Rural hospitals struggle to transfer patients as COVID-19 hospitalizations in Alaska reach new high

Alaska’s large urban hospitals are so crowded with COVID-19 patients that some smaller, peripheral facilities are struggling to transfer critically ill people or scrambling to treat them on site.

The surge in COVID-19 cases in the state continued this week with no signs of peaking as the highly infectious delta variant continues to generate new cases and hospitalizations. Hospitals, particularly in Anchorage and Mat-Su, describe a crushing crisis in staffing shortages and complicated cases of coronavirus patients.

The state reported two more deaths of people with the virus on Friday – an Anchorage woman in her 40s and a Dillingham-area man in her 60s – and hit a new record of hospitalizations for COVID-19, according to the Alaska Department of Health and Welfare. Dashboard of services. A total of 444 Alaskans have died from the virus, along with 14 people from out of state.

Hospitals such as Kodiak, Nome and Bethel face unprecedented challenges as capacity issues related to coronaviruses trickle down to a domino effect of stalled transfer requests.

Nome hospital doesn’t even have COVID-19 patients, but it still faces ‘a COVID problem’, as Dr Tim Lemaire, family physician and member of the command team, said. incidents of Norton Sound Health Corp. “We don’t have COVID here, but we can’t get our regular patients treated… because of COVID everywhere else.”

Trying to move patients with heart attacks, strokes, or injuries from four-wheeler crashes, Norton Sound Regional Hospital sometimes has to call three or four facilities to find an open bed, at least once by moving a patient to Seattle to bring them in. an intensive care unit.

Lemaire is participating in a new daily statewide morning call organized by health officials. Friday’s call was not encouraging, especially the news from Anchorage: full intensive care units, with COVID-positive patients in half of the beds; surgical recovery areas used for COVID patients; patients held in the emergency room because regular beds were full.

“Dude, it’s dark,” he said.

At Kodiak, hospital officials at a briefing Thursday said they had launched “surge” plans for all types of patients in response to continued transfer delays for non-COVID patients and the possible inability to make transfers in the future. Typically, this can mean a brace to handle complex patients who cannot get care elsewhere.

[Unvaccinated people 11 times more likely to die of COVID-19, CDC finds]

Bethel’s Yukon-Kuskokwim Delta Regional Hospital has patients with COVID-19, but providers typically treat them in-house, Yukon-Kuskokwim Health Corp. chief of staff Dr. Ellen Hodges said on Friday. .

It’s the others – heart patients, victims of car wrecks, people with life-threatening sepsis – who are difficult to transfer, Hodges said. Over the past few weeks, it has taken 12 hours, at most 24, to find intensive care beds for people in need of intensive care, as the health organization’s referral hospital, the Alaska Native Medical Center , is usually full.

She has made a habit of warning her friends not to ride a bike unless they wear helmets and fasten their seat belts, as they have nowhere to go if they are seriously injured. .

The only thing that will reduce the pressure on the system is as the number of cases goes down, Hodges said.

“It feels like there is this world inside the hospital and those of us working in healthcare are desperate and helpless,” she said. “And then there’s another world of people who maybe don’t understand or realize how dire the situation is.”

State officials say rural hospitals across the state are suddenly faced with unheard of medical situations because they are holding patients they have never dealt with before.

Brian Ritchie, director of state health emergency response operations, helped a rural hospital find oxygen supplies after COVID-positive patients on high-flow therapy passed through existing cylinders faster than planned.

“It’s a challenge for these small rural communities who have never had to deal with this level of disease before, at this level,” he said.

As of Thursday, there were 208 people hospitalized with the virus in Alaska, a staggering increase of more than 1,200% since the end of June, when there were less than 20 COVID-positive patients.

Hospitals say these numbers are likely an underestimate of the true impact of COVID-19, as they do not include some long-term COVID-19 patients who are no longer positive but are still in need of hospital care.

[Fairbanks schools will start requiring masks next week. Mat-Su and Kenai, both grappling with surging COVID-19 infections, are still going without.]

There are also a few hospitalizations involving people who have been vaccinated, but these infections tend to be less severe, according to health officials. Between January and early September, there were 17 deaths, 105 hospitalizations and 6,378 breakthrough cases among vaccinated Alaskans aged 12 and older, according to interim state health data. That’s out of a total of 131 deaths, 894 hospitalizations and 33,039 cases during the same period.

Unlike the state’s latest wave of COVID-19, in which older people were found to be vulnerable, healthcare providers say they are seeing younger people, generally healthy and largely healthy. unvaccinated get sick and die.

Most people currently hospitalized are not vaccinated, according to hospital data. A state report released in July found that unvaccinated Alaskans were 7 1/2 times more likely to be hospitalized than those vaccinated.

The state also reported 702 new cases on Friday, including 677 residents. Officials said a backlog of reporting means there are likely to be more cases than those reported daily.

Alaska became the most vaccinated state in the country in March, thanks to an aggressive tribal health campaign and strong interest from the elderly. But now the state’s vaccination rates have slowed. The Alaska Chamber and the state’s health department launched a vaccination raffle last week that will run through October in hopes of increasing rates.

As of Friday, 61.6% of eligible Alaskans had received at least one dose and 56.1% were considered fully immunized.

President Joe Biden’s announcement on Thursday calling for coronavirus vaccines or rigorous testing for big business as a way to control the pandemic has met immediate criticism from Alaska Governor Mike Dunleavy and Mayor of Anchorage Dave Bronson.

Dunleavy criticized the Biden plan on Friday but said the vaccine was the most effective way to fight the pandemic.

“It is clear from the data and empirical evidence from last year that the vaccine is the most effective way to fight Covid-19,” Dunleavy said in a written statement. “From what we see in our hospitals, the very sick are mostly those who are not vaccinated. As governor and as someone who has had Covid and been vaccinated, I will continue to recommend that Alaskans speak to their health care providers and discuss the merits of the vaccine based on their individual care needs. health.

“That said, President Biden’s attempt to force vaccinations is ill-conceived, divisive and anti-American. As we are called upon to work together, forced medical interventions run counter to our collective sense of fairness and freedom. My administration aggressively identifies all the tools at our disposal to protect the individual rights inherent in all Alaskans. “

The state’s average seven-day test positivity rate – positive tests out of the total taken – was 8.98%, a near record high. Health officials say anything over 5% indicates the need for more testing.

State health officials said this week they are talking to providers in other states, including northern Idaho, where authorities recently released crisis care standards to help ration care in the midst of scarce resources.

The fact that these conversations are even taking place is shocking, said Jared Kosin, president and CEO of the Alaska State Hospital and Nursing Home Association.

“This should never be discussed in our lifetime, absent for mass events over a short period of time,” Kosin said Friday. “The fact that we are considering incorporating this into our response to care is unfathomable. Hope people realize this. “

Journalist Morgan Krakow contributed to this story.