‘It’s horrible. It’s exhausting ‘: Alaska rations worry about Covid nadir | Alaska


Health systems in Alaska are at a breaking point and Republican Gov. Mike Dunleavy has activated statewide crisis care standards, joining all of Idaho and part of Montana in rationing medical care.

Alaska now has the highest Covid rate in America. The state hit its all-time pandemic-wide cases and hospitalizations on Wednesday, and the numbers continue to rise as its seven-day moving average of daily cases surpasses 800.

For Dr. Anne Zink, Alaska’s chief medical officer and practicing emergency physician, this is the worst part of the pandemic.

“It’s awful. It’s exhausting,” she told The Guardian. know, could potentially save their lives. ” And, she said, it will only get worse.

Crisis care standards, or triage, mean overwhelmed providers may prioritize patients most likely to survive over others for treatment, and they may not be able to care for some people. . At least one patient in Anchorage, the state’s largest city, has died while awaiting treatment.

The Soldotna Central Peninsula Hospital, about 150 miles from Anchorage, is operating at 133% capacity, spokesman Bruce Richards said. And he worries about what will happen next. “We all know hospitalizations are lagging behind after these days of high caseloads, so I don’t know what lies ahead. “

The Central Peninsula serves around 38,000 people, but generally does not offer higher levels of care. For this, patients are usually transferred to nearby hospitals in Anchorage. But with these hospitals also in overcapacity, the central peninsula is caring for sicker patients than ever before.

Alaska initially showed promise with one of the best vaccination rates in the country. But, as in West Virginia, its initial promise quickly stopped as vaccination rates slowed. This has been a repeated phenomenon across the United States, although the slowdown in vaccination rates has been most pronounced in conservative states, which are usually led by Republicans.

Earlier this month, Dunleavy refused to declare a statewide disaster and he opposed mask and vaccination requirements. Asked directly by reporters on Wednesday, Dunleavy said “vaccinations remain the most important tool” but that he will not mandate them.

With less than half of the population fully vaccinated, Zink wonders what she could have done differently to protect her neighbors, her family, her condition – what else could she have done to persuade them to get vaccinated. and take precautions to stop the virus.

“It’s heartbreaking to feel like I’ve been running a marathon sprint for almost two years now, and this point in the pandemic is what I’ve always tried to avoid,” she said.

Health workers report exhaustion and frustration with the crisis, especially because it was preventable. “The evidence speaks for itself,” said Richards. “It is very clear that a vaccine will help you avoid going to the hospital. “

Gov. Mike Dunleavy refused to declare a state of emergency and opposed mask and vaccination requirements. Photograph: Becky Bohrer / AP

About 85% of Alaskans hospitalized with Covid have not been vaccinated, and they tend to get sicker than those who are hospitalized despite vaccination, Richards said: “They require higher levels of care.”

Unvaccinated hospitalized Alaskans also tend to be much younger, Zink said. “To see such young people come in, get so sick, has also been really devastating. She also sees patients, fearful of seeking medical treatment, who could have received life-saving care earlier in their illness but who have waited too long.

There are no survival machines, known as ECMOs, throughout the state of Alaska, which means that very ill patients must be transferred to hospitals in the western states, which have experienced their own increase in the number of cases. “As we have seen a decrease in the number of beds across the country, including Seattle and Portland, we have not been able, or have seen significant delays, in moving people to the lower 48,” Zink said. .

“Geography is really a huge challenge,” Zink said. The average Alaskan travels 147 miles each way to access care, and many communities are only accessible by air, where weather delays can present another barrier.

The Central Peninsula recently had a patient in need of a high standard of care, but any facilities in Alaska that could have provided it were full. Health administrators began calling West Coast hospitals, eventually finding a bed in Portland.

Overwhelmed health care systems across the United States have been a major concern, especially for states like Alaska facing massive health care shortages. “Everyone cares,” Richards said. “Everyone is looking across the country as this wave has passed. It’s not just about providers and beds; some hospitals also face shortages of life-saving machines and other life-saving equipment.

To deal with provider shortages, Alaska now employs nearly 500 health workers, including nurses, licensed practical nurses, respiratory therapists and others.

The state has also focused on distributing monoclonal antibodies, a treatment that can dramatically reduce hospitalizations and deaths if administered early in Covid-19. But, Zink said, there are significant geographic challenges in offering the treatment, which must be given as an infusion or four injections under the skin.

Alaska has been creative in bringing the antibodies to remote communities with cruise ships and fishing boats. But it can take up to four days to be delivered. And, with the Biden administration’s new delivery system for antibodies based in part on the number of doses administered, Alaska could face delays in delivering treatment.

For now, cases appear to be stabilizing in other states, Richards said, giving him hope those states might be able to deal with some Alaskans. “But it’s still very difficult to send patients out of state,” he said. “It’s hard to find a place.

And there are “no signs yet” that cases in Alaska are slowing, Zink said.


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