WADENA, Minn. — In this central Minnesota town, it's hard to find someone who hasn't been affected by the COVID-19 pandemic.

Just about everyone, it seems, either has had COVID themselves or knows someone who did. Many have seen friends or family members die of the disease.

Yet life is going on at a pretty normal pace. The annual Christmas lighting ceremony is set for Sunday night at the local park. The stands are full at school basketball games, and the high school thespians just wrapped up a performance of "The Wizard of Oz." Few residents are wearing masks.

You'd never know that Wadena County is one of the state's — in fact, the nation's — biggest COVID hot spots. The county currently has the third-highest rate of COVID in the state, with about 16% of those tested showing a positive result, according to the Minnesota Department of Health. It also has one of the state's lowest rates of vaccination, with about 45% of residents vaccinated.

And despite the increasingly urgent pleas of local medical professionals, it doesn't look like that's going to change. The people of Wadena County have made up their minds.

"It's political. You're not going to convert anyone at this point," said Brittney Ewert, owner of a downtown hair salon. "A lot of the rural people are very stubborn. They don't like being told what to do." The mother of one of her clients died of COVID, she said.

Ewert, 33, is unvaccinated and had COVID a month ago. She said it felt like "a little more than typical" cold, and she stayed home from the salon for 10 days. She said she's happy to mask up if a client requests it, but on Thursday last week only one person out of six in the salon — a client — was wearing a mask.

Just down the block, Ron Greiman shakes his head at the situation. Greiman, 71, owns a printing and sign shop. He's had two vaccinations and just got a booster shot last week. Several of his employees are unvaccinated, and one just tested positive for COVID. The father of one of Greiman's friends died of COVID three weeks ago.

"I don't understand it," he said. "It's not a political thing. It's not a Biden or Trump thing. It's a medical disaster."

Fighting disinformation

That's the message that local medical leaders have been delivering, and they say they're frustrated that it doesn't seem to be getting through.

"I think the vast majority of people in the county are convinced that it's not a big deal," said Dr. Ben Hess, chief medical officer at Tri-County Health Care, which serves Wadena, Todd and Otter Tail counties. "We've been fighting this disinformation campaign on the internet since the beginning of the pandemic."

Hess grew up in the area and returned to practice medicine there. He thought his background would make him a trusted adviser.

"I would have thought that I would have a little more sway," he said. "I'm not an outsider."

But after reaching out on social media during the early stages of the pandemic, he said, "I couldn't put out information without a deluge of misinformation and attacks. People are resisting our advice and proposing all these cocktails and getting mad and upset that you're not listening to them.

"I wasn't trained for that in medical school."

Joel Beiswenger, Tri-County's chief executive, said the organization has tried to be "a purveyor of good information. Part of our mission of improving and safeguarding the community's health is to put good information in people's hands and advocate for what we believe are sound COVID management techniques."

Acknowledging the passionate disagreement in the community around COVID, Beiswenger said he'd been walking a careful line, not wanting to get caught up in the polarization. But as cases have skyrocketed in the last couple of months, he said, "I've been delivering stark reality messages. We have one of the highest prevalence rates in the nation.

"The fact is, the disease is here. We're seeing it in the data, we're seeing it in the testing rates. We're seeing it in the activity in our hospital." Tri-County encourages vaccination as the most effective means of COVID prevention but also stresses masking and social distancing for those who are unvaccinated.

Tri-County's own COVID statistics, which come from a national health care accreditation agency, are far higher than the state's figures. By those measurements, Wadena County's prevalence rate is 200 people per 10,000 residents. With a population of just under 15,000, that means there are roughly 300 COVID infections in the county right now.

At the hospital in recent weeks, 24-28% of those who came in for COVID tests have been positive. The hospital beds are full and the staff is burned out and stretched thin.

At the same time, as the pandemic moves toward the end of its second year, people want to return to normal life, Beiswenger said — not just in Wadena, but everywhere.

"Trying to send a message that, 'No, you can't and shouldn't,' isn't playing well," he said. "So what can you do?

"If you feel the need to gather, do it responsibly. Mask up, avoid large gatherings, socially distance. If you're sick, get tested or stay home.

"Because the health care system is overwhelmed."

Spike expected to continue

So far, the schools have weathered the spike relatively well, though there have been bumps. In the Wadena-Deer Creek district, one of four that serve the county, there have been times recently when heightened precautions were put in place, Superintendent Lee Westrum said.

The middle school and high school imposed a mask mandate for two weeks in October after cases among students and staff jumped, and three elementary classes went to distance learning for two weeks. Districtwide, there have been 76 cases of COVID among 720 students and staff members, Westrum said.

Local residents say they're well aware of COVID's presence, but they're skeptical of the seriousness of the disease, as well as of vaccination. David Patson, 49, said he had COVID in October 2020. When he got the Moderna vaccine in April, he said, it was worse than the disease. He had chest pains after his first shot and was admitted to the hospital overnight for observation. He later got a second shot and is waiting for a booster. Patson, 49, said he got the shots to protect his elderly parents.

His fiancée, who has a weakened immune system due to multiple sclerosis, has not been infected. Despite the widespread infections in the community, he takes that as a sign the virus is "not as contagious as they say.''

Pat Anderson and her husband, Stu, both had COVID earlier this fall. Neither is vaccinated, and neither plans to be.

"I've had worse colds than that," Stu Anderson said. He lost his sense of taste for about a week and felt "tired and lazy." One of his cousins died of the disease, but Anderson pointed out that vaccinated people have died of COVID, too, though across the world the unvaccinated have been dying at far higher rates.

"The way they're pushing the shots makes me suspicious," he said, suggesting that it was being done in the interests of drug companies.

Sandy Black said she believes the disease is real, "but I think they're making it bigger than it needs to be."

Black, 67, a retail clerk, said her daughter-in-law is currently on a ventilator in a St. Cloud hospital because of COVID-related pneumonia. Black herself is in remission from non-Hodgkin's lymphoma. She said she sometimes wears a mask in crowded places but didn't share whether she's been vaccinated.

Beiswenger doesn't see an end soon to the current spike in COVID cases, saying he expects the infection level to remain high well into January. Until then, it seems that life will go on as usual for Wadena County residents, even as many of them get sick or die.

"I know the good Lord is gonna take me sometime," Patson said. "He doesn't need anyone else's help."