Rural Alaska At Risk as COVID Surge Swamps Faraway Hospitals

TANACROSS, Alaska (AP) -
A welcome to Tok Mainstreet Alaska sign is shown Wednesday, Sept. 22, 2021, in Tok, Alaska. (AP Photo/Rick Bowmer)

But the battle against the coronavirus isn’t over. The highly contagious delta variant is spreading across Alaska, driving one of the nation’s sharpest upticks in infections and posing risks for remote outposts like Tanacross, a village of 140  between the Alaska Highway and Tanana River, where the closest hospital is hours away.

The COVID-19 surge is worsened by Alaska’s limited health care system that largely relies on hospitals in Anchorage, the biggest city. It’s where the state’s largest hospital, Providence Alaska Medical Center, is overwhelmed with patients and was the first weeks ago to declare crisis-of-care protocols, meaning doctors are sometimes prioritizing care based on who has the best odds of survival.

Since then, 19 other health care facilities in Alaska, including Anchorage’s two other hospitals and Fairbanks Memorial, have also entered crisis care mode, something overtaxed facilities in other states have had to do, including Idaho and Wyoming.

“Even though we live here, we’re concerned about Anchorage and Fairbanks,” said Alfred Jonathan, a Tanacross elder. “If somebody gets sick around there, there’s no place to take them.”

While Alaska has contracted with nearly 500 medical professionals to help over the next few months, the ramifications are dire for those in rural Alaska if they need higher levels of care — for COVID-19 or otherwise — but no beds are available.

Sometimes those patients get lucky and get transferred to Fairbanks or Anchorage. Other times, health care staff are on the phones — in some cases, for hours — looking for a bed or facility that can provide specialty treatments like dialysis.

One patient who couldn’t get dialysis at Providence died, hospital spokesperson Mikal Canfield said. Dr. Kristen Solana Walkinshaw, the hospital’s chief of staff, said she knew a patient in an outlying community who needed cardiac catheterization and died waiting.

Options in Seattle and Portland, Oregon, also are being overloaded. One rural clinic finally found a spot for a patient from interior Alaska in Colorado.

Health officials blame the hospital crunch on limited staffing, rising COVID-19 infections and low vaccination rates in Alaska, where 61% of eligible residents in the conservative state are fully vaccinated. According to data collected by Johns Hopkins University, one in every 84 people in Alaska was diagnosed with COVID-19 from Sept. 22 to Sept. 29, the nation’s worst diagnosis rate in recent days.

Officials say medical workers are exhausted and frustrated with what feels like a no-win effort to combat misinformation about COVID-19 being overblown and vaccines being unsafe. Some say it could have long-term effects — further shaking confidence in vaccines and treatments for other illnesses and making the longstanding pre-pandemic challenge of recruiting health care workers to the remote state more difficult.

Alaska, hailed early in the pandemic for working with tribal health organizations to distribute vaccines widely and quickly, was 25th in the U.S. for the percentage of its total population inoculated, according to Centers for Disease Control and Prevention data.

At hospitals, care “has shifted,” said Dr. Anne Zink, Alaska’s chief medical officer.

“The same standard of care that was previously there is no longer able to be given on a regular basis,” she said. “This has been happening for weeks.”

In rural Alaska, six Indigenous villages, including Tanacross, rely on the new Upper Tanana Health Center in the hub community of Tok, about a two-hour drive from the Canadian border. The staff treats who they can and moves those with more serious needs to Anchorage or Fairbanks, said Jacoline Bergstrom, executive director of health services for the Tanana Chiefs Conference, a consortium of 42 Athabascan villages spread over an area of interior Alaska nearly the size of Texas.

Emergency plans are in place to house people overnight if hospital beds aren’t available right away, clinic director Joni Young said. They’re usually flown because it’s a three-hour drive from Tok to Fairbanks and about seven to Anchorage.

Updated Tuesday, October 5, 2021 at 1:03 pm .