Alaska’s coronavirus cases are hitting new highs. A summer surge didn’t turn into a crisis. Will this one?

Alaska’s coronavirus cases are at an all-time high, as evidenced by several red-flag indicators.

Now local and state officials, including Gov. Mike Dunleavy, say they’re watching closely to see what COVID-19 does next, especially when it comes to people getting sick enough to need hospitalization.

On Monday, Alaska reported 194 new resident cases, setting a new daily record. The last time the state saw that many cases in a day was in late July, a spike blamed partly on reporting delays. Monday marked the 12th day in a row new daily case tallies exceeded 100 — the longest such streak since the start of the pandemic.

But that summertime peak of cases in July leveled out, Anchorage Health Department epidemiologist Janet Johnston said in an interview Monday.

That’s not what’s happening now.

“Last week, it felt like we were going the way we were in July, and the curves were pretty parallel,” Johnston said. “But now we’re continuing to go up. And it seems that a lot of the problem is that people have relaxed their vigilance about things like wearing masks and keeping distance at a time when we’re moving inside."

Fifteen of Monday’s new cases were reported in North Pole, the town southeast of Fairbanks with more than 200 confirmed cases since March, where the city’s mayor quarantined at home on the upper level of his house by afternoon.

Mayor Mike Welsh said his wife tested positive for the coronavirus on Friday. She isolated on the floor below.

Welsh said he just got off the phone with Dr. Anne Zink, the state’s chief medical officer, who is “sending a team up here tomorrow” to deal with rapidly rising cases in his region. His most pressing concern at the moment: ensuring North Pole’s main polling location was deep-cleaned ahead of Tuesday’s local elections.

“I think we’re all just stumbling through this,” he said.

‘A lot of virus’

Cases are rising most quickly in Anchorage, Fairbanks and Northwest Alaska, but there’s community spread throughout the state, officials say.

In Anchorage, continued high case counts have delayed the reopening of schools for in-person learning and led to prolonged capacity restrictions at bars and restaurants. Around the state, rising cases have triggered school closures and village lockdowns.

This week, Alaska hit an all-time high for the 14-day average COVID-19 case rate with more than 16 cases per 100,000 as of Monday, state officials warned. That translates to “widespread community transmission with many undetected cases and frequent, discrete outbreaks.”

The state’s test positivity rate as of Monday also passed 4% for the first time since the pandemic began in March. Public health officials have said that if that number goes above 5%, that can indicate high community transmission and not enough testing.

“We’re concerned that there’s a lot of virus in the state right now,” the state’s chief medical officer, Dr. Anne Zink, said in an interview last week. “This is not the place I would like to be entering fall and winter to be totally truthful.”

Municipal officials in Anchorage last week described regular clusters of cases in assisted living centers where some of the state’s most vulnerable may be infected by staff who pick up the virus outside work. This week, Johnston stressed that it is changing community behavior — and the changing season — not these larger outbreaks that are driving the spread.

“What’s mentioned most frequently (in contact tracer reports) is activities with families and friends,” she said.

“The days are getting shorter, it’s getting cooler, and there’s more mixing inside,” she added. “And it feels to me that that’s what the big driver is.”

Fairbanks has the state’s highest case rates at 25.5 per 100,000 and the highest test positivity at 10%, local health-care providers say.

A Fairbanks school that phased in a group of 40 high-needs students for in-person learning in mid-September closed for all but online classes Monday after five people at Ladd Elementary tested positive for COVID-19 in the last two weeks, according to Yumi McCulloch, spokeswoman for Fairbanks North Star Borough School District.

Hospitals ‘holding up’ so far

State models, which briefly predicted declining case counts going into the fall, now forecast an increase to levels of infection higher than we’ve seen to date as the month goes on.

But there are other indicators that show Alaska compares favorably with many other places when it comes to how sick we’re getting with this virus, perhaps because there are more younger people here. So far, officials say, it’s people in their 20s and 30s who are driving up the new case tallies. Generally, they tend to weather the virus with fewer complications than older people or those with underlying medical conditions.

And so far, Alaska’s death rate is still the lowest in the nation, according to Centers for Disease Control data. The number of people sick enough with COVID-19 to need hospitalization hasn’t moved much for weeks and actually dropped slightly in recent days.

As of Monday, there were 37 COVID-19 patients hospitalized statewide, 11 of them in ICU beds in Anchorage where the state’s sickest patients tend to end up, according to data from the Alaska State Hospital and Nursing Home Association.

Generally, hospitalization numbers for coronavirus patients have stayed consistent for the last 30 to 60 days, according to association president and CEO Jared Kosin.

Health care administrators worried this summer, when similarly surging case counts led to fears of a crisis at the state’s hospitals as COVID-19 patients crowded limited ICU space.

That never happened, Kosin said. But it can one or two weeks for someone who contracts the virus to end up needing hospital care, so it’s hard to say what the current spike in cases will bring.

“Community spread is always concerning,” he said. “We’re holding up and we’re intact and able to manage what’s coming … but it is a lagging indicator and no one knows what tomorrow will bring.”

Governor will make changes 'if warranted’

A spokesman for Dunleavy on Monday afternoon emailed a statement in response to questions from Anchorage Daily News about whether rising case counts might provoke any changes to current mandates that include testing or quarantine for most travelers and a mask requirement in state buildings but not statewide. The governor has said that generally he wants communities to dictate their own COVID-19 policies.

Now Dunleavy and state health officials are “closely monitoring the number of cases and are in daily contact with hospital officials about Alaska’s hospital capacity,” the statement said. “While the number of positive cases is climbing, that was anticipated by the Governor and Alaska’s public health experts. It is also important to recognize that for every 100 hospital beds that are occupied, only 2 to 4 beds are being used by a patient with COVID-19.”

The governor is monitoring the counts and evaluating existing protocols and will make changes to the state’s “approach to managing COVID-19 if warranted,” the statement said.

Anchorage Mayor Ethan Berkowitz last week said he wanted to step up enforcement of pandemic precautions and asked businesses “to do the right thing” in order to avoid more restrictions. Berkowitz said he was “looking at options” to bring cases down to allow for in-person school but wanted to make sure they were effective and had community acceptance.

“Wear the damn mask, if I can quote Chris Wallace,” Berkowitz said.

Municipal health officials last week also expressed concern that the city’s hospitals could run out of ICU beds by late this month or early November if the ongoing case increases translates to more seriously ill people.

Cases are rising in Europe and other U.S. states especially in the Midwest, Zink said. Surges in other places are followed by similar surges in Alaska.

The other number that’s rising is the r0 or “r-naught” rate that indicates how contagious COVID-19 is right now, according to Tom Hennessy, an infectious disease epidemiologist and affiliate faculty member at the University of Alaska Anchorage. That raises concerns because of the higher risks of infection as Alaskans who spent the long days of summer outside are forced inside as flu season puts more pressure on clinics and hospitals.

“Whereas we were kind of in a standoff for about two months, we’ve now tipped over into a higher risk transmission, both from the standpoint of increased numbers of active cases and increased risk of transmission from those cases to other people,” Hennessy said in an interview last week. “And that’s a very worrisome setting, given everything else we’ve just talked about — people moving indoors, cold and flu season, the potential amplification of that effect. That’s all very concerning and points toward a fall outbreak that could be very dangerous for Alaska.”

Johnston said that cutting down the number of cases in Anchorage will continue to be made more challenging by the arrival of cooler weather and shorter days, which make socializing outside more difficult, and demands more creativity.

The best thing people can do is to wear a mask and keep six feet of distance any time they’re around someone not in their immediate household, she said. “We’ve been at this a while, and we have to find ways to protect ourselves and protect our sanity."

Reporters Morgan Krakow and Emily Goodykoontz contributed to this story.