The catastrophe that could have been avoided

South Korea and the United States had their first cases of COVID-19 confirmed on the same day. Yet South Korea quickly contained the virus and kept its economy functioning, while the U.S. is now suffering its worst economic cataclysm since the Great Depression. Alaska may be especially vulnerable, with its economy dependent on tourism, oil and commercial fishing. What went wrong, what can be learned from the mistakes and what can be done to minimize risk in reopening the economy in Alaska?

Looking at the dates of when information was available and when action was taken, it is clear that the Trump administration did not act in a timely fashion. Statements were made trivializing the impending threat as cases exploded in Wuhan, China. Instead of making preparations, face masks were shipped from the U.S. to China. No plans were made for testing and tracing contacts. No plans were made to increase production of ventilators or dialysis machines. The Defense Production Act was not mobilized and still has hardly been used. In spite of the president’s claims, he failed to cut off travel from China in time to afford significant protection. The same is true regarding travel from European regions that were known to be experiencing high infection rates.

In Alaska, public health staff urged that cargo pilots and staff to be quarantined when they arrived, and not allowed to mix in the general population. The federal government ignored this advice, and Gov. Mike Dunleavy did not use his close relationship with President Donald Trump to push for it. Weeks after the governor and the president ignored these warnings, Alaska’s first confirmed case was from a cargo pilot. Even now, unlike other advanced nations, the U.S. lacks adequate quarantine regulations for cargo pilots and crew entering the country and Alaska.

In addition, for weeks there were no screening or mandatory quarantine procedures for travelers entering the state. The early travel-related cases led to community spread, and now COVID-19 continues to spread among Alaskans. The quarantine order was eventually issued. It has undoubtedly helped slow progression, but there may have actually been an opportunity to block the spread to Alaska.

As community spread began in Alaska, there was grossly inadequate testing capacity. Only those with the most severe symptoms were tested. Insufficient testing almost certainly accelerated community spread. Today, more than 50,000 Alaskans are out of work. The hospitality industry will miss an entire season, and it is unclear whether salmon will make it to market this summer. Much of this is due to the delayed responses at both the state and federal level. Pretending it was not happening has made it much more expensive in many painful ways.

Now we face the next challenge of the pandemic. Careful steps will have to be taken to protect the public with attempts to reopen the economy. Monitoring for new cases and tracing contacts will be absolutely critical. Though there is now a staged plan to reopen Alaska, it is not at all clear that adequate testing is available. Nor are there adequate resources for tracing contacts. There has been no federal oversight thus far. It has been left to the governors to fend for themselves. That will leave Alaska competing with much more financially powerful states, and even the federal government, to acquire tests, equipment and medications.

On a bipartisan basis, some governors are demanding the federal government use its power to obtain and direct distribution of tests. There is no doubt that would avoid escalating costs from competition among the states. More things are going to be required. Eventually, monitoring for resurgence will involve an antibody test. Hopefully, antiviral treatments will emerge. There will need to be an orderly introduction and not a mad scramble among the states. Until there is an effective vaccine, and that will be at least 18 months, containing COVID-19 will require resources nationwide.

It is more critical than ever that leadership at the federal level take a more responsible role. Gov. Dunleavy, along with other governors, must demand this with clear voice. This is a national crisis with a need for national leadership. However, as the Trump administration’s failures bring to focus, there will continue to be need for strong state leadership to protect Alaskans.

William W. Eggimann, M.D., is a family physician who has been working at Yukon-Kuskokwim Health Corp. in Bethel for the past 25 years.

The views expressed here are the writer’s and are not necessarily endorsed by the Anchorage Daily News, which welcomes a broad range of viewpoints. To submit a piece for consideration, email commentary(at)adn.com. Send submissions shorter than 200 words to letters@adn.com or click here to submit via any web browser. Read our full guidelines for letters and commentaries here.