but are not sick enough to go to the hospital because they are vaccinated or have had the virus before, he said. He mentioned symptoms of coughing and fever, but those symptoms are not as severe as they were for those infected in 2020.


That’s because the state has more tools to fight the virus, Nagpal said.

More people are vaccinated, meaning if a person is infected, the symptoms are less severe, Nesemeier said. There also are more treatments available, he said.

“With all of this, we are in a good position,” Nagpal said.

North Dakota reported 1,952 new cases of the coronavirus the week of July 29 through Aug. 4. That’s more than triple the cases reported at that time last year, but still well under the record of nearly 16,000 reported the week of Jan. 20, 2022.

The last week of August in 2021, cases climbed to nearly 1,400. They went as high as 4,306 by the first week of October. Hospitalizations also ranged from roughly 100 to more than 300 in August through February.

But the state hasn’t seen hospitalizations surpass 100 since March.

Minnesota reported 944 cases the week of Aug. 2. Total weekly cases have been on a downward trend since mid-May and are about 100 cases up from Aug. 3, 2021.

Hospitalizations are about the same as this time last year with 40 people.


At-home tests have become more popular for their accessibility. Residents don’t have to travel to a testing facility, said Garry Bowman, a spokesman for the Minnesota Department of Health.

Because more people are using at-home tests, the CDC has moved away from using transmission levels and case numbers to determine risk levels, Bowman said. Instead, it bases risk on new cases, hospital admissions and hospital bed use.

Cass County in North Dakota and Clay County in Minnesota are listed as medium risk for coronavirus infection.

Newman said Fargo Cass Public Health has gotten a lot of questions because school is about to start. She urged people to stay up-to-date on vaccines, and not just for the coronavirus. A person should test for the coronavirus if they get symptoms, she said.

People who are at high-risk for infection or have a reduced ability to fight diseases should consider wearing a mask when around others, she added.

Those who test positive should look at their own health and situation to determine if they need to see a doctor, Nesemeier said. He suggested people with a chronic medical condition or who become short of breath, such as gasping, seek medical help if they are infected.

Newman, who is also a pediatrician, said parents should make sure children who become sick with the virus are hydrated and monitored for symptoms, such as breathing fast for long periods of time and prolonged fevers.

The CDC recommends people who are infected with the virus isolate themselves at home for the first five days. If they have improved symptoms and no fever for 24 hours without using fever-reducing medication, they can end isolation, Newman said.

“But then we strongly encourage you to wear a mask day six through 10,” she said.

If a person tests positive on days six through 10, they should continue isolation until they test negative, Nesemeier added.

The CDC also has a quarantine and isolation calculator, which can be found at bit.ly/3BOteeL .

To find out where to get a coronavirus test in North Dakota, go to bit.ly/3zXzRtZ .

April Baumgarten joined The Forum in February 2019 as an investigative reporter. She grew up on a ranch 10 miles southeast of Belfield, N.D., where her family raises Hereford cattle. She double majored in communications and history/political science at the University of Jamestown, N.D.
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