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Rural Alaska

From PPE to testing, officials outline strategies for rural Alaska communities to prepare for COVID-19

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As the number of Alaska COVID-19 cases continues to rise, Alaska officials outlined plans for rural communities statewide to defend against the virus.

At a Friday media briefing, Dr. Robert Onders, medical director at Alaska Native Tribal Health Consortium, described preparedness strategies for rural communities in Alaska to stave off the virus. The consortium works with several tribal health organizations statewide.

Onders said that with proper tools, rural communities can manage the virus.

“Everyone points to these communities as being potentially vulnerable to a significant impact of COVID," Onders said. "They’re actually incredibly strong.”

The first tool, Onders said, is being able to test for COVID-19 within local communities.

“The more locally based testing that we can quickly apply, the more likely we can control the spread in these communities,” Onders said.

ANTHC received 40 ID NOW testing machines from Abbott Laboratories and had distributed them around the state on Monday, Onders said. The ID NOW machines return a quicker result than sending a swab to a state or commercial lab for testing, a process that takes at least a week for remote and isolated communities, according to a statement from the Alaska Native Tribal Health Consortium.

The machines were distributed to several of the consortium’s tribal partners.

“Consistent with Tribal self-governance, each region that received the machines will distribute and use them in the best clinical manner for the areas they serve,” the statement said.

On Friday, Onders said that using a combination of the ID NOW machines, which return results quickly but cannot do a high volume of tests at once, alongside testing at the Alaska Native Medical Center and other state and commercial labs, could make it possible to test an entire community with hundreds of residents.

From that point, it’s easier to tell who might need to be isolated within that community. But doing a community-wide testing would vary by place, Onders said.

“Every regional health organization is going to manage it a little bit different, so it’s variable, and it’s going to vary depending on the size of the village, but I think we have that capability now,” Onders said.

Because of social distancing mandates, the number of people someone may have come in contact with likely wouldn’t be hundreds, said Dr. Anne Zink, the state’s chief medical officer. But the state is prepared to initiate testing for a larger group of people living in “close proximity” similar to how they tested all staff and residents at a Fairbanks long-term care facility.

“It’s a huge priority to make sure that everyone who we need to test is able to be tested,” Zink said.

Additionally, both the state of Alaska and the Indian Health Service are moving their shipments of the ID NOW tests to rural communities, Onders said.

The ID NOW devices were sent out to act as braces, while the state has tried to get hospitals testing for the virus as well, Zink said.

“The hope is to then redeploy those (ID NOW devices) into more rural areas and/or to facilities, like prisons, long-term care facilities, homeless shelters,” Zink said.

The devices will continue to act as a tool for places that need swift test results and may not otherwise be able to get them, Zink said.

Rural communities need to be equipped with proper personal protective equipment, Onders said. Stocks of PPE need to make their way to rural communities in order to be prepared for the virus, he said.

“We need to have it well-stocked and pre-positioned,” Onders said.

Last week, the group Samaritan’s Purse helped distribute personal protective equipment to Kodiak and communities in Southeast Alaska, Onders said.

Zink highlighted swabs, used during the initial phase of COVID-19 test, as a “pinch point” when it comes to widespread testing. Alaska manufacturers have begun producing those swabs, she said, “and we’re ramping that up very quickly so that we can get them out to communities early.”

More than 3,000 households in Alaska have either minimal or no running water, Onders said, and need certain supplies as a way to prevent any spread of the illness.

“Those products aren’t readily available in rural communities, and we need to get them out there and pre-positioned,” Onders said.

The logistics of getting mail and other supplies to 115 communities in Alaska became more complicated last week after RavnAir Group ceased its operations and announced bankruptcy. The halt in air service also meant a lack of flights to transport swabs from some villages to hubs for testing.

Several Alaska villages have restricted travel as a way to prevent the spread of COVID-19, Indian Country Today reported on Saturday. Certain restrictions limit incoming water, air and land travel in about 70 villages statewide, the outlet reported. For instance, the Northwest Alaska Inupiat village of Kivalina is asking those who leave to tell the tribal administrator and self-quarantine for two weeks when they return, Indian Country Today reported.

Onders said that although Alaska has been disproportionately affected by epidemics in the past, there is still a “window of opportunity” to change that and be a model for the rest of the nation during the COVID-19 pandemic.

“I think the strengths of the rural communities will shine through in this,” Onders said. “I think if given the right tools, they can provide care that is critical for rural Alaska.”

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