A new poll shows nearly one in four North Dakotans know someone who has died from complications of COVID-19, a stark indicator of the pandemic’s ongoing devastation in this sparsely populated state.

Meanwhile, more than three-fourths of respondents from the conservative and Republican-led state support some form of mandates to curb the spread of the coronavirus.

The poll was commissioned by the North Dakota Newspaper Association, and responses were gathered online by Nashville, Tenn.-based Coda Ventures from Nov. 4-16. Pollsters questioned 400 North Dakotans from across the state on their attitudes about wearing masks in public, the government’s response to the pandemic and how they’ve been affected by the public health crisis.

There was already plenty of evidence of the pandemic’s growing destruction in North Dakota. More than 1 in 1,000 North Dakotans have died from COVID-19 and more than 75,000 have tested positive, straining the state’s health care system.

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But the North Dakota Newspaper Association poll adds more context to the pandemic’s scale.

Nearly half of the poll’s respondents reported that they or someone they know has tested positive for COVID-19, and 24% said they knew someone who lost their life because they contracted it.

The poll, which was done in partnership with the education and public workers union North Dakota United, also tallied the economic damage left by the pandemic. A third of the respondents said they had seen a reduction in their paycheck, hours or sales. Another 15% had been furloughed, laid-off or otherwise lost their job.

And though 83% of respondents agreed that wearing masks, social distancing and avoiding crowds is the best way to stop the virus, only 67% said they “always” wear a mask in public places. In late October, just before polling began, the White House’s coronavirus response coordinator said Bismarck residents’ adherence to COVID-19 guidelines was the worst she had seen in the country.

Tanis Welch, an associate professor in public health education at the University of North Dakota, said more people are wearing masks now, but their initial aversion to them has forced more drastic choices today.

“Why weren’t we talking about these mask mandates in March, April and May?” she said.

Pollsters gathered most of the responses before North Dakota Gov. Doug Burgum reversed course and issued a statewide mask mandate earlier this month to curb the coronavirus’s spread. The order, which is in effect through Dec. 13, also limits bar and restaurant capacity.

Avoiding statewide restrictions by relying on a message of personal responsibility in recent months, the Republican governor said a recent surge in cases required a change.

Despite Burgum’s reluctance, the NDNA poll found 60% of North Dakotans support a statewide mandatory mask order. That enjoyed less approval than a local government mandate (68% support), but it was more popular than a national masking requirement (56% support).

Burgum’s spokesman Mike Nowatzki said the governor’s decision was based on reduced hospital capacity and “feedback from local leaders and local public health units that enforceable state action would support their local efforts.”

“The governor has consistently echoed the recommendations of health experts for increased mask usage and will continue to encourage the use of face coverings to help slow the spread of coronavirus and take pressure off North Dakota’s hardworking frontline health care workers,” Nowatzki said.

Moreover, 78% of poll respondents favored some form of mandates, whether it’s social distancing or masking requirements. More than half said businesses like bars, restaurants, entertainment venues, salons and fitness centers should remain open but with capacity limits and social distancing rules.

“Our civic leaders should take a great deal of encouragement that the majority of North Dakotans support these measures,” said Dr. Paul Carson, an infectious disease specialist and public health professor at North Dakota State University.

But there have already been signs of resistance to the governor’s mandate. Multiple county sheriffs have issued statements saying they won’t enforce the masking order, and the Tioga School Board voted against implementing it before financial pressure from the state caused them to reverse course, said Board President Mark Schmidt.

“We’re not not wearing masks. The issue is local control and personal choice,” he said. “We don’t believe that COVID is fake.”

Of the 11% of survey respondents who said they only sometimes, rarely or never wear a mask, most either questioned their effectiveness or said requiring a face covering “infringes on my freedom of choice.”

The Centers for Disease Control and Prevention says masks are effective in blocking respiratory particles that spread COVID-19, and it recommends people wear non-valved, multi-layer cloth masks. The federal agency says that’s especially important for people who are unknowingly infected with the virus but aren’t showing any symptoms.

Carson raised concerns about the state’s rate of mask usage as well as the 14% of respondents who said they continue to socialize in public places without social distancing, a practice that he said contributes to the virus’s spread.

The survey was completed just before the Thanksgiving holiday, which health officials worried would fuel the continued spread of the virus as people gathered with friends and family.

“It’s a really critical time coming up with the holidays,” said Renae Moch, public health director for the city of Bismarck and Burleigh County. “If we continue to go down the path that we are, the Christmas holiday could be much worse than what we’re experiencing right now.”