Alaska's COVID-19 outbreak takes rapid turn for the worse

If you haven’t done so already, listen to the frightening COVID-19 testimony given by Alaska doctors and health officials Tuesday to the House Health and Social Services Committee.

I think that many Alaskans have been lulled into a false sense of complacency, though we should be more alarmed now than at any point in this pandemic.

The experts are worried that the Alaska health care system is about to be overrun by COVID-19 patients, given the trends of the past month.

The tone of their remarks is nothing at all like that at the state-managed publicity shows in which Gov. Mike Dunleavy resembles a middle school principal cautioning his audience to practice good citizenship and keep calm.

The situation is far more urgent than he lets on and it requires actions that he doesn’t want to take. But there is no time to lose.

The state is steering by looking in the rear-view mirror—the weeks of delay between infection and serious illness is a hard concept to manage.

Listen to Dr. Tom Hennessy, infectious disease epidemiologist at the University of Alaska Anchorage: “Alaska’s COVID-19 epidemic is rapidly worsening.”

"We’ve hit the danger zones for two of the three key pandemic measures followed in the state and we’re on track to overwhelm the third one soon,” he warned legislators Tuesday.

Hennessy, who worked for the Centers for Disease Control for 25 years, has been leading a team of UAA faculty focused on data analysis, mathematical modeling, community surveys and other elements of the COVID-19 illness.

In early June, the models predicted that the Intensive Care Unit capacity in Anchorage would not be exceeded for 16 weeks to 20 weeks at the rate the disease was progressing. The latest data this week says ICU capacity in Anchorage could be overwhelmed in 8 weeks, he said.

“These are conservative estimates because they do not include patients transferred to Anchorage from other parts of the state,” Hennessy said, “So our safety cushion has shrunk from 20 weeks to 8 weeks for Intensive Care Unit capacity. We have never been closer to exceeding our health care capacity at any point in this epidemic.”

“What we are doing now to control the outbreak is not working,” he said. “We have watched disasters of preventable illness and death explode in places like Italy and New York City where they have extensive health care capacity, but were surprised by the speed of the pandemic.”

More recently, Florida, Texas, Arizona and California have been hit with health care disasters because they opened too soon and responded too slowly.

“This could soon be repeated here in Alaska,” Hennessy said. “The time for effective action to control the epidemic in Alaska is running out, but it is not too late to prevent a health care crisis.”

The pandemic in Alaska is like a giant ship with great momentum—the ship is headed for a reef, but it can’t turn quickly. The lag time between the moment someone is infected and the point at which the disease is diagnosed makes it incredibly hard to turn the course of the pandemic, he said.

Patients in the ICUs in Alaska now may have been exposed three weeks or more ago. “Because of this lag we cannot wait until our ICUs are full to take stronger action in Alaska. That would be too late and the cost would be paid by our most vulnerable, our health care workers and their respective families.”

He said a statewide mandate on wearing masks, social distancing, mandates to limit outdoor gatherings and capacity limits in restaurants, bars, gyms, etc., are needed.

The House committee heard a similar call for immediate state action from Dr. Nick Papacostas, an emergency room physician at Providence Alaska Medical Center. He said hospitalizations increased 60 percent in the past week and will continue to rise. More and more people being diagnosed with COVID-19 have risk factors, so they are likely to get sicker.

He said many patients who are going to need to be admitted in one to two weeks have already been diagnosed, but aren’t sick enough to be in the hospital.

“If we wait until hospitals are full completely before enacting public health measures such as mask mandates and cutting down on large gatherings, it will be too late because the pace of increases in cases and hospitalization will continue to increase for at least a few more weeks,” he said.

He said the state COVID-19 dashboard that tracks various statistics does not tell the full story, adding that at one hospital for several days last week there were between two and 10 patients being held in the emergency room while waiting for regular beds to open. He added that the number of ventilators available in Alaska is not the right statistic to focus on—what is essential is having enough skilled ICU nurses, techs and therapists to run the machines and treat patients.

Jared Kosin, president and CEO of the Alaska State Hospital and Nursing Home Association, repeated a similar point. If hospital staffing falls apart, he said, all the hospital beds in the world won’t make a difference.

He said occupancy rates change every day and expressed the same worries about the trends seen over the last month and the potential for a severe crisis. The impending wave of COVID-19 cases can be changed only by lowering the daily case count, he said.

“We need to wake up,” he said.

“We need to wear masks. We need to wash our hands. And we need to practice social distancing. It has to happen,” he said.

“The intent today is frankly to alarm you because the picture is bleak,” Kosin said.

Dr. Robert Onders, medical director for the Alaska Native Tribal Health Consortium, said the course correction can’t wait.

“I believe Alaska’s geography presents a unique advantage to stopping the spread of COVID-19. We lost the early advantage we had in Alaska. Currently, we’re on the same trajectory as the rest of the United States,” he said.

“I don’t think we can bank on Alaska having a different trajectory than the rest of the country. It is clear that something must be done to interrupt our current trajectory,” said Dr. Ellen Hodges, chief of staff for the Yukon-Kuskokwim Health Corp.

If the surge in cases in Anchorage continues, there will be no place to transfer patients from elsewhere in Alaska.

The pandemic is not under control in Alaska, a state with limited health care capacity, and we are not immune to the tragedies that have taken place in states with far more extensive health care institutions and personnel. We need to wake up.

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