Two out of three Alaska adults have at least one risk factor that heath officials link with a higher chance of a severe COVID-19 infection, a new analysis from the state health department shows.
The findings show that most adults in Alaska are at an increased risk for hospitalization or worse if they contract COVID-19, the state’s chief medical officer, Dr. Anne Zink, said in an interview.
Zink, who still practices emergency medicine on nights and weekends, confronts COVID-19 directly while treating patients. Seeing the coronavirus up close, Zink said, is different.
“It’s humbling to see this disease upfront and firsthand,” Zink said. “And (I) see pretty young, fairly healthy people where their only risk factor is obesity being really, really sick and saying, ‘I thought I was going to be fine, everyone else I know was fine,’ and looking at them and wondering if they’re going to make it out alive.”
Zink said she thinks the illness gets incorrectly painted as a dichotomy: Some people assume that young, healthy people will do fine, while older adults will not. But the analysis shows just how many people are at an elevated risk statewide.
The conditions and risk factors are:
• People who are current or former smokers.
• Chronic obstructive pulmonary disease (COPD).
• Heart disease or a previous heart attack.
• Chronic kidney disease.
When someone with COVID-19 dies or is hospitalized, “the first thing everybody wants to know is about that underlying health condition,” said Karol Fink, director of the Chronic Disease Prevention section in the state health department, who helped put together the analysis.
That’s because people who don’t have such a condition or don’t recognize they have one, “they’re like ‘that’s not me, COVID isn’t going to impact me that way,’” Fink said.
But a brother, father, sister, mother, friend or colleague might have an underlying health condition that makes them more vulnerable to the disease, Fink said.
“So we really wanted to put a number to that thought process to help people understand how many Alaskan adults are at risk for serious illness from COVID-19,” she said.
Old age and chronic disease make many Alaskans vulnerable
In October, the Centers for Disease Control and Prevention published a list of conditions that can make someone more likely to develop a severe COVID-19 case, from cancer to obesity to sickle cell anemia, said Kira Anderson, a program evaluator and epidemiologist who worked on the analysis.
Using information from a survey of Alaska adults, she looked at six of the conditions published by the CDC to see how common they were among Alaskans, based on the 8,500 adults who responded to the survey between 2016 and 2018.
While the analysis found that two out of three Alaska adults have at least one of those conditions, other factors, such as being older, make a serious COVID-19 infection more likely as well, said Ann Potempa, public health specialist within DHSS’s Chronic Disease Prevention section.
Adding older age and chronic disease together, that statistic jumps to 71% of Alaska adults who live with some vulnerability to a severe experience with coronavirus, Potempa said.
Dr. Benjamin Westley, a physician who specializes in infectious diseases and has taken care of many COVID-19 patients in Anchorage, said a lot of hospitalized patients have at least one risk factor or condition described by the CDC.
Certain risk factors like smoking can make it harder to expel germs from the lungs and harder to fight a lung infection. And people with lung problems or obesity have trouble getting air out of their lungs, “so they just can’t deal with bad injuries to their lungs as well because they don’t have as much reserve,” Westley said.
Diabetes, on the other hand, puts people at both an increased risk for infections and can also mean having more inflammation in their bodies, including in the lungs, Westley said.
Many Alaskans with risk factors need to work
The state health department gets questions asking whether people of higher risk should just stay home, Zink said.
However, if two-thirds of the state stayed home, it would be hard to keep essential services open — from stores to hospitals and utilities — given how many people who at a higher risk. Everyone needs to do their part in order to protect others, Zink said.
“We need essential services to continue to make sure our food gets delivered and our lights go on,” Zink said. “We need people who have one or more of these underlying risk factors to work,” Zink said. “And that means we need to keep COVID at bay so they can do that.”
Westley, the infectious disease doctor, said everyone should keep in mind that even if they aren’t showing symptoms of the illness, they can still spread it to others who are at risk of becoming seriously ill.
“I think that people need to remember that even though they might feel that if they get COVID-19, it would not be a big deal, that half or two-thirds of the people they know — family or coworkers or friends — may have a risk factor for getting very sick,” he said.