BISMARCK — In one of the worst days of the pandemic in North Dakota, the health department on Friday, Oct. 16, reported 18 deaths from COVID-19 and record-high numbers of active cases and new infections.

The deaths came from all over the state, including four from Burleigh County, three from Stark County, two from Bottineau County, two from McHenry County and one each from Cass, Grand Forks, McLean, Morton, Towner, Ward and Williams counties. All of the victims were at least 60 years old and had underlying health conditions.

The department says 388 North Dakotans have succumbed to the illness since March, and deaths have been mounting at a rapid pace over the last two months. The state is averaging more than seven COVID-19 deaths per day in October, putting it on pace to be by far the deadliest month of the pandemic.

At least 245 of the state's deaths have come in nursing homes and other long-term care facilities, many of which have been decimated by the virus in the last two months. Seven facilities have 10 or more infected residents, including Minot's Somerset Courts, which has 74 residents with the virus — more than half of the facility's residents.

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There are now 5,247 North Dakotans known to be infected with the virus. It's the ninth day in a row the state has set a new record and the first time the figure has surpassed 5,000.

North Dakota has reported the most COVID-19 cases and deaths per capita in the nation over the last week, according to The New York Times. The whole region is experiencing a surge in cases, with South Dakota, Wisconsin, Iowa, Montana and Minnesota all identified by the publication as states where infections are "high and staying high."

The number of hospitalized residents due to the illness rose to 148 on Friday. Another 69 patients were initially hospitalized with some other ailment but later tested positive for COVID-19. Thirty-nine residents with the virus are in intensive care.

North Dakotans who are transferred out of state for medical care are not tracked by the health department, spokeswoman Nicole Peske said.

The state is battling through a shortage of available hospital beds as COVID-19 hospitalizations converge with strains on health care staffing and high noncoronavirus admissions. There are 19 available intensive care beds and 236 regular, inpatient beds in the whole state.

The situation is especially dire in Bismarck, where the two hospitals have one available ICU bed and five inpatient beds between them.

Fargo's three hospitals have a combined five open ICU beds and 17 inpatient beds, while Grand Forks' Altru hospital reports it has two ICU beds and 18 inpatient beds.

The health department reported a record 877 new cases of COVID-19 on Friday. All but 10 of the state's 53 counties reported at least one new case.

Cass County, which includes Fargo, reported a whopping 223 new cases of COVID-19 on Friday. The state's most populous county has seen a spike in new infections over the last two weeks and now has the most active cases in the state with 1,045. That's more than all of North Dakota had as recently as mid-August.

Grand Forks County, which has seen a recent surge in infections, reported 113 new cases, bringing its active case count up to 400.

Burleigh County, which encompasses Bismarck, reported 108 new cases Friday. The county has the second most active cases in the state with 890. Morton County, which sits just west of Burleigh County and includes Mandan, reported 29 new cases and has 315 active cases.

The state's three largest metro areas account for about half of the active cases in the state.

Ward County, which includes Minot, reported 116 new cases Friday. The county, which is seeing its most severe outbreak so far, now has the third most active cases in the state at 445.

About 10% of the 8,761 residents tested as part of the latest batch received a positive result, but 17% of residents tested for the first time got a positive result.

North Dakota does not report a seven-day rolling average for positivity rate, but Forum News Service calculated the rate to be 9.2% for all residents tested and 16.1% for tests taken on previously untested residents. Both rates are the highest since Forum News Service started tracking the figures at the beginning of August.

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