Lesson from North Dakota's horrendous COVID reality: Don't fight precautions. We need them.

I rode my bicycle across the northern United States at age 18, and when I encountered the dusty, endless plains of North Dakota, the ever present head winds slowed me down. I will never forget the struggle to overcome them, or the beautiful oasis of Turtle River State Park, outside of Grand Forks. North Dakota is fighting a different kind of head wind these days, and the oasis is nowhere in sight, at least not yet.

Dr. Paul Carson, director of the Center for Immunization Research and Education at North Dakota State University and a top infectious diseases and public health official, told me in an interview aired on SiriusXM this week that it is a “dark time … pretty dire,” especially in North Dakota, which “leads the country in new cases, hospitalizations and deaths per capita.”

Carson said that most hospitals are at complete capacity, and that there aren’t enough staff. At nursing homes, the night shift became infected and is out. All health care facilities are struggling how to staff and care for residents.

On Saturday, the state reported 2,278 new COVID-19 cases, its highest single-day total since the beginning of the pandemic, with a daily positivity rate of 17%. How did it come to this?

Aggressive testing and army of tracers

Carson, who serves on an advisory committee to the health department and Gov. Doug Burgum, said that at first, the governor was quick and aggressive and North Dakota led the nation in testing per capita.

“We had an army of contact tracers,” Carson said, “We did very well.”

Then over the summer, he said, these efforts combined with low numbers and the fact that they were a rural population “made us complacent and overconfident.”

Fall came and activities moved back indoors. Case spikes occurred at universities, and there were superspreader events at weddings, funerals, parties and other occasions. Carson said he traveled across the state and saw very few masks while people continued to gather in small and larger groups: “Civic leaders were loath to ramp up protections.”

Carson went on to describe the critical shortage of nurses, the stiff competition for traveling nurses and what's happening to intensive care units — they're becoming unsafe, with one nurse for every three or four patients.

“We just had our governor issue a statement allowing infected health care personnel to continue working," he said, calling it a "terrible Faustian bargain to try and have enough staff. The North Dakota Nurses Association pushed back on that pretty hard.”

This new reality is simply horrendous. Carson pointed out the great risks of spreading COVID-19 in the nursing station and break room, by having infected nurses around other colleagues who are not infected: “This is not a great idea, but our alternatives (including asking family members to care for their relatives) are becoming very, very few. … Terrible place to be.”

Research shows that masks dramatically reduce the rate of virus transmission (by 70% or more in some studies), protect the people wearing them as well as those around them, and reduce the severity of the virus in people who do get infected. Carson said he believes in mask mandates, especially in hot spots like North Dakota, with a small fine to be administered for noncompliance. I agree with him.

Lay off my governor: Please stop trying to get Gov. Whitmer killed. She's doing her job to protect us from COVID.

On Friday, Burgum issued an order that people throughout the state must wear face coverings inside businesses and in indoor public settings, as well as outdoors where physical distancing isn’t possible. Failure to comply makes you liable for a penalty up to $1,000. At the same time, bars and restaurants are directed to limit capacity to 50% and must be closed by 10 p.m., with large scale venues limited to a 25% capacity.

Top-down COVID-19 leadership needed

More and more governors are taking such steps. In addition to Burgum, they include Republicans Kim Reynolds of Iowa, Mike DeWine of Ohio, Jim Justice of West Virginia and Gary Herbert of Utah, as well as the Democratic governors of California, New York, Michigan, Virginia and Hawaii.

Will these measures be enforceable, and will they have an impact? I think they will, though it is difficult to say how much. Over the course of the pandemic, I have become more and more a believer not just in the utility of universal masking, but also in the importance of consistent public messaging, beginning with mandating very limited or no gatherings. Leadership must come from the top down (the federal government), especially as this has been a national emergency involving every state in the country to varying degrees for several months now.

COVID, COVID and COVID: Top 10 ways Joe Biden can lead on health care, and why he should

Last spring, Turtle River State Park saw a surge of visitors looking to escape the restrictions and closures of the pandemic. While the beautiful park and Turtle River Nature Trail remain open, I certainly hope that the hikers are paying attention to the park’s warning about social distancing and the governor’s new mask mandate. This oasis from my past is a natural focal point for all North Dakotans and all Americans.

To avoid punitive lockdowns and devastating stay-at-home orders, we must understand how this virus spreads and how to protect each other. We are all in this together. To enjoy our country’s beauty and our freedoms, we must comply first and foremost with across-the-board public health measures needed to fight the pandemic.

Dr. Marc Siegel, a member of USA TODAY's Board of Contributors and a Fox News medical correspondent, is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. His latest book, "COVID: the Politics of Fear and the Power of Science," was published last month. Follow him on Twitter: @DrMarcSiegel

You can read diverse opinions from our Board of Contributors and other writers on the Opinion front page, on Twitter @usatodayopinion and in our daily Opinion newsletter. To respond to a column, submit a comment to letters@usatoday.com.

This article originally appeared on USA TODAY: COVID safety: Mask mandates and social limits help us protect each other