Fallout continues from expiration of state’s emergency health declaration

There’s still fallout from the Feb. 14 expiration of the state’s pandemic emergency health declaration. Legislators are working on a bill that would solve some of the difficulties but it had not yet been introduced as of Monday.

A key problem that has emerged is a difficulty in providing medical consultations via telehealth. Under the state’s emergency declaration medical specialists in other states were allowed to provide services by telehealth to Alaska patients. With the declaration having expired, that’s no longer allowed.

Cancer specialists in Washington state immediately stopped telehealth services to Alaskans when the declaration expired. For Alaska patients the ability to consult specialists without having to travel out of state, and risk virus exposure, is important.

Another impact is from the lack of mandatory airport virus testing, which public health officials were counting on to detect when new variants of COVID-19 arrive. Testing is available at airports but it’s voluntary, which means many people arriving skip the procedure.

The lack of mandatory testing on arrival is already being linked to a serious infection outbreak in Petersburg, in southeast Alaska.

One more problem is that the ability to shift vaccine supply between communities, for example from a community with a surplus of vaccines to another where there is a shortage, can no longer be done. When the emergency declaration expired a series of waivers from federal rules were also lost, according to Jared Kosin, CEO of the Alaska State Hospital and Nursing Home Association, or ASHNHA.

One federal waiver gave hospitals and other health providers the authority to operate alternative care sites, including drive-through virus test services. With the waiver to federal restrictions gone, Providence Health Systems, for example, shut down its drive-through test centers in Anchorage. This eliminated a large amount of capacity for people to get tested in the community.

The 132 federal waivers that were lost allowed health providers to operate 32 types of services. It is possible the federal government may allow some waivers to continue absent the state declaration, but whether that will happen is unknown, Kosin said.

ASHNHA wrote to the federal Center for Medicare and Medicaid Services Feb. 19 asking for clarification, but two weeks have passed and there has been no answer, he said.

The problem with the declaration arose when the Legislature failed in an effort to pass an extension basically because the House was delayed in organizing. Gov. Mike Dunleavy was asked to extend the declaration administratively, as he did earlier last November, but the governor he felt he couldn’t legally do it while the Legislature was in session. Once lawmakers convened their annual session Jan. 19 only the Legislature can extend the declaration.

There is also a political sensitivity to the issue that has slowed the Legislature’s ability to deal with it, however. There is a belief among many conservative constituents in legislative districts that the emergency declaration is linked to mask-wearing and business restrictions, which has led to losses in employment.

If the emergency declaration were extended it would give the government more authority to impose restrictions or to enforce business closures, according to those belief.

The governor has tried to explain that there is no connection between the state emergency declaration and the various state health mandates, which are mostly advisory, and municipal restrictions on occupancy in public places or requirements for the wearing of face masks.

Municipalities that have health powers can impose restrictions independent of the state, Dunleavy has said. However, the message hasn’t gotten through to many. Sen. Lora Reinbold, R-Eagle River, a conservative legislator, has been vocal in challenging the governor and state health officials on the urgency of health precautions.

The governor has rebuked Reinbold in a harshly written letter, but the senator is still being vocal. Reinbold refused to wear a face mask in the capitol and during a Senate floor session on Monday, defying a rule that a mask be worn.