‘We can and must do more’: YK Delta combats near-record COVID-19 case surge

Published: Oct. 6, 2021 at 6:39 PM AKDT
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JUNEAU, Alaska (KTUU) - The Yukon-Kuskokwim Delta is seeing a surge of new COVID-19 cases at rates far above Alaska as a whole.

Dr. Ellen Hodges, chief medical officer at Bethel’s hospital, said on Tuesday that there were 355 active cases across 32 villages. Approximately 1,000 residents were in quarantine having close contact with positive cases.

She explained the challenge of providing health care to 46 villages over a region the size of Oregon. Health care workers travel to remote communities that have small clinics, but that is often being delayed.

“It is taking longer now because we have so many outbreaks in our villages,” said Dan Winkleman, CEO of the Yukon-Kuskokwim Health Corp.

Patients with serious medical issues are transferred from villages to Bethel. If they need acute or critical care, they are then sent to larger hospitals on the road system.

Winkleman spoke on Tuesday at a virtual town hall meeting. He described the rapidly fluctuating capacity at Alaska hospitals that triggered activation of crisis standards of care guidelines for 20 facilities last week.

“We began again encountering long waits for medevacs because there were no hospital beds available at facilities with higher levels of care,” he said.

Winkleman reiterated that the 26-bed Bethel hospital is not rationing life-saving care, but that could change if the region’s health care system remains strained.

Bethel Democratic Rep. Tiffany Zulkosky, who is a spokesperson for the hospital, said crisis standards of care have meant delays for some nonelective procedures, like screenings for colon cancers, but those delays have largely been at Bethel’s hospital and not at village clinics.

Hodges explained that the hospital is used to holding patients for extended periods due to bad weather cancelling flights. This is different.

Pneumonia patients might typically spend three days in the hospital, Zulkosky said, but “COVID patients that are requiring hospitalization during the current surge are requiring two weeks of hospitalization or longer.”

These recent COVID-19 patients are younger and sicker than earlier in the pandemic and the vast, vast majority are unvaccinated, she added.

Resources like bottled oxygen and monoclonal antibodies are said to be in good supply, but the case rates of the highly-transmissible delta variant have health care officials worried.

The Bethel Census Area is seeing the third highest county-level rate of new cases across the United States, according to the New York Times. The YK Delta has recorded case rates 74% higher than the state as a whole over the past seven days.

Vaccination rates across the region are also higher than the statewide average, but vary village to village. Health officials want to get those numbers up and encourage masking and social distancing and to avoid large indoor gatherings.

“We can and must do more,” Winkleman said.

There has been some recent relief for Alaska hospitals with hundreds of out-of-state health care workers coming to Bethel and across the state. Ten nurses arrived into the regional hub on Tuesday and more are expected soon, Zulkosky said.

Challenges with transferring patients from Bethel have somewhat eased recently. And some of the state’s largest hospitals also saw patient numbers plateau over the past two days.

“This week, we have some signs of optimism,” said Dr. Michael Bernstein, chief medical officer at Providence Alaska Medical Center.

The state’s largest hospital typically takes patients from across rural Alaska. It has been rationing care and increased its alert level last week, placing negative pressure ventilation in some rooms.

“It’s never been done previously,” Bernstein said.

Dr. Bob Onders, administrator of the Alaska Native Medical Center, explained his hospital had also recently had some free beds, but that capacity can change shift to shift and hour to hour.

“I’m still worried with where we’re at with the number of community cases out there,” Onders said. “That it’s still going to be a challenge for a while.”

In the Yukon-Kuskokwim Delta, case rates have trailed behind state and national trends, Hodges said. The region’s numbers are not as high as they were in November last year, but they’re close and the delta variant could change that.

Thirty-three YK Delta residents have died with the virus since the pandemic began. There are fears that number will rise.

Hodges said the ongoing surge had revealed in stark terms the interconnectedness of Alaska’s health care system: Choices made in Anchorage that result in limiting hospital bed space impact remote villages hundreds of miles away.

“And how important it is that everyone in Alaska pull together to combat this outbreak,” she added.

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