[1][2] In October 2020, North Dakota had the highest rate of COVID-19 cases of any U.S. state or nation in the world, although this had been attributed in part to extensive testing.

[8][9] That day, the Standing Rock Sioux and Turtle Mountain Band of Chippewa tribes began restricting access to their reservations.

[20] On March 27, North Dakota reported its first death related to COVID-19, involving a man in his 90's from Cass County with underlying health conditions.

[30] On April 28, Governor Burgum announced that the state would begin to lift some of the business closures it had implemented in March, under its "Smart Restart" system.

[35] On June 23, Governor Burgum stated that several counties were close to reaching the lowest "New normal" (blue) level on the Smart Restart system, noting the less than one percent positivity rate of COVID-19 in North Dakota.

[38]On August 19, it was announced that interim state health officer Andrew Stahl (who had succeeded Mylynn Tufte following her May 27 departure) would resign.

This came amid disagreements with the office of the Governor over aspects of North Dakota's COVID-19 response, including the risk level system and mandating face masks.

[42] On September 3, North Dakota held onto the most COVID-19 cases per capita in the United States for the past two weeks, according to figures by Johns Hopkins University Center.

[49] An Associated Press report released found that a statewide educational campaign on the importance of masks and social distancing had not begun, despite receiving federal funds.

The interim State health officer Paul Mariani resigned after serving less than a month on the position, due to Governor Burgum rescinding a requirement for self-isolation after returning from travel, and breaking away from guidelines recommended by the CDC.

The spike is suspected to have been contributed in part by hundreds of thousands attending the Sturgis Motorcycle Rally in South Dakota from early August.

[72] Renane Moch, the director of Bismarck-Burleigh Public Health, warned of the strain on the hospital system, with 241 inpatient and 32 ICU beds being available as of October 13 throughout the state.

[86] Governor Burgum announced that the state would refrain from reporting persons who had underlying conditions that died of COVID-19, as to not give residents "a false sense of security surrounding their risk.

In a press briefing, Governor Burgum warned that North Dakota was headed towards a "challenging time", and considering it the beginning of a fall surge.

[102][103] On November 9, Governor Burgum announced that all state hospitals were full, and that all counties would therefore be raised to level orange on the Smart Restart system.

[104] The North Dakota Nurses Association objected to the proposal, citing a potential decline in workers due to growing fatigue and inadvertently creating more avenues for the virus to spread.

[110] On November 17, the Federation of American Scientists projected that North Dakota had the highest mortality rate from COVID-19 of any state or country nationwide, at 18.2 per 1 million residents.

[128] On December 21, North Dakota health officials stated that contract tracing had become "more manageable" due to the decreasing infection rate, determining that it could restart full operations within the week after being halted in October.

[129] On January 2, new data including coronavirus numbers from the New Year's Day holiday put North Dakota's death toll past 1,300 cumulatively.

Governor Burgum announced that the state-wide risk level would be lowered from orange to yellow ("Moderate") on January 8, allowing an easing of capacity limits on bars, restaurants, and event venues.

Additional members include North Dakota University System Chancellor, Mark Hargerott, and State Superintendent, Kristen Baesler.

[139][140] On March 24, Governor Burgum issued an executive order halting in-person North Dakota Department of Transportation (NDDOT) administrative hearings and eliminated load restrictions on state highways.

[145] Burgum also signed a new executive order waiving the one-week waiting period to access unemployment benefits to mitigate the impact of COVID-19 on individuals and household members who lost their jobs.

[148] On May 22, it was announced that entertainment venues, recreation facilities, and personal care services could reopen under Smart Restart guidelines, and that some state employees would return to on-site work.

[107][108][109] On December 21, the curfew for bars and restaurants was lifted due to a decrease in cases and hospitalization, but occupancy limits remained in force — having been extended through January 8.

[131] During a press briefing on May 23, Governor Burgum appealed for residents to stop "shaming" others for wearing face masks in public, arguing that they were not a political issue, and that they may be doing so to help protect vulnerable family members.

[152][153] In response to a heightened rate of new cases, on October 20 Mayor of Fargo Tim Mahoney utilized emergency powers to enact a citywide mask mandate.

[155] In an October 26 meeting with White House Coronavirus Response Coordinator Deborah Birx, Governor Burgum stated that he did not plan to mandate masks state-wide.

[165][166][167] On May 20, North Dakota was one of the first states to commit to using the Bluetooth-based Exposure Notification System, which wirelessly logs encounters with other users of the app, and can inform them if they had been within proximity of someone who had later tested positive for COVID-19.

[173] In September 2020, MedicareAdvantage.com found North Dakota ranked fifth in the U.S. when it came to Coronavirus conspiracy theories per the research study which looked at Google search trends.