(CNN) Chris and John Bjorkman bought their home in De Smet, South Dakota, less than a year ago. The couple, who celebrated their 39th anniversary last June, thought they would spend the rest of their lives together on the idyllic land, home to the "Little House on the Prairie" Laura Ingalls homestead.
The small town, home to just over 1,000 people, according to the 2019 census estimates, is about 100 miles northwest of Sioux Falls.
As the couple renovated their new home, they took caution to avoid the Covid-19 virus that swept the world into a pandemic in March. Despite keeping mostly to themselves, they both tested positive in September.
"We wore masks all the time. We wore masks, we stayed home," Chris Bjorkman told CNN. "We were more worried about me. I have several underlying conditions. He didn't."
But she survived. Her husband, a healthy 66-year-old, did not.
"He yelled that he had fallen," Bjorkman recalled. As she went to help him, he told her he couldn't breathe.
She took John to a hospital, but he was transported out of state just a few hours later. "He was flown out to Marshall, Minnesota, because they said the Sioux Falls hospital was full at the time."
John Bjorkman is one of 644 people who have died in South Dakota -- where the per capita Covid-19 rate leads above any other state in the country. The seven-day positivity rate is also alarmingly high -- at nearly 60%, according to data from the COVID Tracking Project -- higher than any other state in the US, which has seen more than 11 million people infected and over 247,000 killed by the virus.
The South Dakota governor's office disputed CTP's positivity rate, instead saying theirs is just over 21%, according to the state's Department of Health data. South Dakota does not provide the number of new tests that were administered in a single day, making it impossible to tabulate a 7-day average and get a complete view on the positivity rate.
"When they flew me over here, I literally didn't know ... if I would see the next day," John said through tears in a video call shortly after being transported. "It makes me nervous. Literally, it could be December, January, before I get up, play a little bit with my grandson."
While John fought for his life in the hospital, his wife tried to speed up the renovations at home, so that he would have a comfortable place to recover. He had been given Remdesivir and started to get better. He was even taken back to South Dakota as his condition improved.
He died on October 20.
"I never thought he would not make it," Bjorkman said holding back tears. "I always thought he was going to come home ... I knew he might be in a wheelchair or something, but I just wanted him to come home."
She now holds onto her memories of her late husband as she sits in what was supposed to be their home.
"I just miss him, I miss all the things that he did," Bjorkman said. "He was a very positive person ... He was always happy, ready to go, ready to conquer the day. I mean, that was just John."
Bjorkman said her husband was always helping people, especially the children at the schools where he worked.
"When he was in education, he was always going out of his way for kids and stuff. Finding them tennis shoes or glasses if their parents couldn't afford it," she told CNN. "He was a good person."
Bjorkman told CNN she's speaking out because she knows if John were alive, he would still try to help people by telling them how deadly this virus can be.
"People need to take this very serious. And a lot of people don't, and we just need some kind of leadership in this state to help us get through this time," she said. "We have no one telling us what to do and I think some people need that ... They need to be told to wear a mask."
"People need to wear masks and they just need to social distance," Bjorkman said people should limit their interactions, social distance and wear a mask because "you don't know who is gonna survive it."
More than 62,000 people have tested positive for the coronavirus and over 3,500 have been hospitalized, according to the state's Covid-19 website.
But as coronavirus cases and hospitalizations continue to rise, rural areas are being hit the hardest despite lower populations and density.
According to data from the US Centers for Disease Control and Prevention, rural Americans are dying at rates 3.45 times higher than Americans living in metropolitan areas.
As of November 13, according to the CDC's data, the seven-day death rate per 100,000 people for Americans living in large metro areas is 0.2, while in rural areas it is 0.69. The national average seven-day death rate is 0.33.
South Dakota Gov. Kristi Noem never issued a stay-at-home order, and as people continue to get sick and die, says she will not mandate mask wearing.
Over the summer, the state hosted thousands at the Sturgis motorcycle rally, which has since been linked to dozens of cases of the virus and at least one death as well as a mostly maskless Trump rally in July.
Gov. Noem's office did not respond to a request by CNN on Monday and declined to join "New Day" for an on-air interview that morning.
A few weeks ago, while attending a Trump rally, the governor claimed people in her state were happy. "The only reason you know who I am today is because the liberals have been busy kicking me in the head for all the decisions I've made for my people in South Dakota. But let me tell you, my people are happy. They're happy because they're free."
Although the governor feels no mask mandate is needed, health care workers told CNN they believe that could be the only way to curb the uncontrolled spread of the virus.
Former US Air Force veteran Dr. Shannon Emry wants a mask mandate to help mitigate the rapid increase in cases she's seen.
"Our governor has been misleading her constituents. From the start, she has downplayed the dangers of the virus, downplayed the importance of wearing a mask and it has really undermined the people's trust in their medical community," Emry said. "And by doing that, she's putting people in danger."
Emry said the lack of restrictions has left the state powerless to control the deadly virus.
"Our hospital systems across the state are already at capacity, are already at this critical state," she said. "The health care workers are obviously exhausted and the devastating thing for them is that we don't see an end in sight. There's not a stop date, there's not a timeline."
Jodi Doering, an emergency room nurse, told CNN's Alisyn Camerota on "New Day" on Monday morning that she's seeing many people in her state in denial over their Covid-19 diagnoses, and are often angry in the last moments of their lives when they could be talking to loved ones.
"Even if positive results come back, some people just don't believe it," she said, adding that they sometimes will insist it's something else like the flu, a cold or even lung cancer.
"It's hard and sad because every hospital, every nurse, every doctor in this state is seeing the same things. These people get sick in the same way, you treat them in the same way, they die in the same way. And then you do it over again," Doering told CNN. "It just makes you mad and sad and frustrated."
Doering wants people to recognize the cost and the severity of this virus in South Dakota and take steps to protect themselves so that they don't end up in the hospital, where "it might be too late."
Update: After this story published, the governor's office disputed the 60% positivity rate from the COVID Tracking Project. This story has been updated with information about how South Dakota calculates the state's positivity rate.