More hospitalizations, deaths seen as COVID-19 infections rise, experts tell legislators

COVID 19 infections are rising fast across the state. So far we’re not in the “red zone” for hospital beds and intensive care unit capacity, but it wouldn’t take much to put us there as winter sets in.

That’s what health care experts and physicians told a state legislative committee Wednesday.

Some good news is that it wouldn’t take much to slow increasing infections if Alaskans were more diligent about things like wearing face masks, physical distancing and handwashing, all simple steps taken earlier this year that slowed the virus, experts appearing before the committee told legislators.

The current rate of transmission could be reversed if people did those things, they said.

The not-so-good news, however, is that a lot of Alaskans, particularly young people, don’t want to do those things. There’s growing evidence of COVID 19 “fatigue” among people tired of being cooped up and wanting to party with friends.

Christi Laughton, manager of Anchorage’s environmental health services unit, said one effect of COVID-19 fatigue is that some working age people who have been in contact with infected people, and who have been reached by “contact tracers,” are showing reluctance to be tested for infection. “They say ‘not knowing’ is better than knowing and then having to quarantine and not be able to work,” she said.

Other signs of virus fatigue include a reluctance to follow recommendations. “One example is a person one of our contact tracers spoke with who had been in contact with an infected person,” Laughton said. “He said, ‘I feel great and I’m having lunch with friends right now, so I’ll start my quarantine as soon as lunch is over.’”

Earlier this summer state officials loosened restrictions, allowing businesses to reopen and many people to go back to work. Now the virus has returned with a vengeance. The cause is widespread “community transmission” of the virus mainly through social gatherings, the experts said.

“Infections are an indicator we watch closely because we know that two to eight weeks after a surge in infections we’ll see rising hospitalization and higher needs for intensive care and ventilators,” as well as deaths, said Dr. Tom Quimby, director of MatSu Regional Hospital’s emergency room services.

“Emergency room physicians are very concerned. We are grateful that we’ve had time to prepare, to obtain personal protective equipment and to install protective barrier in hospitals. However, there are limits to what we can do,” Quimby said.

Hospitals in Alaska, as across the nation, typically operate at near capacity,” to make optimal use of their facilities, he said. “But operating at near capacity gives us very limited ability to handle a surge,” he said.

“Our large hospitals are frequently over capacity, and there have been many accounts of overcrowding and ambulance diversion that have been reported in the news in recent years. In addition to this, there has been increased difficulty in finding adequate hospital staff, specifically nurses. Given this, a COVID surge could overwhelm the existing system relatively quickly and limit the ability to provide routine medical care, including emergency services.” Quimby said.

Dr. Tom Hennessy, a physician and infectious disease epidemiologist with the University of Alaska Anchorage, told legislators, “the current rate of transmission could be reversed if Alaskans increased our use of facial masks, maintained physical distancing, avoided closed indoor spaces and increased handwashing. Public messages and or public policies that promote these basic steps could reverse the current upward trend and save lives.”

Hennessy is modeling rates of infections and hospitalizations to predict when Alaska hospitals will reach their capacity limits. If the current rate of infections were to increase just 10 percent, he said, hospitals will be at capacity in mid-December. If the infection rate were to increase 20 percent hospitals will be at capacity in mid-November, Hennessy told the House committee.

Dr. Janet Johnston, an epidemiologist with the Municipality of Anchorage Health Department, told legislators that Alaska Natives are being infected at twice the rates of non-Natives, with 20 percent of total infections being Native although they are only 10 percent of Anchorage’s population. In total, the bulk of the infections are among younger people aged 20 to 49 but the adverse outcomes of sickness and hospitalizations are felt mainly among older and more vulnerable people. Still, younger working-age people mostly carry the financial burden, mainly with their employment being cut.

Hennessy told the legislators that experience in Alaska earlier this year show infections can be quickly reduced by taking steps like using facemasks and physical distancing. In June, when the Anchorage municipality put its facemask rule in place, infections dropped 15 percent within two weeks, he said. These results show that it’s possible that easily-done safeguards can allow businesses to operate and to keep the infection rate at modest levels with simple measures already being pursued, like face masks.

If more people could be convinced on the simple things – face masks, physical distancing and handwashing –hospital use can remain stable and things that further damage the economy like another lockdown of businesses can be avoided.

Dr. Janet Johnston, an epidemiologist with the Municipality of Anchorage’s Health Department, told the legislators that Alaska Natives are being infected at twice the rates of non-Natives. Twenty percent of total infections in Anchorage are Alaska Native although they are only 10 percent of the city’s population. Of total infections, the bulk are among younger people aged 20 to 49, Johnston said, but the adverse outcomes of sickness and hospitalizations are felt mainly among older, more vulverable people. However, it is also younger working-age people who are carrying the financial burdens, Johnston said, mainly because of their employment and income being cut.

One new concern to medical providers is that there is evidence that COVID 19 becomes more virulent in colder weather. Dr. Mohammad Sajadi, an infectious disease researcher at the University of Maryland, told the New York Times for an article about Alaska published by the Times Wednesday. https://www.nytimes.com/2020/10/21/us/coronavirus-cold-weather-winter-alaska.html

There could be a number of things happening as temperatures cool, Dr. Sajadi said. Some viruses last longer in colder and drier conditions. Also, airborne viruses like COVID-19 can be more stable in cooler air, he said. Gov. Mike Dunleavy has said he expects infections to go up with the onset of cold weather. “It’s going to be a very tough fall and winter,” Dunleavy told the Times.