COVID-19 quickly sickened an Anchorage woman in her 40s, then killed her. Her family has a message: ‘It’s here, and it’s deadly.’

Scott Wells is grieving. And he is angry.

His significant other, the mother of their two young children, died from COVID-19 on Sept. 8.

Amanda Bouffioux was 44, among the youngest Alaskans to die with the virus that hits Alaska Native people especially hard. Bouffioux, an Inupiat woman born in Kotzebue, got sick in mid-August. Within days, she was hospitalized and unable to breathe on her own.

She was buried in Anchorage on Tuesday. Her three grown sons helped serve as pallbearers.

Wells, a 53-year-old heavy equipment operator, says Bouffioux’s family wants her death to serve as a wake-up call: This virus is lethal. People need to take it seriously.

“I’m pissed. I’m pissed about how this country has handled this thing. I’m pissed about how our state has handled it,” Wells said last week, as he made funeral arrangements. “I mean our bars are open right now. It’s ridiculous. Our kids can’t go to school and our bars are open. What the hell?”

Cases predicted to start rising again

Forty-four Alaskans have died with COVID-19, the lowest death rate in the country. The number of people sick enough with coronavirus to need hospital care has yet to overload the state’s limited health care capacity.

Still, the Alaska Department of Health and Social Services for the first time in weeks is anticipating a rise in cases in coming days.

Younger people in their 20s and 30s, and most recently teenagers, are driving the state’s growing number of infections, state health officials say.

Young healthy people may be less likely to get sick or even show symptoms, and may also be less likely to abide by public health recommendations to wear masks and stay more than 6 feet apart from non-household members, state epidemiologist Dr. Joe McLaughlin said this week. But they can pass the virus to others who could get seriously ill or die.

Wells said he gets disheartened when he sees whole families shopping together in the store, nobody wearing masks, or hears others dismiss the virus as a hoax.

“I’m telling you man, I’ve gotta do something. I can’t just sit here and not warn people,” Wells said. “I’m not doing this for any other reason than to say look, it’s out here and it’s deadly.”

Bouffioux’s sister, 32-year-old Clarissa Coffin, said her sister was humble and caring, the kind of mother who had multiple nicknames for all of her children. Her smile was her best feature. She loved people regardless of the choices they made.

Coffin hopes her sister’s death serves as a warning to practice COVID-19 precautions like masking and social distancing — or at least understand those who do.

“Nobody likes to be told what to do, especially when you’re an adult. Come to a common ground and understanding and respect for people’s choices," she said. “We’re supposed to make mistakes. We’re supposed to learn from things.”

Last words

Bouffioux started to feel sick in mid-August, on a Saturday. The family had just gotten back from a quick trip to Seward the day before. They ate at a restaurant but in back, so they could avoid others.

The next day, she felt worse. By Monday, she took the day off and Wells took her to the emergency room. She tested positive for COVID-19.

Wells isolated Bouffioux in a bedroom, away from 8-year-old Chris and 9-year-old Teressa. She slept most of the time, not eating or drinking. Her throat hurt so much she couldn’t talk.

The kids knew she was sick and not to go near her or the door, he said. “She said when she opened the door to call for me, our youngest son saw her and she said his face was just so sad."

After a few days without improvement, Wells brought her back to the ER. Her temperature had soared to 106 degrees.

Bouffioux was admitted as a patient at Alaska Native Medical Center and hooked up to an IV to treat the dehydration and fever, Wells said. She was diagnosed with double pneumonia.

The hospital denied an Anchorage Daily News request to interview Bouffioux’s doctor. Family members described what happened next.

Wells said she spent a few days communicating with family members, texting and calling.

“She was actually in pretty good spirits,” he said.

Then, on her third day in the hospital, Bouffioux called to say she was about to be intubated and put on a ventilator. That was Aug. 19. Wells didn’t know it would be their final conversation.

“She could barely talk. I could barely hear her. I just said, ‘OK baby, don’t worry about it. I’ll take care of the kids. Don’t worry about it. You just get well and know that we love you,’” he said. “And then she hung up. And that was the last time I talked with her."

Disproportionate risk

Wells doesn’t know just how Bouffioux caught COVID-19.

An administrative assistant at the NANA Management Services maintenance shop, she worked from home for as long as she could but eventually had to return to the office. Wells said she was the only one in the family who left the house regularly. Maybe she got the virus going out to lunch, he said. Nobody else in the house got it. They all tested negative.

One of Bouffioux’s grown sons also tested positive for COVID-19, Wells said. The family doesn’t think the two cases are connected. Bouffioux had no contact with him. He came down with fever and headache. Now he’s fine.

Bouffioux was healthy, Wells said, and didn’t smoke. They both could have exercised more, he said, but that was hard with all the restrictions once the virus hit.

Generally, certain medical conditions put people at increased risk for more severe cases of COVID-19 including cancer, lung or kidney disease, obesity, serious heart conditions, and Type 2 diabetes.

The virus is also proving to be more severe for American Indian and Alaska Native people.

A Centers for Disease Control study found that, in 23 states with adequate data, the cumulative incidence of confirmed COVID-19 among American Indian and Alaska Native people was 3 1/2 times that among non-Hispanic white people.

Of the 44 Alaskans who have died with the virus since March, 16 — more than a third — are identified as American Indian or Alaska Native people, a group that accounts for only about 16% of the state’s total population.

“We are seeing disparities in cases, hospitalizations and deaths by race and ethnicity, both here in Alaska and nationally,” McLaughlin said.

The state’s COVID-19 case numbers overall are relatively low, however, so it’s difficult to draw any conclusions from the data, health officials say. They hope to release more specific information about the residents who have died and any underlying medical conditions they may have had in an upcoming epidemiology bulletin.

‘Nothing she could do’

Once Bouffioux got to the hospital, no friends or family could visit. Hospitals in Alaska and around the country have severely restricted visitor policies during the pandemic to protect patients and staff.

Coffin kept a daily log of her sister’s condition in regular Facebook posts. The reports didn’t change for days: intubated, sedated, a ventilator breathing for her while Bouffioux’s lungs fought the infection. Nurses kept her mostly on her stomach, a medical strategy called “proning” used to expand lung capacity and improve breathing.

At one point, a nurse held a phone up to Bouffioux’s ear on speaker. Coffin and the older boys talked to her that way. She was unable to talk back.

Her best friend, Nereid Wells (no relation to Scott), tried to visit Bouffioux at the hospital even if it meant looking at her through a window, but wasn’t allowed in.

“Her being sedated, she didn’t know that everybody was trying to lift her spirits up, trying to help her fight,” she said. “It’s unfair.”

By early September, Bouffioux was struggling. She spiked a fever.

On Sept. 8, her doctor called Wells. Bouffioux’s lungs were scarred. Her heart rate was dropping. She wasn’t going to recover.

“So we chose to let her go,” Wells said. “It was amazingly hard. I knew that I wouldn’t want to live like that. I knew she wouldn’t want to live like that. I know she fought as hard as she could for as long as she could but this thing just took over and there was nothing she could do."

Coffin, Bouffioux’s adult sons and other family members gathered on the roof of a parking garage across from the Alaska Native Medical Center as hospital staff set up a secure livestream relatives could watch as they took her off life support. Bouffioux’s last moments flickered on Coffin’s small phone screen.

Wells stayed home with his son and daughter. When the call came that Bouffioux was gone, he left the room so the children wouldn’t see him cry.

Wells visited the parking garage for the first time last weekend. His family used to see the hospital as a happy place to get check-ups and dental visits. Both the young children were born there.

The room where Bouffioux died, on the second floor, was behind him as Wells spoke. The family had only good things to say about her treatment at the hospital. But the happy feelings were gone.

“I’ll never come here and think the same about it," he said.

‘I want you to rest’

The virus also stole the chance for Bouffioux’s loved ones to grieve together.

Her funeral service Tuesday morning was livestreamed. Social distancing protocols meant just a few people attended, wearing masks even as they wept, and mourners from communities outside of Anchorage could only watch.

Wells and Coffin took turns, sometimes overcome by emotion, reading from Bouffioux’s obituary. Born in Kotzebue in 1976, she graduated from Kotzebue High School, where she played flute and sang in choir. She spent time in Fairbanks, Kotzebue, Noorvik and Seward before moving to Anchorage 12 years ago.

She loved country singer George Jones and the documentary about Alaska mushing icon George Attla. She was quiet and shy, a whiz at trivia games and Pictionary, someone who made everyone around her feel loved.

Wells met her about 20 years ago on the North Slope. She was a housekeeper. He was an operator. They both lived in Noorvik when they were younger but didn’t know each other from there. She was sitting alone, Wells said, and he couldn’t resist walking over and asking to sit down. “She was beautiful," he said.

Their family had planned a trip together to Hawaii in October, Wells said last week.

They had kept a calendar on the wall. It showed the date they planned to leave. His daughter crossed off each day that passed with an X. The calendar stayed up even after Bouffioux was intubated, in case she might still recover.

Wells canceled the trip last week. That was his son and daughter’s choice.

"The kids said they didn’t want to go,” Wells said during an interview. “They didn’t want to leave mom ... they just said it wouldn’t be fair without mom.”

Left behind

During Tuesday’s memorial service, Wells walked his children into the funeral home’s display room. Bouffioux’s casket sat, open, at the front of the room surrounded by photos and flowers.

He asked if they wanted to see their mother.

They both shook their heads no and sat down.

“I’m going to be here for you,” Coffin told them during the service. “I’m not going to replace your mom but I’m going to try to be the best auntie I can be and I will love you as much as your mom loved you.”

Then she looked at her sister’s body and started crying. She told Bouffioux she loved her, that her children would be cared for.

“Know peace. I want you to know peace,” Coffin said. “And I want you to rest.”

As the service came to an end, she brought the camera close to the casket so friends and family could see Bouffioux, her purple and white atikluk bright against the satiny white lining and her hands folded beneath her chest.

“There’s a lot of people who want to say goodbye to her," Coffin said.

At the Anchorage Memorial Cemetery, friends and family gathered at Bouffioux’s gravesite. It was a gray day, with the bite of fall in the air and birch trees going yellow. The buzz of small planes from nearby Merrill Field broke the silence.

Coffin FaceTimed the funeral to her mother, Edna, who was in Kotzebue.

“We’re not ready,” she told cemetery staff as they moved forward to place a plastic cover over the casket. They waited as the family grieved, holding each other, for another 30 minutes.

The group sang a prayer. One of Bouffioux’s sons rested his head on the bright white casket as he sobbed. The rest of his brothers surrounded him, their hands on his back.

Coffin threw a handful of dirt into the grave and dropped a pink rose — a last request from their mother in Kotzebue as Bouffioux was buried.

She still wonders if her sister might have pulled through had family had been able to sit nearby, hold her hand, speak to her, through all those long days in the hospital.

“The pandemic and the COVID … it takes away your comfort," Coffin said. “It takes away healing for a loved one who can’t do it by themselves."