Providence Alaska Medical Center begins rationing care as COVID-19 continues to surge

ANCHORAGE, Alaska (KTUU) - Providence Alaska Medical Center, the state’s largest hospital, has implemented crisis standards of care, which means treatment and resources for patients can be rationed, as COVID-19 continues to surge in Alaska.

A letter published Tuesday on behalf of the hospital’s Medical Executive Committee confirmed that crisis standards of care are being implemented within the hospital.

“In short, we are faced with a situation in which we must prioritize scarce resources and treatments to those patients who have the potential to benefit most,” wrote Dr. Kristen Solana Walkinshaw, Providence chief of staff, in the letter.

Providence spokesperson Mikal Canfield confirmed in an official statement from the hospital that crisis standards of care and treatment prioritization are occurring in Providence. According to the statement, demands on acute care within Providence and other Alaska hospitals are exceeding capacity limits and forcing providers to make “difficult choices regarding allocation of specific life-sustaining treatments or resources and regarding patient transfers to higher levels of care.”

“As a result of this situation, providers and health care facilities are currently experiencing limitations in their ability to provide the standard of care that we wish to provide to our community and normally expect to provide,” the statement reads. “This situation may persist for some time, which has required us to use processes developed to ensure the most equitable allocation of limited resources.”

Rationing of care is already happening in medical facilities in the Lower 48, perhaps most notably in states like Idaho. Last week, Alaska State Hospitals and Nursing Homes Association president and CEO Jared Kosin called the idea of rationing care in Alaska “unnerving” and “almost incomprehensible” as the state continued to see record numbers of people being hospitalized with COVID-19.

“We believe that this situation is primarily a result of the global pandemic and its effects on disease burden in the population as well as its impacts on healthcare workers and facilities,” the official statement from Providence says about the crisis standards of care being implemented.

According to the letter published on behalf of the Medical Executive Committee, more than 30% of the adult patients hospitalized at Providence right now are COVID-positive.

“While we are doing our utmost, we are no longer able to provide the standard of care to each and every patient who needs our help,” the letter reads. “The acuity and number of patients now exceeds our resources and our ability to staff beds with skilled caregivers, like nurses and respiratory therapists.”

Last Thursday, the state’s hospital system was officially raised to the high alert level for the first time since the pandemic made its way to Alaska. As Anchorage hospitals remain full and other, more rural facilities begin to fill up as well, health care workers are encountering difficulty transferring patients in need throughout the system.

The current surge of COVID-19 in Alaska shows little signs of slowing, driven largely by the highly contagious delta variant. On Tuesday, the state’s hospital data dashboard showed that as of Monday, there were at least 202 people being hospitalized with COVID-19 statewide. That’s soared from just 19 people who were hospitalized with COVID-19 at the beginning of July.

The hospital dashboard shows that as of Monday, there were 23 adult ICU beds left open statewide, and just four left open in Anchorage.

Dozens of medical professionals attended Tuesday night’s meeting of the Anchorage Assembly. Several of them spoke, including Solana Walkinshaw, who wrote the letter on behalf of Providence’s Medical Executive Committee.

“ ... The bottom line is this weekend, we initiated our crisis care mode,” Solana Walkinshaw said. “And we had to begin rationing care. That’s the bottom line. We had to make decisions based on our post crises care policies to serve rationing care. I’m going say it one more time, we had to ration care.”

“The reason we are here, and I’m actually working at the hospital this very moment. I’m here outside of my usual time at the hospital, to tell you, it is not good for all of you, for our entire community, not just COVID patients.” said Dr. Leslie Gonsette, also from Providence. “We have to have everyone realize that isn’t just the unvaccinated. This is your child getting in a car wreck, this is you going to work and getting run over on your bike, you will not get the care that you deserve.”

Dr. Michael Savitt, the chief medical officer for the Anchorage Health Department defended the Centers for Disease Control and Prevention recommendations of non-pharmacological mitigation recommendations, but went on to say that the effectiveness of face coverings and masks depends on what they’re made of and how ventilated a room is.

In a Tuesday night press release, Mayor Dave Bronson reiterated that he does not plan to institute COVID-19 mitigation measures, such as mask requirements, in Anchorage.

However, members of the assembly passed a resolution during Tuesday’s meeting that requests that Bronson makes face covering mandatory while inside municipal buildings, when the city is in “substantial risk” or high alert when it comes to the spread of COVID-19. The resolution passed 8-3, with the three no votes coming from assembly members Jamie Allard, John Weddleton and Crystal Kennedy.

Assembly member Kameron Perez-Verdia said the resolution is not a requirement, but simply a communication tool between the assembly and the mayor’s administration.

“It is not a requirement... it’s simply a request,” Perez-Verdia said. “So I think it should be taken from that perspective, that if this body approves this, that it’s a request to the mayor and he can choose to do it or not.”

“I think the biggest hurdle, if you will, that we have to overcome if we’re trying to convince people that a mask mandate will stop COVID,” Kennedy said during the meeting. “We really don’t have the data that will do that. I am absolutely going to wear my mask when I feel like I really need to ... But I can’t go and tell somebody that wearing a mask will prevent COVID-19 because it just, it just won’t.”

Editor’s note: This article has been updated with additional information.