Alaska health workers face anger and threats from COVID patients and public, chief medical officer says

Alaska’s unprecedented COVID-19 crisis escalated Thursday with the state reporting seven new deaths, a record 1,330 new cases and a near-record 209 hospitalizations.

It’s the third time in two weeks that the daily record has been broken: The previous highs were recorded Wednesday, with 1,251 cases, and Sept. 15, with 1,095 cases.

The recent surge has meant the state is still working through a backlog of cases, said Dr. Joe McLaughlin, state epidemiologist.

“At this point, there’s no indication that I’ve seen that we are leveling off,” he said.

Over the last week, Alaska saw a 29% increase in cases, state data showed.

By Thursday there were 209 people hospitalized around the state with confirmed cases of COVID-19, according to a state dashboard. That’s a near-record, and far above last winter’s previous peak.

Hospitals say their numbers are likely an undercount of the true impact of COVID-19, since they don’t include some long-term COVID-19 patients who no longer test positive but still need hospital care.

The new numbers come a day after state officials announced they would implement crisis standards of care statewide, a worst-case scenario that forces hospitals to ration care due to resource and staffing limitations.

Those limitations and continually high numbers of COVID-19 patients have overwhelmed health care facilities around the state. At least one rural cardiac patient died recently when a bed in Anchorage wasn’t available.

Providence Alaska Medical Center has faced limited resources over the last ten days, including equipment, space, staffing shortages and could not take transfers from other parts of the state, said Dr. Michael Bernstein, chief medical officer at Providence.

At that point, they implemented crisis standards of care and began to use a triage committee, to help relieve the burden from frontline providers tasked with difficult and distressing decisions about care, Bernstein said.

“That is a very difficult situation for physicians to find themselves in,” he said. “Most physicians — unless they worked in a third world country or something — may never have experienced that before in their career,” Bernstein said.

Supply of certain equipment, from breathing machines to dialysis has been strained. While the hospital has enough high-end ventilators, a different type of non-invasive ventilator was in short supply, Bernstein said, as were continuous dialysis machines that patients have needed during the current surge.

Staff are working overtime and some nurses have had to increase the number of patients they care for at once, which is hard for staff as some worry about keeping up on the details of patients with complex medical needs.

‘Under attack’

Exhausted health care workers around the state have also recently been experiencing hostility by patients and the people they serve, according to Dr. Anne Zink, the state’s chief medical officer, who discussed the issue during a call with reporters on Thursday.

“Our public health team has literally been under attack,” Zink said. “We’ve seen many triage nurses in the emergency department stop asking (if patients are vaccinated or not) because patients have become violent towards them,” she said.

Zink said she had received reports from health care providers who had spoken out at local meetings and were spit at or received threatening letters in the mail. Some pharmacies have stopped asking if people want a COVID-19 vaccine because of such angry responses by customers, she said.

Contact tracers have also recently seen an increase in hostility when they reach out to people about their positive test, said Sarah Hargrave, a regional nurse manager who helps coordinate that response.

“We’ve had public health nurses followed out of community meetings being yelled at,” she said. “We’ve had one of our public health centers vandalized this week.”

At Fairbanks Memorial Hospital, patients have died with COVID-19 “almost every day this week,” according to Dr. Owen Hanley, an internal medicine physician at the hospital.

“This is a really hard disease to treat, and it’s a really hard disease to watch people go through,” he said Thursday during a call with reporters. Like other doctors around the country, he said he’s continuing to see a high number of younger, healthier COVID-19 patients — nearly all unvaccinated.

“These are young people that aren’t unhealthy, and they’re dying of this, or spending weeks in the hospital sick, away from their families and it’s frankly awful to watch,” he said.

The hospital’s chief medical officer, Dr. Angelique Ramirez, on Thursday described the facility’s capacity as strained.

The hospital’s emergency department was reporting wait times up to four and five hours, surgeries have had to be cancelled, and staffing issues persist, she said.

Over the past week, Fairbanks’ test positivity — the percentage of COVID-19 tests that come back positive — was between 16% and 18%, the highest the community had ever seen, and “a clue that we are still on a surge going upwards,” Ramirez said.

The state announced Wednesday that it had signed a contract to bring nearly 500 health care workers from the Lower 48 to Alaska beginning next week, among other efforts to help hospitals struggling with staffing shortages.

Alaska’s case rate per capita is the highest in the nation, according to a New York Times tracker.

Statewide, 8.95% of tests conducted over the last week returned positive results.

Among eligible Alaskans 12 and older, 62.7% had at least one dose of the COVID-19 vaccine while 58.3% were considered fully vaccinated by Thursday.

The seven newly reported deaths all occurred recently.

They included a man from Fairbanks in his 80s, a man from Fairbanks in his 70s, a woman from Fairbanks in her 30s, a woman from North Pole in her 60s, a man from North Pole in his 50s, a man from Palmer in his 70s, and a man from Anchorage in his 60s.

In total, 473 residents and 15 nonresidents in the state have died from COVID since the start of the pandemic.