In a statewide emergency alert Thursday, Gov. Mike Dunleavy implored Alaskans to immediately take steps to slow the spread of the coronavirus over the next three weeks as the state’s health care challenges continue to grow under the burden of rising hospitalizations and widespread community transmission.
The Alaska Department of Health and Social Services also reported 478 new COVID-19 cases and no new deaths Thursday, continuing a trend of daily case tallies above 400.
Dunleavy’s office on Thursday described how the governor “has deemed the current escalation of COVID-19 infections among front-line workers, including healthcare staff, first responders, and servicemembers and their support crews, as an imminent threat to the safety of Alaskans.”
“If we can buy time for our critical workers — if we can keep our systems operational — we can avoid being forced to take further action,” Dunleavy said in a video shared through an emergency alert that was sent to cellphones across Alaska. “But if we cannot reduce the spread of this virus, we reduce our future options for how to proceed.”
With the holidays typically a time for gatherings and travel, Dunleavy reiterated his call for Alaskans to celebrate the upcoming holiday season differently. He urged Alaskans to stay at least 6 feet from non-household members and wear a mask wherever distancing isn’t possible.
“For the next three weeks, I am asking you as the governor of Alaska, that we do everything possible to reduce these cases and bend this trend downward," he said in the video.
Mounting health care challenges
Hospitalizations and deaths have risen statewide in recent days, and 12 of the state’s 96 COVID-19 deaths were reported by the state this week. By Thursday, 100 people confirmed to have COVID-19 were currently hospitalized statewide while 13 other hospital patients were suspected of having the illness, according to the Alaska Department of Health and Social Services.
Hospital officials and public health experts have expressed concern that a growing number of cases could stretch the state’s health care staff beyond its capacity.
More than 1 in 10 people hospitalized in Alaska have COVID-19, said Dr. Anne Zink, the state’s chief medical officer, during a call with reporters Thursday. As that number increases, it’s harder to transfer patients and challenging to care for people with other urgent medical needs.
For the past month at Providence Alaska Medical Center in Anchorage, roughly 80 staff members at a time either have tested positive for COVID-19, had a recent exposure or are showing symptoms, Dr. Michael Bernstein, chief medical officer for the Providence Alaska region, said in an interview. Most of those exposures happened outside of work, he said, and quarantine or isolation can keep a staffer sidelined for up to two weeks.
A mounting number of hospitalizations nationally has made getting temporary, traveling health care workers a challenge as well with higher demand, he said.
On top of staffing concerns, COVID-19 hospitalizations at Providence have reached new levels, hitting a high of 40 twice in the past week. “We are in new territory,” Bernstein said.
If the total number of COVID-19 patients at the hospital were to double, Bernstein said, they might have to stop or delay elective medical procedures, which can create a backlog of people who need care.
Elective procedures at the state’s hospitals aren’t cosmetic procedures or frivolous procedures, said Jared Kosin, CEO and president of the Alaska State Hospital and Nursing Home Association: “We’re talking about procedures that are necessary for your medical care.”
Additionally, Kosin said stopping elective procedures at hospitals wouldn’t free up many beds.
“You don’t necessarily pick up a bunch of capacity. It’s not like your magic bullet," Kosin said. “This really comes back to controlling the number of patients that are coming through the doors with COVID, and the only way to do that is the public health mitigation measures.”
Central Peninsula Hospital in Soldotna had 76 staff members in quarantine on Thursday, Kosin said. Some nursing homes have as many as 14 people out a day, while he’d heard from another facility with 27 staff members out, Kosin said.
“The fact that we have this number of staff out, pulled off the front lines on a daily basis, is not usual," Kosin said. "And it is a major problem and is yet another example of how serious this is.”
Hospitals are designed to run full, Kosin said, and this time of year is busiest as people try to meet their deductibles and other seasonal illnesses become common. With the onset of a pandemic, there are now 100 or more people in the hospital who wouldn’t have been there this time last year, he said.
Calls to action
Dunleavy on Thursday noted several executive actions taken in response to the growing spread of the virus: a new 30-day emergency disaster declaration takes effect Monday; state employees will work from home “whenever feasible”; and employees and visitors at state work sites will be required to wear face masks and socially distance.
Through the end of November, Dunleavy and public health officials are also asking all local governments, businesses and organizations to have employees work from home if possible and urging businesses and organizations to provide food and supplies through curbside pickup. A spokesman for the governor clarified that Dunleavy’s message was not meant to suggest that schools in the state should close.
“My job as governor is not to tell you how to live your life. My job is to ensure the security and safety of Alaska," Dunleavy said in the video. "I can’t do that without your help.”
The governor has so far declined to issue a statewide mask mandate despite calls to do so from legislators, public health experts and local officials. Instead, he has said he supports local communities in their individual decisions to issue their own pandemic restrictions.
In response to an emailed question regarding whether Dunleavy’s thoughts on a statewide mask mandate had changed amid the increasing cases, spokesman Jeff Turner deferred to what the governor said in a briefing Friday.
“Do I have the authority to act unilaterally? Yes, I do,” Dunleavy said at that time. “Is that what’s best and is that going to get the best response from from Alaskans? We didn’t need to do that for the past several months and I don’t think we need to do that going forward. I think that can be done at the local level.”
Dunleavy has become more emphatic in his public messaging to Alaskans since hospital leaders and public health officials have expressed increasing alarm over the state’s health care capacity. In an extraordinary step, his video message was sent through the wireless emergency alert system — used for tsunami alerts, Amber Alerts and “other messages that require immediate action," according to the governor’s office — in addition to being shared on social media.
Turner said Dunleavy used the emergency text messaging system to directly reach as many Alaskans as possible at one time, noting that not everyone in the state regularly uses social media or follows the news.
“The capacity of our healthcare system to care for any Alaskans that need hospitalization is a legitimate and urgent concern,” Turner wrote in an email.
Dunleavy has maintained that increased transmission of the illness was an expected outcome of the highly contagious virus. But last week, he noted that the state’s health care capacity could soon become overwhelmed as COVID-19 cases continue to climb statewide.
“No matter what you believe about the virus, the facts are the facts,” Dunleavy said in Thursday’s video. “Hospitalizations and sick health care workers are reaching untenable levels.”
Dunleavy’s message is clear, Alaska public health director Heidi Hedberg said.
“The governor really is using this to implore Alaskans to just step back, and to make a few more sacrifices for the next three weeks to collectively drive down the numbers," she said.
Thursday’s new cases
The state’s testing positivity as of Thursday was 9.66% over a seven-day rolling average. A positivity rate over 5% can indicate high community transmission and not enough testing, health officials have said.
Of the 477 resident cases reported by the state Thursday, 275 were in Anchorage, plus 13 in Eagle River, three in Chugiak and two in Girdwood; 31 in Fairbanks; 24 in Wasilla; 16 in Kenai; 13 in Palmer; 10 in North Pole; 10 in Soldotna; nine in Bethel; eight in Juneau; six in Sterling; six in Utqiagvik; three in Kodiak; three in Seward; three in Willow; three in Sitka; two in Ketchikan; two in Anchor Point; two in Delta Junction; two in Chevak; one in Homer; one in Nikiski; one in Kotzebue; one in Haines; and one in Dillingham.
Among communities smaller than 1,000 people that are not named to protect privacy, there were 17 resident cases in the Bethel Census Area; two in the northern Kenai Peninsula Borough; two in the Northwest Arctic Borough; two in the Bristol Bay plus Lake and Peninsula boroughs; one in the Nome Census Area; one in the Aleutians West Census Area; and one in the Kusilvak Census Area.
The state also reported one nonresident case in an unidentified part of the state.
Of the new cases, it is not reported how many patients were showing symptoms of the virus when they tested positive. While people might get tested more than once, each case reported by the state health department only represents one person.
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