Alaska activated crisis standards of care today as part of a statewide effort to ration health care as the state’s ongoing surge in covid-19 cases continues to break new records, strain on the health care system and put Alaska at the lead of the nation in per-capita rates.
The measures will allow hospitals to direct the state’s limited care to maximize the number of lives saved. Already implemented at Anchorage’s Providence Medical Center, the change allow hospitals to direct the state’s already limited care to maximize the number of lives saved. Those decisions have already led to otherwise preventable deaths of patients who are seeking care not related to covid-19 infections.
“We are at the worst place in the pandemic that we’ve had this entire time,” said Alaska Chief Medical Officer Dr. Anne Zink during a news conference today. “We have more cases, we have our hospitals being overrun by the number of patients that are coming there and we need to collectively move that direction. … It’s going to take all of us to change this course.”
As far as health care capacity goes, the state announced a $87 million contract to bring in more than 400 health care workers—300 registered nurses, 100 nursing assistants, one physician and a slate of other health care support employees—for a 90-day stretch beginning next week. The state said it would be reimbursable by the Federal Emergency Management Agency.
The effort seeks to provide reinforcements for a health care system that was limited before heading into the pandemic, which has only seen things get worse and more stressful. During her comments, Zink personally thanked the health care workers and pleaded for “kindness and compassion” for them, noting that there has been a wave of misinformation directed at health care workers “who have been physically threatened and violently attacked at times.”
Much of that animosity toward the health care system has come from the right-wing sphere, where a countervailing narrative is that hospitals are either lying or understaffed due to vaccine mandates, and has even been echoed by Anchorage Mayor Dave Bronson and his allies. When asked about those claims, Gov. Mike Dunleavy acknowledged the strain on hospitals is real but shied away from saying it was driven solely by covid-19, suggesting the burnout and stress experienced by health care workers is simply par for the course for all industries after the pandemic and that other factors are combining with covid-19 to strain hospitals.
“You have people who are leaving the profession, you have more cases obviously, this time of year people are getting injured while hiking, hunting, four-wheeling, boating, etc. surgeries are scheduled for this time of year. The fact is capacity is tight, from what I see,” he said. “The last thing I want to do is become melodramatic or exaggerated. We’re all trying to thread this needle, but I do see that and I do see the capacity being strained.”
Dunleavy, who in the early days of the pandemic suggested it would be a “momentary glitch,” sought to assure Alaskans that the health care capacity issues could be addressed without measures like a mask mandate that would anger his base heading into an election year. He also argued that the number of covid-19 deaths—466 residents and 15 nonresidents—is still low compared to the rest of the country and relatively minor in the bigger picture of the thousands of people who die every year.
“We’re on top of this,” he said. “We’ve always been on top of this.”
Stories that have emerged from hospitals paint a different picture.
There have been reports of people dying from issues not related to covid while waiting for beds to open up or for specialty care to become available. The strain has been particularly hard on rural Alaska, which has relied on the city centers for emergency care. Hospital groups thanked the administration for its action to beef up staffing but called for more effort to curb the infection rates.
“While these efforts are important, we also want to use this opportunity to call on all Alaskans to do their part,” the Alaska State Hospital and Nursing Home Association said in a prepared statement. “Mitigation remains the single best path for persevering through this surge and ending the pandemic. Support our caregivers by getting vaccinated NOW and wearing masks indoors in all public settings.”
There was very little said during the roughly hour-long news conference about what—if anything—the state would be changing as far as preventative measures. Though Zink pleaded with the public to wear masks and get vaccinated, Dunleavy was far more mild in his urging of the public to take any preventative actions and became combative with reporters when asked if he would ever consider mask mandates. Alaska is among the states challenging Biden’s federal vaccination/testing mandate.
Dunleavy argued that access to the vaccine, monoclonal antibody treatment and the 90-day contract providing for additional health care workers should be enough to curb the latest surge in cases. He went on to argue that most Alaskans will develop antibodies to covid-19 one way or another.
“With the number of cases that we’re getting per week and the number of folks that are being vaccinated—it’s anywhere from 10,000 to 13,000 per week that are getting the antibodies either through an infection or through the vaccination,” he said. “The majority of Alaskans are going to be having these antibodies one way or another.”
Asked if he was going to “take his hands off the wheel” when it came to mitigation, the governor lashed back and asked if there was a “hands-off” approach then why had the state done well in the early course of the pandemic and had initially led the nation in vaccinations (a feat that was largely accomplished off the back of the tribal health care system).
Asked if he would consider doing anything more than “strongly urging” Alaskans to get vaccines, he said he wouldn’t “cajole” people on the vaccine. Dunleavy also more than once during today’s hearing referred to how “the scientific community is not unanimous in their view” on the pandemic or its treatments. He also referred to the early effort as if we “We had a tsunami warning and we were all standing together, locked in arms on the shore to meet the tsunami,” adding that the initial wave was so small that people questioned whether there was a pandemic at all.
When asked about criticism that his administration was putting politics ahead of the pandemic response, Dunleavy became particularly irate and said it was his political opponents who were guilty for politicizing the pandemic. “It’s all about elections and campaigns for these people,” he said, adding, “that’s a pox on their house.”
That comment didn’t sit well with one of his critics, Democratic gubernatorial candidate Les Gara. Gara, a former Anchorage representative, has been one of the more vocal critics of the governor’s handling of the pandemic as cases began to skyrocket earlier this summer.
“I’ve asked him to act and do exactly what hospitals have been warning about since July so they could have prevented people from dying. He doesn’t get to blame his refusal to act, or refusal to take any personal responsibility on people who asked him to do what hospitals have been pleading for,” Gara said. “As the husband of a hospital worker whose life has changed, I want people to be treated, cared for, and not told that we’re in such a crisis that life-saving care has to be rationed.”
He is the tallest guy in the room