**The answer is both straightforward, and strikingly odd: They aren’t hospitalizing many COVID-19 cases. **

For a while now, I’ve been reading that North Dakota is down to just a handful of staffed ICU beds. That’s been going on for weeks, even as the count of new cases per day has climbed rapidly. I keep asking myself, why hasn’t North Dakota run out of hospital beds?

Let me just do the simple comparison between ND and VA, for comparable periods, to show how the hospitalization rate has dropped in North Dakota. This is all based on data as reported by covidtracking.com.

And so, the hospitalization rate of new COVID-19 cases fell more than in half, in ND, for the last half of October, compared to the last half of September.

And the odd upshot is that, as it works out, ND hospitals remain very close to capacity, but do not exceed it, thanks to that greatly reduced hospitalization rate. The orange line above is daily new cases. The blue line is the number of cases actually in the hospital at any one time.

While the number of new COVID-19 cases per day more than doubled in the past month, the blue line stayed at very close to the same level. Which is right at the point where ND hospitals are very close to running out of inpatient ICU beds.

The upshot is that ND hospitals have been very close to (e.g.) running out of ICU beds, for about the last month. But, somehow, it has all worked out so that they haven’t actually run out of beds yet. Through the simple arithmetic of admitting a far smaller proportion of new cases than they did historically.