COVID-19 in Alaska: Fact-checking claims about case trends, death rates, masks and ivermectin

Alaska is at a critical point in the pandemic. Twenty health care facilities across the state are now operating under crisis standards of care, a reflection of the added pressure facing hospitals that are contending with scarce resources and high COVID-19 patient counts — and bracing for worse. Alaska’s recent per-capita case rate is the highest in the U.S., and higher than that of any country in the world.

At the same time, recent statements from public officials paint a much different picture of the pandemic, warranting closer scrutiny.

In Anchorage over the past week, a divided city debated whether to implement a mask mandate, and Mayor Dave Bronson touted a debunked medical treatment, pointed to data that he said showed Alaska’s case counts were actually declining and questioned the effectiveness of masks.

We fact-checked some of these claims.

Case counts are staying high, but there’s a COVID-19 case onset graph that appears to show a recent decline. What’s going on?

Anchorage Mayor Dave Bronson, who opposes a proposed citywide mask mandate and COVID-19 mandates in general, recently cited a graph on the city’s COVID-19 dashboard that he said showed a decline in the city and state. His remarks during Wednesday night’s tumultuous Anchorage Assembly meeting came in response to a testifier who was speaking in support of the mask ordinance.

Bronson said to the testifier: “I’m looking at the case onset by date graph, and I see that the seven-day moving average for both the state and municipality have been decreasing significantly since Sept. 13. I’m just curious, in your mind, which mandate caused those decreases?” A video of Bronson’s remarks popped up the next day, posted by his mayoral Facebook account.

In the graph Bronson was looking at, “onset date” refers to the day a person’s symptoms first began or, if they’re asymptomatic, the day they got tested.

Because the date a person gets tested or first experiences symptoms occurs earlier than the date the state reports that case, the last few weeks of data in the case onset graph are missing information that will get added in the coming days, Louisa Castrodale, an epidemiologist with the state health department, explained last week.

“Because the onset date is something that’s in the past, if you’re looking at the onset data curve, you’ll always see it falling off at the end there,” she said. That dip is even more pronounced because of recent backlogs in data processing.

“At a time when there’s really fast turnarounds with the labs, the report date and the onset date might be super close together, but when we know labs are having trouble processing specimens, and sometimes reporting in those results, you can really see a difference between that onset date and the report date,” she said.

A better way to measure Alaska’s current surge is by looking at week-to-week trends, said Dr. Joe McLaughlin, state epidemiologist.

By that measure, Alaska’s daily cases are still increasing — last week saw a 10% increase in cases compared to the week before — and the state’s seven-day per capita case rate is currently the highest in the nation. Specifically looking at Anchorage, the municipality’s seven-day per capita case rate is also higher than any other state’s, and there’s no evidence in the case numbers of a recent decline.

[Are Alaska’s hospitals short-staffed over COVID-19 vaccination mandates? Not yet.]

Does Alaska really have one of the lowest COVID-19 death rates in the country?

Essentially, it depends: Are you looking at the pandemic overall, or are you looking at how Alaska’s doing more recently?

Based on data from the federal Centers for Disease Control and Prevention, Alaska continues to have one of the lowest death rates in the nation since the start of the pandemic, along with Oregon, Maine, Vermont and Hawaii. Alaska has averaged 76 deaths per 100,000 people since January 2020, giving it the fourth-lowest death rate in the country for that time frame.

It’s a statistic often touted by Alaska Gov. Mike Dunleavy and Mayor Bronson, even while other data points — like hospital intensive care unit capacity and current case rates — continue to raise alarm from health officials.

However, looking at just the past week, Alaska as of Friday had the highest death rate in the nation, with 11.4 deaths per 100,000 people.

It’s important to consider how those death rates get calculated, according to state epidemiologist Dr. Joe McLaughlin. The CDC includes all deaths that were added to the state’s COVID-19 dashboard, which last week included many deaths that had occurred earlier in the year. There were actually only 20 that took place in the last seven days, rather than the 80 deaths that pushed Alaska into highest death rate nationally last Friday.

So, we can probably expect Alaska’s national position for the seven-day death rate to fluctuate in the next few days. Some might misinterpret the drop in death rate as an example of the state turning the corner on the virus, but that’s not exactly the case, said Rosa Avila, who works with COVID-19 data at the state’s health department. Rather, it’s just that the CDC was no longer including those additional older deaths in the seven-day death rate.

The bottom line, McLaughlin said, is cases are soaring right now.

“And we know that anytime we see a spike in cases, deaths will follow,” he said.

That’s what has played out across the state as case counts have risen since summer. In June, there were six Alaska residents who died with COVID-19, while there were 21 who died in July, 75 in August and 71 so far reported in September — and that tally could change as health officials tracking the virus receive more information about recent deaths.

[‘Watching themselves die’: Fairbanks nurse describes panic and ‘air hunger’ among COVID patients in video encouraging vaccination]

Do masks work?

In a recent op-ed opposing Anchorage’s proposed mask mandate, Mayor Bronson wrote: “Certainly, there are many studies that support the use of masks but ... there are also several studies that have found masking and mask mandates largely ineffective. That is why even the World Health Organization has recognized the science on masking is inconsistent and inconclusive.”

He’s referencing WHO guidance from December 2020 that advised the wearing of masks as one part of a more comprehensive strategy to limit virus spread. The WHO said at the time: “At present there is only limited and inconsistent scientific evidence to support the effectiveness of masking of healthy people in the community to prevent infection with respiratory viruses, including SARS-CoV-2.”

Bronson also cited a May 2020 article in a CDC journal that included research from 2018 and earlier, and found “limited” evidence of the effectiveness of surgical masks at preventing flu virus transmission.

Bronson was right that some of those early studies on masking were sometimes confusing and inclusive. But the science behind masking has evolved since those studies he referenced.

The vast majority of research now backs the theory that masks work — that they significantly protect both the wearer and those they come into contact with.

More than 10 studies cited by the CDC have since confirmed the benefits of universal masking at preventing community spread — including an analysis conducted last spring among 12 hospitals in Massachusetts that employees over 75,000 health care workers, a German study published in June 2020 and an Arizona study that tracked transmission rates before and after mask mandates were widely enforced, among others.

“Each analysis demonstrated that, following directives from organizational and political leadership for universal masking, new infections fell significantly,” the CDC said.

In Alaska, public health officials and medical providers have near-universally and consistently recommended the use of mask-wearing as one of the most effective, easy and inexpensive ways to slow community transmission, protect hospital capacity and prevent deaths.

Should ivermectin be used to treat COVID-19?

Ivermectin meant for livestock was in high demand at some Alaska feed stores after it gained traction on social media as a purported treatment for COVID-19. The FDA has approved ivermectin in both people and animals for some parasitic worms and for head lice and skin conditions — but the FDA hasn’t approved its use in treating or preventing COVID-19 in humans. The agency has strongly urged people not to use it to treat COVID-19, especially since many were turning to formulations meant for animals, not humans.

Kenai Peninsula Borough Mayor Charlie Pierce, who has no background in health or medicine, publicly backed the use of the treatment. Speaking at an Anchorage Rotary Club meeting last week, Bronson claimed the treatment worked very well.

“It’s an approved drug and it’s very effective,” he said. “It’s not a horse pill.”

Merck, the drug company that manufactures ivermectin, in February explicitly said that researchers found no scientific basis for a potential therapeutic effect against COVID-19 from pre-clinical studies and no meaningful evidence for clinical activity or clinical efficacy in patients with COVID-19. The company also cited “a concerning lack of safety data” in most studies.

Taking too much ivermectin can cause nausea, diarrhea, low blood pressure, itching and hives, dizziness, balance problems, seizures and even death, according to the Oregon Poison Control Center. Ingesting ivermectin formulations that are designed for animals is especially dangerous, as veterinary medications are often more concentrated and many of their ingredients aren’t considered safe for human use.

Dr. Anne Zink, Alaska’s chief medical officer, said last week that there is no proven benefit to taking ivermectin. Vaccination is the best way to fight the virus, and monoclonal antibody treatment can help those who do contract it to stay out of the hospital, she said.

[Touted by some as a cure, monoclonal antibody demand is high in Alaska’s least-vaccinated places — but it’s no replacement for a vaccine]