Monthlong lockdown needed in Y-K Delta to prevent COVID-19 crisis, regional health corporation says

As COVID-19 continues to spread at high rates through the Yukon-Kuskokwim Delta, the region’s tribal health organization is urging all communities in the region to implement a month-long lockdown to curb the spread and prevent a health care crisis.

A statement released Monday by the Bethel-based Yukon-Kuskokwim Health Corp. cited “continued exponential transmission” of the virus in the region, increasing hospitalizations — particularly among older patients — and limited ICU bed capacity in Anchorage as reasons for the recommendation and the growing concern.

“YKHC asks residents to remain in their homes as much as possible, and limit exposure to other community members only for essential needs like buying groceries or medical appointments,” said Tiffany Zulkosky, vice president of communications with the YKHC, in an email Monday. “We also recommend, when possible, that only one member of a household run essential errands.”

YKHC said that in addition to the new region-wide recommendation, they are now preparing to implement “crisis capacity care strategies,” which are protocols recommended by the state on how to allocate resources or prioritize care when under “scarce resource situations.”

“We may be forced to make difficult choices when it comes to activating medevacs, providing care, and allocating scarce patient care resources,” said Dr. Ellen Hodges, YKHC Chief of Staff.

The organization is currently preparing for a crisis within the next one to two weeks, based on the current modeling, and the fact that hospitalizations are a lagging indicator, the statement said.

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Beginning Monday, the corporation also said it would also pause lower-priority medical procedures for a month in order to preserve staff and resources.

Zulkowsky said while YKHC is able to issue recommendations, tribes and cities have to individually decide whether to implement them.

“We are unable to make a determination of how many communities will enact these protective measures,” she said. A running list of COVID-19 precautionary measures listed by tribe is available on the Bethel-based Association of Village Council Presidents' website.

That association "is urging regional community leaders including tribal councils, municipal governments, businesses, schools, to heed the advice of YKHC,” said Maria Nicolai, AVCP spokesperson, in a recent statement.

Some communities are already in some form of a lockdown, including the village of Chevak, where the state has so far reported nearly 300 cases — about a third of the total population.

The recommendations come after weeks of surging cases in the region and across the state. As of Monday, the Y-K Delta had the highest average case rate in Alaska, with 150.13 cases per 100,000 residents over a 14-day average — about 15 times the state’s high-alert threshold of 10.

Only two U.S. states had higher average case rates than that as of Monday: North Dakota and South Dakota.

Eleven of the region’s 12 cumulative medical evacuations have occurred in the last month. And on Sunday, YKHC reported the eighth COVID-19 death associated with the region: a Y-K Delta resident in their 80s who died Saturday.

YKHC has reported community spread in at least nine communities in the region in recent weeks, including Akiak, Kwethluk, Scammon Bay, Bethel, Chevak, Quinhagak, Napaskiak, and Toksook Bay.

State health officials have expressed recent concern about the situation in the Y-K Delta, a rural region in southwest Alaska that’s made up of dozens of villages not connected by roads, where the population is largely Yup’ik, and where case rate have recently been among the highest in the country.

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Dr. Anne Zink, the state’s chief medical officer, last week urged residents in the region to continue to follow public health guidance, and noted challenges unique to the region, which include a lack of running water in some communities and limited health care capacity.

She said the state was continuing to do all it could to provide support to the region, but she stressed that individual actions — like avoiding gatherings, social distancing and wearing a mask in public — will be necessary to slow the spread.

“We’ll get through this winter, but it’s going to take all of us,” she said.