Mayday, mayday, mayday: A distress call from an Alaska ICU physician to Anchorage’s mayor

As a board-certified physician in pulmonary and critical care medicine in Anchorage for 14 years, I have served the Anchorage community as part of a strong team of ICU physicians in the state’s largest ICU. People need to realize that, in this latest surge of the COVID-19 pandemic, we are facing an unprecedented emergency in the ICU.

Mayor Dave Bronson, as an outstanding pilot before being elected as Anchorage mayor, you will understand that I am only sending this distress Mayday call to raise attention to a very time-sensitive matter, a matter of life and death. I am sending this distress call in a desperate attempt to save the patients who I am losing nearly daily to an almost entirely preventable disease.

I owe this to the patients in rural Alaska whose transfer I had to reluctantly decline, because I had assigned the last available ICU bed to a critically ill COVID patient who had to be placed on a breathing machine. And I owe this to our incredible nursing and respiratory staff who tirelessly come in, including on their days off, to make sure we save as many lives as we can in these extraordinary times.

There are no empty ICU beds in our ICU. In fact, there hasn’t been one in the last couple of weeks. As soon as one becomes available, it will be assigned to a patient who is on the waiting list for critical care. By having to triage phone calls and thus not being able to accommodate critically ill patients from rural communities, I am condemning them to suboptimal care and a much higher risk of mortality. It is a dispiriting process with no end in sight.

On a daily basis, we face heartbreaking situations. Caring for a COVID patient gasping for air, who is asking if it’s too late to get vaccinated before we place him on a breathing machine. Responding to a request from a similar patient on the verge of respiratory collapse when she asks, “Can I have another last phone call?” when we know well that her chances of making another phone call ever, once intubated, amount to a coin toss. To update a COVID patient’s family with the condition of their loved one who is deteriorating on a daily, sometimes hourly basis.

There is a crisis inside the walls of the ICUs and emergency rooms, almost as invisible as the virus itself. Action needs to be taken, now.

To defeat the pandemic, we need all the weapons we have at our disposal. It starts with leadership, promoting vaccination for all eligible residents, coupled with mask-wearing in appropriate settings. We cannot run through a minefield and hope that we will come out at the other end unharmed. As for vaccines, one of the strongest tools we have, you have repeatedly claimed “natural immunity” is as good as vaccination, and therefore you have not been vaccinated. But “natural immunity” did not work out for the roughly 650,000 Americans who have lost their lives to COVID infection.

I ask you to strongly encourage vaccination, setting an example by being vaccinated yourself. American science, technology and ingenuity, as exemplified by the rapid vaccine development, should not be denied or feared. It should be embraced and celebrated. It is patriotic and something to be proud of. Please encourage mask wearing in appropriate settings — this is another strong weapon we have at our disposal, one that prevented numerous deaths before vaccination roll-out. And, please, always consult with experts who tell you what you need to hear, rather than people who may tell you just what you want to hear.

As in aviation, medicine must place as its top priority the safety of the people it serves, identifying the cause of a safety issue and putting in place an effective solution. A virus is the cause of the COVID infections and the resulting deaths. The effect of the vaccines is to reduce the risk of hospitalization of vaccinated patients to 0.004% and death to 0.001%, if infected.

“Did Anchorage residents choose the right pilot to fly us to safety in these stormy skies?” will be the question for the future. Depending on your leadership, it may be too late for many of our residents to discover the answer by the time of the next mayoral election.

Javid Kamali, M.D., is an Anchorage ICU physician. He has worked in pulmonary and critical care medicine in Alaska since 2007.

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