COVID infections and hospitalizations will rise, governor warns, but surge should be manageable

COVID-10 infections and hospitalizations will continue to rise as October rolls into the “dark days” of November and December, Gov. Mike Dunleavy warns.

That’s when more Alaskans will be cooped up indoors where the virus spreads more easily.

But there’s no need for immediate alarm, the governor said. Infections are rising, but that was expected.

Hospitalization rates are still manageable and other indicators for Alaska show the state is doing better than other states are doing, Dunleavy said in a briefing for reporters Oct. 21.

“While virus cases are up, hospitalizations are steady and the death rate is going down,” the governor said. “We’ve learned a lot about how to treat this disease,” since March, when the pandemic started.

A positive indicator is that the average days in a hospital for a COVID-19 patient are going down, Dunleavy said.

In March the average hospital stay was 11.8 days; in June it was 8.8 days, and in September it was 6.7 days,” the governor said in the briefing. Of 11,605 COVID-19 cases reported since March, 6,040 have recovered.

“There are not as many people going to the hospital as we expected originally, and they’re not staying as long. We’re learning how to deal with this,” the governor said.

Despite that upbeat attitude, state health officials cite disturbing trends. Dr. Anne Zink, the chief state medical officer, said the number of Alaskans showing positive results in tests is rising and nearing 5 percent, which is higher than earlier in the year.

“We’re seeing widespread community spread,” of the virus, she said. Alaska hd 187 new cases per 100,000 population in the last week compared with 117 per 100,000 people for the past week on a national level.

All parts of Alaska are now in the “red zone” for new inflections on a public database maintained by the Department of Health and Social Services except for Southeast and Southwest Alaska, where infections are still low, according to the state database.

However, the benefits of the preventative measures Alaskans are taking, mostly voluntary, are substantial and can be calculated.

In a study released Oct. 19 by Evergreen Economics, a health care consulting firm, Alaska’s total hospitalizations of 320 as of early October would be three times greater, at 964, for a population group of similar size in six U.S. “peer” states (similar to Alaska and selected for comparison) selected in the study and four times greater, at 1,308, for a similar-sized group drawn from a national average.

Similar comparisons can be drawn with deaths. Under the peer-state comparison more than 200 Alaskans would have died compared with 60 actual Alaskan deaths. On the national level, nearly 500 would have died in a similarly sized population, according to Evergreen Economics.

“This shows prevention works,” Dr. Zink said in the briefing for reporters.

“With most of Alaska now in the ‘red zone,’ for the 14-day daily case average, we must step up our prevention efforts,” she said, through facemasks, handwashing and physical distancing in social settings.

Dr. Heidi Hedberg, a state epidemiologist, said there is progress being made on a vaccine, with several in the testing phase. Assuming approval by the Federal Drug Administration, “we are planning to have a limited supply of vaccine by the end of the year and more widespread availability between January and March,” Hedburg said.

However, there is no way of really knowing if the timetable is possible, Hedberg acknowledged. Most health professionals feel availability to the public in early 2020 is optimistic.

There may be limited supply of an approved vaccine by early spring but manufacturing at the scale needed will take many months.

Also, many people will be reluctant to take a vaccine until its effectiveness and safety have been proven over time, particularly if there is a perception that its development has been rushed.

Although the governor is optimistic, many health care providers are showing concern about the trends.

Jared Kosin, CEO of the Alaska Hospital and Nursing Home Association, or ASHHNA, told a state legislative committee, “Last week we averaged 46 COVID patients in hospitals of any given day. Fourteen of those were in Intensive Care Units each day. In September, the average COVID patients in a hospital was 37, so what we are seeing now is about 24 percent higher.”

“With hospital capacity being a lagging indicator, and with the positive case counts (rising) over the last four weeks, we don’t think the wave has really hit our doors yet, so we expect hospitalizations to increase into the foreseeable future,” Kosin said.

Kosin cited other problems, mainly staffing in both hospitals and nursing homes. “Staffing is stretched in both sectors, especially with COVID infecting staff and pulling them off the line for extended periods to quarantine. Additional staff are hard to come by in terms of ‘travelers’ (temporary staff from other states) because of high demand in the Lower 48,” he said.

“If we don’t improve on this front, Alaska’s heath care system will experience significant stress statewide. It is inevitable,” Kosin told the legislators.