It's not just garbage-in, garbage out; it's also sample size.
The IHME works great in New York, where you have a huge sample size, high density and lots of hospitalizations. But the smaller the populace, the more that statistical noise gets baked in. You have less density, less person-to-person contact, smaller social circles and thus a smaller R0.
Since North Dakota isn't tracking recoveries, I'll use South Dakota as an example. South Dakota has 66 counties. A majority of them—I counted 44, but I might have missed or double-counted while scrolling—either no longer have any active cases or never have had any to begin with. But that Sioux Falls meat-packing plant outbreak skews the results for the whole state. Those 44 counties have no reason to be locked down.
I will also note that the IHME also projects no shortage in hospital or ICU beds for either North Dakota or South Dakota, so in those cases there is arguably no need for lockdown there.
Whoa....North Dakota IS tracking recoveries. There are 310 recovered as of today.
Here is the Dept of Health website.
https://www.health.nd.gov/diseases-conditions/coronavirus/north-dakota-coronavirus-casesNorth Dakota had its skewing event in Grand Forks County at the Wind turbine plant, but generally, the number of cases is highest in Cass County (Fargo, and by far the most long term care facilities) and Burleigh county (Bismarck) Those three counties also contain the three largest cities in the State.
Living here these past 42 years, I have watched this closely as it developed from the first case in the State in Ward County. Despite being first on the board, that gentleman stayed home and self-quarantined. I pray he is well. The county, however did not continue on to have the most cases, despite having the 4th largest city in the state, and an AFB, still well behind the six counties with more cases.
If you do a mental overlay of the
highway map with the dept of health map (see link above) showing cases by county, the following trend applies. Cases generally are greatest along main highway corridors, I-94, US2, and I-29, HWY83, and US85.
For the most part the highest number of cases are in counties with the largest cities. Dickinson, in Stark County, is the last large town on the way to Billings, with the exception of Miles City, MT. Not just destinations, these are the places people get a bite to eat, a room for the night, fill up the gas tank.