In COVID years, new patterns emerged in Alaska hospitals and emergency rooms, report says

The COVID-19 pandemic brought some big changes to patterns for hospital stays and emergency-department visits in Alaska, according to a new report issued by the state Division of Public Health.

While the disease became one of the dominant causes of hospitalizations and emergency-room visits, the need to treat patients for other respiratory diseases appears to have dropped dramatically in 2020 and 2021 from prior years’ levels, the report said.

In the two pandemic years, rates of hospitalizations and emergency-department visits for various non-COVID-19 respiratory problems dropped at rates ranging from 39% to 70% compared to the average for 2017-19.

The 2020-2021 Excess Hospitalizations and Emergency Department Visits Report tracks trends for more than a dozen selected diagnosis categories. Among those categories, influenza and pneumonia was the top cause of emergency-department visits in the 2017-2019 period, followed closely by chronic lower respiratory problems. Emergency treatments for injuries sustained in motor vehicle accidents ranked a close third in those years.

But by 2021, COVID-19 was the top cause for emergency-department visits and the third-leading cause of hospitalizations out of all the categories analyzed. Unintentional injuries and heart disease remained the leading causes of hospitalizations in 2020 and 2021, just as they were in the three years prior.

The report compares rates of hospitalizations and emergency visits per 100,000 residents.

Aside from the opposing trends for COVID-19 and other respiratory diseases, there were some notable trends in other categories.

Hospital stays and emergency-department visits for motor-vehicle crash injuries declined during the two pandemic years from average rates posted in the three pre-pandemic years. But for kidney disease and for chronic liver disease and cirrhosis, rates of hospitalization and emergency-department visits increased during the two pandemic years from the average 2017-19 levels.

Overall, for all medical causes, the rate of emergency department visits fell substantially in 2020 and 2021 compared to the three prior years, and the rate of hospitalization fell slightly.

For the emergency visits, the 2020 rate was 23% lower than the 2017-19 average, while the 2021 rate was 17% lower. For hospitalizations, the 2020 rate was 7% lower than the 2017-19 average and the 2021 rate was 4% lower than the average for those three pre-pandemic years.

The report does not make conclusions to explain the trends. “This report’s purpose is primarily descriptive,” Clinton Bennett, spokesperson for the Alaska Department of Health, said by email. The changes could be related to a variety of factors, he said. “We hope that this information might spur additional research about the mechanisms involved that lead to these changes,” he said.

The hospital and emergency-department data for non-COVID respiratory diseases in Alaska is consistent with trends reported within the state and elsewhere around the nations and the world. Protections imposed to prevent the spread of COVID-19 wound up reducing outbreaks of other respiratory diseases, studies show.

Within Alaska, social distancing and travel restrictions had been credited with bringing a substantial reduction in cases of respiratory syncytial virus infections among children in the Yukon-Kuskokwim Delta, a region that usually struggles with some of the world’s highest rate of those infections. RSV rates dropped to miniscule levels in the winter of 2020-21 but increased in the 2021-22 season, though even then, they did reach pre-pandemic levels, according to a different report from the Alaska Division of Public Health’s epidemiology section.

Influenza had a somewhat similar pattern within Alaska, according to a separate bulletin recently issued by the state’s epidemiology section. Influenza rates dropped to extremely low levels in the 2020-21 season but increased substantially in the 2021-22 season, the bulletin said. Still, the 2021-22 influenza rates were lower than those in the pre-COVID years, the bulletin said.