The first reported COVID-19 death stemming from the Sturgis Motorcycle Rally has occurred in Minnesota, The Washington Post reported on Wednesday. The rally, which drew over 400,000 attendees to Sturgis, SD last month, was widely criticized for a lack of safety protocols.

The biker, who was in his 60s, had underlying conditions and was hospitalized in an intensive care unit upon returning from the rally, infectious-disease director at the Minnesota Department of Health Kris Ehresmann said. This case was only one of a known 260 coronavirus cases across 11 states directly linked to the rally.

Related: COVID-19 Concert Cancellation Tracker: Gauging How Long The Event Shutdown Will Last [Updates]

While this is the first reported death linked to the rally with only 260 confirmed cases resulting from the gathering, epidemiologists are concerned those are far from the true numbers. This undercount is thought to be the result of resistance to testing as well as limited contact tracing in some states. The Washington Post states that the true number of cases resulting from the rally held August 7th–16th is likely to never be known.

As the 80th edition of the annual Sturgis Motorcycle Rally drew closer serious attention was paid to the small town of Sturgis and how it could possibly control the spread of an infectious disease at such a large gathering. South Dakota does not have a mask mandate in place, and Governor Kristi Noem has even publicly disparaged making face coverings mandatory in schools. So attendees were not required to wear masks when roaming about the town.

Both the main attraction of the rally and the main concern for health experts was the Sturgis Buffalo Chip, which staged nightly concerts from the likes of Smash Mouth, Buckcherry.38 SpecialTrapt, and many more. Prior to the event, organizers stated that hand sanitizer would be available throughout the concert grounds and that masks would be required upon entry. During the first weekend of the 10-day music festival, however, footage of a Smash Mouth concert went viral as thousands of fans gathered shoulder-to-shoulder without masks. Meanwhile onstage, singer Steve Harwell could be heard saying “F*ck that COVID sh*t!”

In the wake of the rally, states across the Midwest are seeing large spikes in new cases as the rest of the country begins to level out. South Dakota, where the seven-day averages for new cases was 107 in mid-August as the rally was happening, saw new cases spike to an average of 347 a week as of September 2nd. North Dakota also saw spikes in new cases from 8,968 to 12,267 in the same span of time. Health experts, however, cannot lay all of the blame on the rally and also fault the flaunting of health safety protocols across the Midwest.

[H/T The Washington Post]