Providence Hospital

Providence Hospital in Anchorage. 

Aggressive action by state and municipal health officials helped stem what could have been a catastrophic spread of COVID-19 virus in Anchorage in July, local officials told a state legislative committee Wednesday.

A system of “contract tracing” to identify those exposed to infected people had broken down and cases were rising so fast that hospital officials warned of shortages of ICU beds and other critical care by mid-September.

Things have eased thanks to several actions taken in mid-summer, Christy Lawton, director of Anchorage’s public health division, told legislators in a joint meeting of the House Health and Social Services and State Affairs committees. “We’re in a much better position than we were,” Lawton told a joint hearing of the Health and Social Services and State Affairs committees of the state House.

Actions included another emergency closure of bars and restaurants that limited social gatherings along with efforts by state and municipal health officials and the University of Alaska Anchorage’s health sciences department to build up a trained group of contact tracers.

One important improvement, Lawton said, was a new electronic data system acquired by the state Department of Health and Social Services and shared statewide allowed those infected and their contacts to be accurately and efficiently tracked, replacing a cumbersome procedure of documenting on paper that had slowed things. Finally, five large-scale testing sites were mobilized, with state help, which speeded the return of test results.

What happens in Anchorage affects much of the state because capacity in smaller hospitals in the state can rapidly fill and the two large hospitals there, Providence Health Systems and Alaska Regional Hospital, acts as a backup.

“We were beyond capacity in mid-July and we were very worried about (hospital) bed capacity. We were near a dangerous ‘tipping’ point,” beyond which the virus might have been uncontrollable,” Lawton said. “We were seeing 75 new cases a day, well beyond our capacity (at the time), and we had a backlog of 300 cases,” and delays of five days in tracing contacts, with the virus spreading during that time,” she said.

Things are better now. The state, municipal and UAA partnership has built a group of 200 contact tracers which allows contacts to be traced and contacted within 24 hours. Anchorage’s infection rate has been cut in half since Mayor Ethan Berkowitz issued public health mandates in July.

While the July crisis was averted, things still aren’t that great. An ability to bring down the rate of increase (in cases) in July was demonstrated, “but we’ve just reached a plateau,” in the 14-day average of new cases, which is the most-watched indicator, said Janet Johnston, epidemiologist at Anchorage’s health department. Alaska currently has higher infection rates than many other urban and rural states, including Washington, Oregon, Maine, New Hampshire, Connecticut, and others.“We’re lower than in July but we’re not where we’d like to be. We’re still at the ‘high alert’ level for the entire state,” she told the legislators. Anchorage is now experiencing clusters of new cases, particularly in its homeless population, Johnston said.

Getting the virus further under control is important for school officials and parents who are waiting on improvements before allowing a return to teaching in schools instead of on-line instruction.

Health officials are meanwhile still working to explain to the public how the virus spreads. “Masking is very important, and so is limiting the size of gatherings,” particularly indoors,” Johnston said. Basic precautions like handwashing, masking, and physical distancing are most important.

“Emergency orders (for public spaces) are useful, but we still have to convince people. There are still reports of large indoor gatherings,” Johnston said.

Lawton said it can be difficult to keep at safe distances, particularly indoors in places like bars. “People have the best intentions but when alcohol is involved,” it’s easy to forget, she said.

The results this summer in reducing the virus spread were painful but things could have been much worse, Lawton said.

However, the lack of statewide, and federal, public health mandates means infection rates remain too high to safely reopen schools or other areas of indoor congregation, the legislators were told. “We need to protect public health in order to protect the economy,” Johnston said.

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