In September 2020, a farmer in Divide County, North Dakota, suffered a heart attack during harvesting. While he was in critical condition in a local hospital, nearly 60 of his neighboring farmers came to his aid — halting their own harvest so that his crops could be gathered in time.

This is the Dakotas that I know.

I am a transplant here in South Dakota. Over 10 years ago, I arrived as a new physician who had graduated from an Ivy League school and had lived for several years in New York City. Truth be told, I came with preconceived notions of this community.

I could not have been more wrong. What I found here was a community more caring, more willing to sacrifice, and more willing to take on hardship for each other than I have witnessed anywhere else.

The story of this farmer is not unique.

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During my time in South Dakota, I have lost track of the acts of selflessness I’ve witnessed in our intensive care unit, of the innumerable times that a community rallied around a sick child. This spirit of community and shared sense of duty are felt in many areas of the country, from small towns to large cities. We come together in a crisis and look out for our neighbors.

But over these past several months during the COVID-19 pandemic — the most significant professional challenge I’ve faced as a pediatric critical care provider — I’ve lost sight of the Dakotas I’ve come to know and love.

You see, the Dakotas I knew would do anything for their neighbor. The Dakotas I knew would bear any burden if it helped their community. The Dakotas I knew would sacrifice anything to protect their kids.

Recently, I admitted a child from North Dakota with COVID-19. Unfortunately, because of the surge in critically ill pediatric patients, all pediatric critical care beds in North Dakota were full and he was transferred to South Dakota, hours away from home.

He was not old enough to be vaccinated and he contracted COVID from his community. He ultimately survived and returned home, but he required treatment and aggressive respiratory support in the intensive care unit.

Across the U.S., my colleagues in pediatric intensive care units face a remarkably unique illness. We know how to limit its spread and we have a way out — through a deeply tested and proven vaccine. Yet this is an illness that has overrun numerous pediatric intensive care units in the South and Midwest.

The Dakotas I knew and love would do anything to prevent this from happening.

But the Dakotas I see now are fighting over the science of masking while accepting that all surgeons wear masks to prevent infections in the operating room. The Dakotas I see now are arguing against COVID-19 vaccine mandates even when, in our own states, many other vaccinations are required for school entry. The Dakotas I see now are challenging the scientific knowledge and integrity of providers yet expecting the same overwhelmed providers to provide them the best possible care based on science when they become ill.

This is not the Dakotas I knew.

Divide County, North Dakota, the county where so many farmers came out selflessly to help their neighbor, currently has a vaccination rate of only 42%. COVID cases in the county, similar to other parts of the country, have skyrocketed in recent weeks to levels not seen since December 2020.

I have a simple request: Please bring back the Dakotas I knew. We can do this by:

— Caring for the kids in our communities who are too young to be vaccinated or are immunocompromised by masking and limiting the spread of COVID.

— Supporting masking in schools so that kids can continue their education in person without fear of being taken out of schools for quarantines or illness.

— Getting vaccinated so that a COVID hospitalization doesn’t overwhelm the local hospital to the point that kids must be transported to another state for care.

The Dakotas I knew and love would do anything to prevent suffering in their community.

I long to see those Dakotas again.

Dr. Benson Hsu is a pediatric critical care physician in Sioux Falls, South Dakota, and the chair-elect to the Section on Critical Care at the American Academy of Pediatrics.

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