SIOUX FALLS, S.D. — In early April, with COVID-19 sweeping across the nation, South Dakota Gov. Kristi Noem made a big bet.

The state had yet to be hit by an explosion of the virus. But it expected one. Its modeling showed an overwhelming surge arriving in mid-June, one that would require 5,000 hospital beds, far more than the state had.

Many other states’ governors were fighting the pandemic by instituting lockdowns, a bludgeon of a policy meant to slow the spread of a relatively unknown virus and protect beleaguered hospitals from becoming overwhelmed with critically ill patients.

The first-term Republican governor of South Dakota took a different approach. There would be no statewide restrictions, she said, no lockdowns. South Dakota was not New York City, she said.

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Here, it seemed, was Noem’s gamble. She would hope South Dakota policed themselves, count on the state's dispersed population to limit the spread of the virus, and keep the state's economy open for business. Meanwhile, state officials and health system leaders would scramble to come up with the needed number of beds in time to meet the surge.

"We have a plan to get there," the governor said on April 3. "We do not have those currently today."

It was a bet she initially appeared to have won.

There were local spikes, including an outbreak among workers at the Smithfield meatpacking plant in Sioux Falls. Yet summer passed and an overwhelming statewide surge never materialized. New COVID-19 cases rarely exceeded 100 statewide a day, with serious cases well within hospitals’ capacity. The state’s economy and unemployment rebounded from early pandemic lows.

But COVID-19 wasn’t finished with South Dakota. As 2020 comes to a close, a resurgent virus has now pummeled the state for months, adding more than 1,000 South Dakotans to the state's COVID-19 death toll and staining Noem's laissez-faire approach — the very reason her political star has risen this year.

Noem's office refused an interview request with the governor from Forum News Service for this story.

A right-wing rising star

Noem's COVID-19 approach catapulted her into the national argument over pandemic restrictions.

Over the summer months, as COVID-19 simmered in South Dakota, conservative national media outlets held Noem up as an antidote and rebuke to governors who had throttled their economies with lockdowns to save lives.

"You have now stared down the mob and can say that you were victorious in being able to change the narrative," said conservative activist Charlie Kirk, in a May 1 podcast interview with Noem. "What is your advice for young conservatives out there that look to you for inspiration and also as a role model?"

Noem held near-daily news conferences during the pandemic's early days. But she also made plenty of national media appearances, almost exclusively on conservative media outlets and right-wing talk shows, beaming in from a taxpayer-funded TV studio she had built in the basement of the state Capitol in 2019.

Noem made 40 media appearances in the 65 days between the state's first reported COVID-19 case in March and her last regular pandemic news conference in mid-May, according to a list released by her office.

Just over half of her media appearances, 22 in all, were with conservative national media outlets such as Fox News and talk shows hosts like Rush Limbaugh and Glenn Beck, according to a Forum News Service analysis. Most of the rest were with local radio hosts, with a sprinkling of other in-state outlets.

Gov. Kristi Noem posted a photo on her Twitter account of her carrying the American flag during the opening ceremony of the Red Wilk Construction Bull Bash on Thursday night at the South Dakota State Fair.
Gov. Kristi Noem posted a photo on her Twitter account of her carrying the American flag during the opening ceremony of the Red Wilk Construction Bull Bash on Thursday night at the South Dakota State Fair.

Her national exposure only grew over the summer. Noem hosted President Donald Trump at a Fourth of July fireworks extravaganza at the Mount Rushmore National Memorial and she garnered a coveted GOP Convention speaking slot in late August.

"We are not — and will not — be the subjects of an elite class of so-called experts," she told a national TV audience. "We the people are the government."

But by the end of August, after the heavily attended Sturgis Motorcycle Rally and the reopening of schools and universities, South Dakota health officials reported a noticeable uptick in new cases, one that wasn’t slowing down.

A surge was here.

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A promising summer turns grim

COVID-19 had simmered in South Dakota. Now it boiled.

By late September, the state was nearly leading the nation for newly reported daily cases of the virus per capita, behind only North Dakota.

Noem, meanwhile, crisscrossed the country stumping for Trump's re-election, posing for selfies with fans and fundraising for both him and herself.

The governor was outside South Dakota for at least 12 days visiting eight states in October, according to a Forum New Service analysis of her social media sightings and media reports. Her travels, including events at two Trump resorts in Florida, came amid South Dakota's deadliest month of the pandemic to that point, with 202 reported fatalities.

“We haven’t had a governor who’s spent this much time out of state for business that was clearly not state business,” said Michael Card, political science professor at the University of South Dakota with a focus on the state's politics, in an Oct. 30 interview.

South Dakota Gov. Kristi Noem speaks during Sunday’s Women for Trump rally in Hermantown. (Steve Kuchera / skuchera@duluthnews.com)
South Dakota Gov. Kristi Noem speaks during Sunday’s Women for Trump rally in Hermantown. (Steve Kuchera / skuchera@duluthnews.com)

Her reviews at home that month were more mixed. Just over half of voters in the deeply conservative state approved of her performance as governor and rated her performance during the pandemic as excellent or good, according to a Mason-Dixon poll in October commissioned by Sioux Falls news outlets Argus Leader and KELO TV.

The unchecked virus began to kill scores of South Dakotans. It took about four months for COVID-19 to kill 100 of the state's residents. By the end of November the virus was killing 100 people in the state every five or six days. South Dakota regularly led the nation in the number of COVID-19 deaths per capita in November into December, on a rolling weekly basis.

The wave of serious COVID-19 cases slammed the state's health systems. Daily hospitalizations tripled in September and nearly doubled in October, hitting a Nov. 10 high before easing over the following months.

'Science, facts and data'

Noem has routinely said she would let the "science, facts and data" guide her COVID-19 decisions. But the governor has increasingly been at odds with the science, facts and data used by medical professionals and public health authorities.

The U.S. Centers for Disease Control and Prevention in July recommended universal community masking when outside the home and in December expanded its recommendation, citing a growing body of evidence that mask-wearing slows the spread of the virus.

Yet Noem and her staff have doggedly touted increasingly outdated advice that doesn't promote broad use of masks and remains focused on encouraging hand-washing and social distancing, with masks advised in only limited situations.

Noem rejected instituting a statewide mask mandate, dismissing recommendations from the state’s medical association, the state's three largest health systems and the White House Coronavirus Task Force.

South Dakota Gov. Kristi Noem, center, in a meeting with leaders of Sanford Health and Avera Health in Sioux Falls, South Dakota, March 17. (Submitted / Office of Gov. Kristi Noem)
South Dakota Gov. Kristi Noem, center, in a meeting with leaders of Sanford Health and Avera Health in Sioux Falls, South Dakota, March 17. (Submitted / Office of Gov. Kristi Noem)

Noem claims mask mandates don't work. But public health experts, including the CDC, point to convincing evidence to show such mandates do work, not as a light switch for the virus, but as part of a comprehensive public health strategy.

“Until we have an effective and widespread vaccine, the virus will spread — science tells us that,” Noem said in a Dec. 8 budget address to legislators.

Yet the virus is not an unstoppable force. Science — public health officials and experts, backed by accumulating research — have made clear the spread of the virus can in fact be slowed down by concerted, collective action such as masking.

RELATED: Health care after COVID-19: vaccine passports, social disruption and a forgetting of this era

Noem's mask mandate rejection pushed the decision down to local leaders, many of whom found themselves facing weeks of fiery, divisive public debate as they weighed local restrictions.

“I hate to say it, but it appears that we’re on the course right now that we’re going to remain on for the duration of this pandemic and that cities are virtually helpless to make anything better,” said Rapid City Mayor Steve Allender on Dec. 8, after a proposed mask mandate was tabled, according to the Rapid City Journal.

A question of gambles

If Noem was gambling her hands-off approach could save both the economy and lives, the death toll of the state's staggering late-year COVID-19 surge cast real doubts on her strategy.

The state's economy has thrived, especially compared to other states. But the human toll has been depressing.

As of Dec. 16, the number of COVID-19 fatalities in South Dakota stood at 1,300, only a few hundred deaths behind heart disease and cancer for 2018 causes of death among the state's residents. One in 10 South Dakotans has tested positive for COVID-19. One in 681 has died from it.

Gov. Kristi Noem speaks in April during a press conference as Sanford Health Executive Vice President Micah Aberson, left, and Dr. Allison Suttle, chief medical officer for Sanford Health announcing the state of South Dakota will be the first state to take part in a medical trial utilizing the drug Hydroxychloroquine to help treat Covid-19. Matt Gade / Forum News Service
Gov. Kristi Noem speaks in April during a press conference as Sanford Health Executive Vice President Micah Aberson, left, and Dr. Allison Suttle, chief medical officer for Sanford Health announcing the state of South Dakota will be the first state to take part in a medical trial utilizing the drug Hydroxychloroquine to help treat Covid-19. Matt Gade / Forum News Service

The COVID-19 surge appeared to have peaked in late November, with fewer daily cases reported and a slipping number of hospitalizations. Still, the death rate remained high into December, and state health authorities remained uneasy, cautioning that holiday gatherings might well reverse the declining case count.

If Noem was betting her pandemic approach, and her outspoken advocacy of it, would slingshot her into the national political limelight, she's won. She's there, showing up in a recent poll about potential 2024 GOP presidential contenders.

Noem has staked out a corner as a telegenic, conservative governor aligned with Trump, said Mack Mariani, a political science professor at Xavier University in Ohio with a focus on campaigns and elections. That should serve her well in the future of the GOP, which is essentially a party of Trump, he said.

"I see her as being well-positioned. The challenge is, the optics of COVID cases raises the concerns that, well, maybe you should have been more aggressive about masks, or more aggressive about state policies to limit people from coming together," Mariani said. "Where we end up a year from now with the virus, as we look back, we'll know a lot more about these decisions."

And maybe, too, we'll know what Noem's bet was.

This story is part of a 13-day series that looks at all the ways 2020 has changed us. From now until 2021, expect stories on workplace and education, sports, economics, politics and everything in between. Contact Fugleberg at jfugleberg@forumcomm, or 605-777-3357 or follow him on Twitter: @jayfug.