With Thanksgiving approaching, health officials are urging everyone in the Yukon-Kuskokwim Delta to stay home this holiday to prevent spreading COVID-19. Hospitals across the state are filling up, and cases could soon overwhelm the local health care system.
When patients in the Yukon-Kuskokwim Delta need advanced medical care, they are usually sent to the Alaska Native Medical Center in Anchorage. But now, ANMC is over capacity with COVID-19 patients.
ANMC has opened an alternate care site on its campus to hold the overflow, and is dedicating another hospital wing to COVID-19 cases. Its critical care unit is nearly full. There are now multiple critical patients who require individual nursing, and who are lying on their stomachs in a prone position to help them breathe. ANMC Acting Administrator Dr. Robert Onders said during a virtual town hall on Nov. 23 that the critical care unit is so full and so challenged that it cannot hold all the hospital’s acute patients.
“So we’re extremely tenuous right now,” Onders said.
Twenty percent of COVID-19 patients hospitalized at ANMC require critical care, and the staffing and beds in critical care units across the state are limited. With the COVID-19 cases increasing statewide, he expects the situation to worsen.
“Now is the time to act to reduce our case loads and try to prevent us from completely overwhelming the entire health care system,” said Dr. Ellen Hodges, Chief of Staff for the Yukon-Kuskokwim Health Corporation.
So far, the regional health corporation has been able to medevac every patient who needs advanced care to another hospital in the state, though some patients have been held in Bethel for days until a bed opens elsewhere. Hodges said that the Bethel hospital has been able to admit every patient who needs care for COVID-19 pneumonia, and she wants to keep it that way.
“We’re sorta in the yellow status. We’re a little bit on the edge of tipping over [into the red status]," Hodges said. "But with the increase in case counts, every day more and more cases, I’m concerned that we will reach the capacity soon.”
The Yukon-Kuskokwim Delta has the highest COVID-19 case rate in the state. Across the region, the rate is about 273 cases per 100,000 people. The Kusilvak Census Area along the lower Yukon is even higher, at 455 cases per 100,000 people. In the City of Bethel the case rate is higher still, at 475 cases per 100,000 people.
Because cases in the region are so high, many people are likely carrying the virus and don’t know it, but are still able to spread it to others. State epidemiologists estimate that at least a third of people with COVID-19 never show symptoms. YKHC is encouraging everyone in the region to get a COVID-19 test to identify who is carrying the virus, and it’s asking everyone to hunker down. If cases overwhelm the local health care system, there might not be anywhere else to send patients.
Alaska’s Chief Medical Officer, Dr. Anne Zink, said that most hospitals in the state are full on most days. And with cases rising nationwide, it’s becoming harder to send patients out of state. It’s also hard to get health care workers to come into the state.
Alaska is reaching a tipping point. When hospitals in other states have overflowed, excess deaths have followed. There aren’t enough health care workers to treat COVID-19 patients as well as emergent cases such as strokes, heart attacks, and appendicitis. Zink said that it will take everyone working together to avoid that.
“This is not going to last forever," Zink said. "This is the time to dig deep, all of us, and really limit the spread. Not travel, not gather. Wear a mask, keep our distance.”
The Yukon-Kuskokwim Health Corporation has urged every community in the region to lock down for a month. Most communities have done so.