Joyce Johnson-Albert watches as she is given an antibody infusion, while lying on a hospital bed at the Upper Tanana Health Center in Tok, Alaska, Wednesday, September 22, 2021. AP
Dr. Jeremy Gitomer, Providence Alaska Medical Center Anchorage, realized that there wasn't enough dialysis equipment to treat the Covid patients with renal damage. He recalled that a 70-year old woman intubated with kidney disease was on dialysis for six consecutive days. She wasn't likely be able to survive. Gitomer and his medical staff decided to end her treatment in order to make room for a 48 year-old man, who was also on dialysis and was more likely to recover if he received it. He said that both patients died at the end. Gitomer, a nephrologist at Anchorage's Kidney and Hypertension Clinic of Alaska, said that it was terrible to be going through this. "I have been doing this for 25 years. Providence doctors have had to make tough decisions about who may live and who will die because of the influx of Covid patients. This has strained Providence's resources.
Angie Cleary is a registered nurse who cares for Joyce Johnson–Albert while she receives an anti-inflammatory infusion. She lies on a hospital bed at the Upper Tanana Health Center in Tok, Alaska. AP
The highly contagious Delta variant is fueling a flood of cases in Alaska that has decimated the U.S. continental over the summer. Alaskan officials created "crisis standards for care" Oct. 2 in 20 hospitals. This gives them legal protection in case they need to decide who gets a ventilator or bed that will save their lives, while avoiding treatment for those who are less likely. Gitomer stated that Anchorage hospitals are where almost all the state's dialysis machines can be found. They have had to refuse transfers from patients with low survival chances from other in-state medical centres. This is not only putting Covid patients at greater risk. Non-Covid patients are also at risk. Hospitals have difficulty treating them. Doctors say that patients with brain tumors may experience longer delays in the emergency room, which can delay their access to an MRI and a visit with a neurosurgeon.
Mat-Su Regional Medical Center is located 40 miles northeast from Anchorage and can't transfer patients with renal or heart failure to Anchorage. According to Dr. Anne Zink (the state's chief medical officer, and Mat-Su's emergency room physician), the hospital must now keep some patients overnight. Zink stated that instead of one nurse being able care for four to five emergency department patients, they could be caring for ten emergency department patients at Mat-Su. Covid patients occupy nearly half of the hospital’s 100 beds. Patients who have to board at the emergency department are required to wait for quite a while. Alaska has seen dozens of Covid-related cases during the entire outbreak. Wednesday's high of more than 1,200 cases was a result of a CNBC analysis of Johns Hopkins University data. Alaska is third in population, but has 120 new cases per 100,000 inhabitants. According to data from the Department of Health and Human Services, Covid patients are crowding hospitals at almost twice the rate of national average. Zink stated that Alaska's geographical isolation makes it difficult for the state to fight the epidemic. The state's health-care facilities are scattered across the state, meaning the average Alaskan has to travel approximately 150 miles each way to get medical attention. Mat-Su Regional Medical Center serves an area as large as West Virginia. Zink stated that the state had brought in 400 medical professionals from outside the state to assist with the surge. Zink explained that Alaska is particularly susceptible to the highly transmissible Delta variant of this fall's spread because of the combination of snowfall, school resuming and people spending more time indoors. Zink explained that many communities had no access to water or sewers, and were at risk of developing respiratory diseases like asthma and other illnesses before the pandemic. This increased their vulnerability for a Covid epidemic. "We are seeing far more death, and dying from this surge," stated Dr. Angelique Ramirez of Foundation Health Partners in Fairbanks. It's happening every day, in younger people, and it's happening despite all that we know. Monoclonal antibodies are a popular Covid treatment in Alaska because of vaccine hesitancy. Ramirez stated that Foundation Health had to limit the use of life-saving treatment to the most seriously ill patients because the supply of antibodies was decreasing with the surge.
Tanacross Village Council president Herbie Demit walks through a Tanacross cemetery on Thursday, September 23, 2021. Alaska has seen one of the highest rises in COVID-19 in the country. This is in addition to a limited state healthcare system that almost exclusively relies on Anchorage hospitals. AP
