South Dakota’s Republican Governor Kristi Noem is one of the only governors that has not issued a stay-at-home order to combat the spread of the coronavirus. Now, coronavirus cases in the state have surged and a meatpacking plant in Sioux Falls with a large immigrant workforce has become the largest coronavirus hotspot in the country.

As a response to the outbreak, Noem announced she is launching a statewide clinical trial of hydroxychloroquine, the anti-malaria drug that President Trump has repeatedly promoted during his daily press events.

“For the past week, I have been in direct contact with the White House, with President Trump’s team, spoken with Vice President Pence, Jared Kushner, the chief of staff, many within the task force on making sure that they knew what we wanted to do here in South Dakota,” Noem said at a press conference on Monday. “This would be the first-ever state-endorsed, state-backed, statewide clinical trial available in the United States to help take care of our people here.”

South Dakota’s trial will have two components: all coronavirus patients in the state—44% of whom are from the meatpacking plant’s immigrant workforce—will have the option to take hydroxychloroquine, and a randomized placebo-controlled trial will be conducted for people who have been exposed to the virus.

While there is anecdotal evidence that hydroxychloroquine can be helpful, there is also reason to be cautious with the drug. In Brazil, a trial of a related drug, chloroquine, was recently halted after coronavirus patients developed potentially fatal heart arrhythmias. And in the U.S., while a number of federal agencies are currently facilitating clinical trials, coronavirus task force member Dr. Anthony Fauci has warned that very high doses of the drug are used for coronavirus patients and the toxicities are not yet known.