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Stephen Groves
Associated Press 

SIOUX FALLS, S.D. (AP) — A small hospital serving the Cheyenne River Sioux Tribe has sent two coronavirus patients to an out-of-state hospital in recent days, the tribe's health agency said Wednesday, even as South Dakota's top health officials insist the state has plenty of hospital capacity for COVID-19 patients.

The Cheyenne River Sioux Health Department reported that it tried to find better-equipped hospitals to transfer coronavirus patients, but that 14 facilities said they were also diverting COVID-19 patients. Eventually, the tribal health department found a hospital in Burnsville, Minnesota, that would accept patients.

Gov. Kristi Noem has made the state's hospital capacity the bottom-line of her coronavirus response strategy. But as hospitals feel the squeeze of a rising number of cases and hospitalizations, the state's hospital systems have seen ripple effects from the largest hospitals that boast hundreds of beds down to the eight beds at the Cheyenne River Health Center, an Indian Health Services Facility.

The state's number of coronavirus-related hospitalizations again rose to an all-time high on Wednesday with 273 patients statewide.

Danette Serr, director of nursing at the Cheyenne River Sioux Health Department, is helping keep track of five hospitalizations among tribal members. The tribe depends on larger facilities when infections worsen.

"We're a very, very basic hospital," Serr said. "We can't do much here."

The Cheyenne River Sioux Tribe's chairman, Harold Frazier, has said the limited number of beds and remoteness of the facility is part of the reason the tribe enacted strict lockdowns and coronavirus checkpoints to minimize outbreaks on the reservation. 

(Related: South Dakota lawmakers criticize Kristi Noem on tribal checkpoints)

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But as the coronavirus surges statewide, the tribe and its health department have not been able to keep the virus completely at bay. 

Nonetheless, the South Dakota Department of Health reports that the state's hospital capacity remains in good shape. Secretary of Health Kim Malsam-Rysdon said hospital diversions and transfers are part of the way that hospitals share the burden of patients.

"The reason we will see diversions is due to a lot of different factors," she said. "We'll see diversions happen at various times of the year in certain parts of the state just due to more activity in that part of the state, more need for certain kinds of beds."

There are currently 37 South Dakota facilities caring for COVID-19 patients, including 10 with intensive care units and three using ventilators, according to Malsam-Rysdon. She said the large number of facilities handling COVID-19 patients shows the state's hospitals have prepared for the pandemic.

Malsam-Rysdon did not directly address why the two patients from the reservation hospital had to be transferred out of state.

The Department of Health is working to publicly report hospital capacity in greater detail, but currently only lists the percentages of occupied and available beds statewide. Thirty-nine percent of total hospital beds and 21% of ICUs are currently open.

Native Americans have been disproportionately affected by the coronavirus, accounting for nearly a quarter of hospitalizations statewide despite making up roughly 9 percent of the population. About 19 percent of the 258 people who have died from COVID-19 in South Dakota have been Native American.

Serr said that for the Cheyenne River Sioux Tribe's Health Department, the pandemic is worsening.

"Just recently, it's been the most difficult," she said.

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