Minneapolis, Minnesota — On Saturday afternoon, Torey Van Oot visited the recently opened COVID-19 saliva testing centre at the Minneapolis-Saint Paul International Airport.
After following well-marked free parking instructions, the Minneapolis resident arrived at a station, demarcated by plexiglass, where she spat into a cup, while surrounded by fellow residents doing the same.
“The whole experience car to car was 47 minutes,” Van Oot told Al Jazeera. She received the test results by email at 12am on Monday.
The airport testing site was opened on November 12, the same day that Minnesota launched statewide at-home saliva testing following a 24-county pilot last month. So far, more than 50,000 tests have been sent to homes in the Twin Cities metro area alone.
The testing blitz, in partnership with Vault Health, a New York-based men’s health company, is an attempt to contain the rapid spread of the coronavirus, which has surged in the Midwest in recent weeks.
“We’re at a dangerous point in this pandemic. As many of you have seen, it is raging across the upper Midwest and across this nation. We’re seeing infection rates in the state surrounding Minnesota that are the highest on the planet,” Minnesota Governor Tim Walz said in a press briefing on Wednesday.
The governor announced a raft of new measures designed to slow transmission, including a halt to indoor dining at bars and restaurants, and closures of gyms and fitness facilities.
The Minnesota department of health on Wednesday reported 5,102 new cases of COVID-19 and a record 67 deaths. According to data from Johns Hopkins University, the state recorded 47,268 cases over the previous seven days.
The recent spike in cases comes amid continuing partisan battles in the state legislature over the response to the outbreak.
Republican officials, including State Representative Matt Grossell and State Senate Majority Leader Paul Gazelka – who announced a COVID-19 diagnosis on Sunday – have been outspoken critics of Walz’s use of emergency powers to manage the pandemic from the beginning.
Despite internal resistance, Minnesota has launched what Vault founder Jason Feldman describes as “a full-scale assault on COVID on every level” with its wide-sweeping testing efforts that were mobilised in just seven weeks.
However, the state is surrounded by others with worse COVID-19 situations than its own – so much so that it has started allowing Wisconsin and North Dakota residents to get tested at Minnesota sites near the borders.
While much of the Midwest, particularly North and South Dakota, avoided major outbreaks earlier this year, experts fear that the recent surges suggest that the states’ lackadaisical approach to containing COVID-19 has caught up with them.
Between September 1 and November 18, Wisconsin’s positivity rate rose from a 9.2 percent seven-day average to 33.1 percent. Iowa has recorded a 22.1 percent testing positivity rate over the past 14 days.
In North and South Dakota, the situation is even more dire. On September 1, North Dakota had around 1,900 active positive cases. On November 18 there were 10,131 active positive cases. As of Thursday in South Dakota, there were 17,884 positive cases which account for 26 percent of the 68,671 total cases the state has seen to date.
“It’s the culmination of months of inaction,” Dr Jeremy Youde, an expert on global health politics and Dean of the College of Liberal Arts at the University of Minnesota, Duluth, told Al Jazeera. “The states where we’re seeing big outbreaks in the Midwest have delayed or refused to take actions that Fauci and the CDC have been recommending.”
Youde explained that public health issues are “seen through a partisan lens”.
In addition to a lack of mask mandates and social restrictions to mitigate spread, there has also been active pushback when attempts were made. Jere Fabick, a board member and adviser of the conservative think-tank Heartland Institute, sued Wisconsin Governor Tony Evers after he attempted to require mask-wearing statewide last month.
South Dakota remains restriction free, a position that its Republican Governor Kristi Noem has maintained since the beginning of the outbreak.
Republican North Dakota Governor Doug Burgum and State Health Officer Dirk Wilke announced North Dakota’s first COVID-19 mitigation requirements (PDF) on November 13, three days after Burgum’s November 9 announcement that the state was at 100 percent hospital capacity.
These included 50 percent capacity in bars and restaurants, 25 percent capacity at event venues, and wearing face coverings in indoor businesses and public settings as well as outdoor settings where social distancing is not possible. The mask mandate does not come with enforcement, expires on December 13 and excludes religious services.
Burgum and Wilke also took an unusual step to attempt to address the state’s lack of hospital capacity: allowing healthcare workers with asymptomatic cases of COVID-19 to continue working in hospitals and nursing homes (PDF).
The announcement took Tessa Johnson, president of the North Dakota Nurses Association, and her group by surprise. “It was kind of a punch in the gut for us because we did not have any conversation with him,” she said.
Johnson told Al Jazeera that she loves her job and her team, and that if she was asked to work while positive, she likely would if there was not anyone else available to do it. Others are worried that if they do not continue to show up to work while sick that the decision might be held against them in the future.
Yet, without federal relief and a national mitigation strategy, waiting on a vaccine – unlikely to be widely available before 2021 – is the most likely solution to the upper Midwest’s battle with COVID.
For Johnson, North Dakota got into this situation “because our elected officials have not listened to science. They have not made hard decisions soon enough.”
Johnson concluded: “People keep saying that it’s taking away personal freedoms, but at the end of the day there’s no accountability and guess who communities want to pick up the pieces? Nurses.”