The Midwestern state saw the country’s biggest two-week increase in COVID cases at 230%, according to New York Times data. The state recently increased the frequency with which it reports its COVID cases—from once a week to every weekday—which may have contributed to the boost.

Despite the spike, the state still has a much lower concentration of new COVID-19 cases (20 per 100,000 people) than current COVID hotspots such as Florida, Louisiana, and Mississippi, which all have more than 100 cases per 100,000 people.

The state has fully vaccinated 41% of its population as of publication, according to New York Times data.

At last week’s 81st annual Sturgis Motorcycle Rally, Gov. Noem reiterated that she will avoid mandates, including masks or vaccines. Noem said she prefers to give her constituents the information they need to make informed personal decisions. The Sturgis Motorcycle Rally was criticized by Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, who worried it could become a superspreader event, as it had been in 2020.

“There comes a time when you’re dealing with a public health crisis that could involve you, your family, and everyone else that something supersedes that need to do exactly what you want to do,” Fauci said on Meet the Press.

In a tweet about the motorcycle rally, Noem said she has “chosen to let people take personal responsibility for decisions the government has no authority to make.”

When COVID vaccines were first broadly introduced, Gov. Noem put out a video supporting vaccinations and talked about South Dakota’s initially high vaccination rate, which has since fallen.

The governor also took a shot at President Biden on Twitter Wednesday, saying he was pushing his authority too much.

“President Biden is overstepping his authority to try to push masks in schools and mandate vaccines,” read a tweet from Gov. Noem’s account. “He’s doing it to distract from the disastrous withdrawal from Afghanistan where Americans are left behind.”

More health care and Big Pharma coverage from Fortune:

• U.S. COVID travel restrictions are slowing growth, new hires—and love
• Americans ineligible for COVID booster shots are already snagging extra doses
• Inside the FEMA program that spent $1 billion on COVID-19 funerals
• Hong Kong is stuck between being open to China and closed to the world, or open to the world and closed to China
• Maven Clinic becomes the first U.S. “unicorn” dedicated to women’s and family health