There are unique challenges for a remote community to deal with a contagious disease like COVID-19, but the staff at the Yukon-Kuskokwim Health Corporation hospital says that these are not new challenges for the region.
What happens if health aides get sick with COVID-19?
YKHC has had to deal with other epidemics in the past. Dr. Ellen Hodges, Chief of Staff at the regional hospital in Bethel, says that they are prepared, when needed, to shift more resources and staff to help village clinics that need assistance. They are calling each village daily to assess the situation. She also says that the remoteness of the region’s bush communities means that they are changing the guidelines for quarantining staff coming into the region. The guideline from the state is to quarantine medical staff for 14 days.
“Because of the complete lack of resources in our area,” said Hodges, “this is really not possible. So we’re asking our healthcare providers, if they were out of region, to wear a mask on themselves when they are treating a patient; to as much as possible to stay at least 6 feet away from people; and to wear gloves when they’re doing things with a patient.”
Will COVID-19 reach the Y-K Delta?
Hodges says that she has no doubt that COVID-19 is out in the community population in Alaska, as it is in many places in the lower 48. She says that the medical establishment is just waiting for the tests to prove it. The main reason she says this, is that it is increasingly known that the coronavirus is contagious before people show symptoms.
“So if a person is sick, they may already have been infectious for a couple of days,” Hodges explained. “So that’s kind of the approach that we’re taking, which is a little of a modification of Dr. Zink’s recommendations. But because of our remote area and our lack of resources, this is the safest way to take care of our patients and also to keep our healthcare workers safe.”
How to quarantine or practice social distancing in crowded homes?
The challenge of quarantine is also difficult in tiny communities that have many people crowded into homes. Brian Lefferts, YKHC’s director of Environmental Health and Engineering, says that when a person comes back home from outside the region, the whole family should go into quarantine. If possible, the person coming home should stay in their own room for much of the time.
YKHC is also producing signs to post outside the doors of homes under quarantine so that people coming to visit will know. They are also making signs that Elders can post to ask people to stay away, because Elders are more vulnerable to COVID-19.
“We’re working on having those signs created,” said Lefferts. “Before something like that is available, you can makes signs like that yourself. That just gives people a heads up before they actually come into your house.”
How will COVID-19 testing will be done in the villages?
The big question right now is how many people in the region have been infected by the coronavirus. As of March 20, Hodges said that less than 20 people have been tested. The samples were sent out to labs to be analyzed. Hodges also acknowledges that village residents need better access to the tests. Right now, health aides can’t gather the samples needed for the tests, but YKHC is rolling out training to teach them how to do it.
“Testing in the villages will be logistically challenging. We are trialing this in our larger villages to see if we can actually accomplish this,” said Hodges.
YKHC is also gearing up to provide the needed tools and material, but there is a problem with that too.
“No one has testing supplies, and we’re no different than anyone else,” said Hodges. “But we will be rolling out testing to villages on a case by case basis and making sure we can have the test kits in the right place, the right time, and transport the samples safely.”
YKHC reminds everyone who wants to get care during this pandemic that they must call the hospital and the clinics to make appointments ahead of time. There are no longer walk-in appointments, which is part of the program to control the spread of the coronavirus.