GRAND FORKS — Thirty-three new cases of COVID-19 were reported Tuesday, Aug. 3, in Benson County, which encompasses most of the Spirit Lake reservation, and an additional three cases were confirmed Wednesday, Aug. 4.

The majority of those new cases came from a mass test on the reservation Friday, July 31, where 977 people were tested. Spirit Lake Tribal Health, which oversaw Friday's mass test, could not be reached for an interview.

Benson County and neighboring Ramsey County, which also includes the Spirit Lake reservation, have emerged as a new hot spot in recent days. Ramsey County, also home to popular summer destination Devils Lake, reported 13 new cases Monday morning and another six on Tuesday.

It's unclear how many of those cases, if any, were the result of Friday's mass test.

According to the North Dakota Department of Health, Benson County has 68 active cases of COVID-19, with 61 other cases that are considered recovered. Ramsey County has 34 active cases and an additional 29 cases that are considered recovered.

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Spirit Lake tribal leadership has spent recent weeks warning of the spread of COVID-19 through the reservation and has taken a number of actions to slow the spread. Last week, Chairman Doug Yankton Sr. issued an executive memorandum mandating face masks in public. There is also a 10 p.m. to 6:30 a.m. curfew and a stay-at-home order for those who test positive for the virus.

Attempts to reach Yankton for comment for this story were unsuccessful.

Scott Davis, the executive director of the North Dakota Indian Affairs Commission, said he has worked closely with Yankton and other tribal leaders across the state since the beginning of the pandemic. He said that, while tribal leaders take the virus seriously, they're not in "panic mode."

"They know they have resources; they know they can call us," Davis said. "They have help."

He said state officials have communicated regularly with tribal leadership to try to connect them with resources to fill their needs. Wednesday morning, he said the state sent a shipment of 3,000 face masks to Spirit Lake. Testing will continue on the reservation on a weekly basis.

In a news conference in May, Gov. Doug Burgum said that positive rates among Indigenous people in North Dakota are roughly in line with their proportion of the state's population. Wednesday morning, Davis said he believes that remains the case.

Nationwide, Indigenous people have been among the hardest hit by coronavirus outbreaks. Davis said Indigenous people in North Dakota are not shielded from some of the same issues that have exacerbated the pandemic on other reservations: health disparities such as higher rates of heart disease, diabetes and other underlying conditions can put some at higher risk if they were to test positive, and housing shortages on reservations can result in more people living in a single household, increasing the chance of transmission.

But Davis said his sense from working with tribal leaders from across North Dakota is that they count themselves fortunate.

"Compared to other states, other tribes across America, it's scary," Davis said. "I've talked to a lot of my traveled friends across America who don't have these resources, and I see the little panic in their voices and some of the decisions they make because they don't know who to turn to. The federal government is limited, and it's always late, and it's always minimal resources that you get from the feds, it's always been that way. So we're very fortunate here. I think the tribes are not in panic mode; they're very on top of this."

Though Spirit Lake oversees testing and coronavirus response on the reservation, Spirit Lake Tribal Health works frequently with the Lake Region District Health Unit, which is based in Devils Lake and operates as the health unit for Benson, Ramsey, Eddy and Pierce counties.

Health Unit administrator Allen McKay agreed with Davis that the recent spike in cases in the area could likely be attributed to more people enjoying the warm weather, socializing and relaxing social distancing practices following the Fourth of July. McKay said he also believes that numbers will likely continue to go up before they go down as health officials begin testing close contacts of people who have already tested positive.

"Up until this point, they thought, 'Well, geez, we have really low numbers in Ramsey County. We're outside, it's not that big a deal,'" McKay said. "Once they see these numbers, I think it will shock people. Maybe they'll start wearing their masks more often, and social distance, and not get together in large groups."

Ramsey County has a positivity rate around 1% to 2%. That's relatively low, McKay said, though it's the highest the county has seen throughout the pandemic.

He also noted that, in recent days, he's seen more Devils Lake businesses post signs encouraging patrons to wear masks, and at the Ramsey County Commission meeting Tuesday morning, commissioners voted to require masks in the county courthouse.

McKay said 200 tests were administered at a mass testing Tuesday morning at Lake Region State College in Devils Lake, but another 200 people were turned away when testing supplies were depleted. He expects results from that test will be available within the next few days. Another test will be scheduled in Devils Lake on Tuesday, Aug. 11.

"I'm sure, after this 13 (positive cases reported Tuesday), we're going to have a big rush of people that want to get tested," McKay said.

A combined three people have died of COVID-19 so far in Benson and Ramsey counties. NDDOH reported on July 19 that a Benson County man in his 30s was the county's first person to die of the virus. At that time, the man was the youngest person to die of COVID-19 in the state.

Two people have died of the virus in Ramsey County: a woman in her 90s with underlying health conditions, reported on May 18, and a woman in her 80s with underlying health conditions, reported on July 30.