TANACROSS, Alaska, Oct 5 (US): An Alaskan Native Village has known what to do to keep COVID-19 at bay. They put a gate on the only road to the city and guard it around the clock. It was the same idea used a century ago in some isolated indigenous villages to protect people from strangers during another deadly pandemic – the Spanish flu.
It worked pretty much. Only one person has died of COVID-19 and 20 people have fallen ill in Tanacross, a 140-year Athabascan village that sits rustic log cabins and other homes between the Alaska Highway and the Tanana River.
But the fight against the Corona virus is not over yet. The highly contagious delta variant is spreading across Alaska, leading to one of the most severe infections in the country and posing risks to remote outposts such as Tanacross where the nearest hospital is hours away, the Associated Press reports.
The COVID-19 wave has been exacerbated by Alaska’s limited healthcare system that relies largely on hospitals in Anchorage, the largest city. It’s where the state’s largest hospital, Providence Alaska Medical Center, is overwhelmed with patients and before the first weeks it was announcing crisis-of-care protocols, which means doctors sometimes prioritize care based on who has the best odds of survival.
Since then, 19 other Alaskan health care facilities, including two other hospitals in Anchorage and the Fairbanks Memorial, have entered crisis care mode, something that tax-exhausted facilities in other states, including Idaho and Wyoming, have had to do.
“Even though we live here, we are concerned about Anchorage and Fairbanks,” said Alfred Jonathan, a senior at Tanacross. “If someone gets sick there, there’s nowhere to take them.”
While Alaska has contracted nearly 500 medical professionals to help over the next few months, the consequences are dire for those who live in rural Alaska if they need higher levels of care — for COVID-19 or otherwise — but no beds are available.
Sometimes these patients get lucky and are transported to Fairbanks or Anchorage. Other times, health care staff is on the phone — in some cases, for hours — looking for a bed or facility that can offer specialized treatments such as dialysis.
Hospital spokesman Michal Canfield said one patient who was unable to get dialysis in Providence died. Dr. Kristen Solana and Alkenshaw, the hospital’s chief of staff, said she knew of a patient in a remote community who needed a cardiac catheterization and died on hold.
Options in Seattle and Portland, Oregon, are also overburdened. A rural clinic finally found a place for a patient from Alaska in Colorado.
Health officials blame the hospital crisis on limited staffing, high COVID-19 infections and low vaccination rates in Alaska, where 61% of eligible residents in the conservative state are fully vaccinated. According to data compiled by Johns Hopkins University, 1 in 84 people in Alaska was diagnosed with COVID-19 from September 22 to September 29, the worst diagnosis rate in the country in recent days.
Officials say medical workers are overwhelmed and frustrated with what appears to be a no-profit attempt to combat misinformation about the COVID-19 swell and that vaccines are unsafe. Some say it could have long-term effects — further undermining confidence in vaccines and treatments for other diseases and making the long pre-pandemic challenge of recruiting health care workers in the remote country more difficult.
Medical workers are “describing feelings of: ‘You hear a code going on, and there’s someone dying,'” said Jared Kosen, president and CEO of the Alaska State Hospital and Association of Nursing Homes. “This is devastating. You never want to lose a patient. But in the back of your mind, you’re thinking, “Okay, another much-needed bed is now available.” How do you balance those feelings? It’s painful.”
At Tanacross, the elderly are encouraging people to get vaccinated, especially as the facilities are strained. The village is located in a sprawling, sparsely populated area of eastern Alaska where the vaccination rate is less than 50%.
Jonathan, 78, tells villagers that COVID-19 is here and, like the delta variant, will develop in other ways.
Those who “haven’t been vaccinated? Oh my God, we’re afraid for them,” said Jonathan, who recently led a crew to remove dead and dying trees to reduce wildfire fuel and firewood to heat homes.
His wife Mildred helped guard the gate into the community this year. Those restrictions ended this summer as the pandemic appeared to be improving. Now, she says, she’s tired of strangers calling their friends in Tanacross to scare them, claiming there are vaccine problems.
“I’ve got my shots, I’m alive and nothing is wrong with me,” she said before stacking bags of sanitizer, masks and nitrile gloves in her car for delivery around town.
Alaska, which was welcomed early in the pandemic to work with tribal health organizations to quickly and widely distribute vaccines, ranked 25th in the United States for the percentage of the total population vaccinated, according to data from the Centers for Disease Control and Prevention.
Dr. Ann Zink, Alaska’s chief medical officer, said hospital care “has changed.”
“It is no longer possible to provide the same level of care that previously existed on a regular basis,” she said. “This has been happening for weeks.”
In rural Alaska, six Aboriginal villages, including Tanacross, rely on the new Tanana Health Center in the central Toke district, about a two-hour drive from the Canadian border. Jacqueline Bergstrom, executive director of health services for the Tanana Presidents Conference, is a consortium of 42 Athabascan villages spread over an interior region of Alaska roughly the size of Texas.
Clinic director Johnny Young said emergency plans are in place to house people overnight if hospital beds are not immediately available. They are usually flown in because it takes a three-hour drive from Tuck to Fairbanks and about seven hours to Anchorage.
“If for some reason we cannot get out of the hospital, we prepare from the start to help our patients if we need to,” Young said. “We’ve had cribs before, stocked here, and we have another building we rent out that we can use to separate COVID patients.”
Staff are working overtime, with nurses receiving COVID-19 questions from callers and weekends away. They need to hire urgent care registered nurses, but few have applied.
Joyce Johnson-Albert was lying on a bed at the health center with an IV in her arm. She has been vaccinated but is infected, she also suspects she is from a hunting camp.
“I just hope in the next few days, I’m going to be a little bit better than now,” Johnson Albert said while receiving an injection of a monoclonal antibody, given at the start of COVID-19 to reduce symptoms. “It’s hard to say. You can go either way.”
Registered nurse Angie Cleary is grateful that the clinic is offering infusion therapy.
“However, I do get concerned some days where we’re not sure when we’ll get more,” Cleary said. “For example, I think we’re going to get five doses now, and we can get more tomorrow or it might not be until next week. That’s one of the concerns we have here, like, when are we going to get our next shipment?”
They are also fighting misinformation about the pandemic.
Republican Governor Mike Dunleavy has faced criticism for not imposing masks and not adopting vaccines as fully as some would like. He encouraged people to take an injection but said it was a personal choice. Others accused him of promoting vaccines and spreading fear.
Solana Walkenshaw said Providence Hospital staff have difficulty with tough speech. The chief of staff said that one of the employees was spit on when leaving work.
“We still have people who are COVID-denying while intubated, or family members who are COVID-denying as they say on their iPad, say goodbye to their loved ones,” she said.
Daisy Northway of the Talk Native Society knows how hard it can be to advocate for vaccinations, saying she “talked to be blue in the face” in an attempt to impress one of her sons.
The Athabascan Sheikh said she is urging people to get the shots, but in a way that reduces political fervor.
“We need to say, ‘get a vaccine’ in a way that benefits them and doesn’t criticize them for their beliefs,” she said.
RAE