SIOUX FALLS, S.D. — South Dakota Gov. Kristi Noem is showing no sign of budging from her hands-off approach to the pandemic, despite her state having the nation’s highest death rate this month.

South Dakota has reported 219 deaths in November — about a third of all its deaths over the course of the pandemic. The COVID-19 deaths have sent the state to the top of the nation in deaths per capita this month, with nearly 25 deaths per 100,000 people.

Still, Noem, a Republican, has no plans to issue mask requirements. The governor’s spokeswoman Maggie Seidel pushed back against arguments by public health experts, pointing to states like Illinois, Minnesota and Wisconsin that have also experienced significant virus waves in spite of having mask rules.