As pandemic-weary hospitals in Alaska face mounting pressures on staffing and non-COVID-19 patient volume, the state’s virus case counts shattered records Wednesday with no sign yet of a slowdown in the surge driven by the ultra-contagious but often less-severe omicron variant.
Alaska on Wednesday reported 4,520 new COVID-19 cases among residents and nonresidents over the previous two days. That breaks down into 2,494 cases Tuesday and 2,026 on Monday, setting daily records that easily surpassed the previous highs reported just last week.
Meanwhile, the number of patients hospitalized with the virus rose to 81 statewide. Even though that’s less than one-third of the record hospitalizations seen during the surge last fall, hospital officials say those cases are still adding to the strain currently faced by health care facilities.
Around the state, some facilities are seeing higher numbers of patients sickened with other respiratory illnesses, or chronic health issues that may have been left untreated during previous surges, hospital administrators say. Other hospitals now have fewer staff than they did in the fall and are being hit with significant absences among workers who were exposed to or infected with the virus recently.
The latest developments have dealt yet another blow to an exhausted health care workforce, and come just months after a delta-driven surge pushed many of the state’s hospitals close to a breaking point.
Within the Providence Alaska system — which includes the state’s largest hospital, in Anchorage — the omicron surge’s impact on staff is significant though not at crisis levels, said Dr. Michael Bernstein, regional chief medical officer. The hospital is working daily to find people willing to work extra shifts and moving workers around to cover those who are out.
There’s also an outbreak of the virus at two of the system’s long-term care facilities, Bernstein said: In 14 days, roughly 30 staff members and 14 residents tested positive, further straining operations.
The current COVID-19 case rate was a factor in Providence Alaska Medical Center’s decision to tighten its visitation policy to its strictest rules starting Thursday, spokesman Mikal Canfield said. Visitors will not be allowed for adult hospitalized patients in most circumstances. One person is allowed in maternity and end-of-life situations, and for pick-up and check-in for day surgery as well as for pediatric patients.
The hospital is “on guard” and has certain contingencies available, like delaying certain surgeries, if the hospital or intensive care unit is full, Bernstein said. Those were some of the measures that had to be enacted during the delta surge in September and October.
At the same time, Bernstein said he’s cautiously optimistic about the coming weeks given that the variant seems less severe, many people likely have some level of existing immunity through vaccine or prior infection, plus there are some newer oral antiviral medicines. As of Wednesday, about 63.3% of Alaskans 5 and older have received at least their first vaccine dose while 57.9% were considered fully vaccinated.
“All those things give us some confidence that we won’t be back where we were in September, October,” he said.
As the virus spreads, Foundation Health Partners, which operates Fairbanks Memorial Hospital, has seen a swift rush of staff out sick recently, said chief medical officer Dr. Angelique Ramirez.
She said she’s anticipating that the current surge may be as bad as the delta variant surge last fall.
On Wednesday, 38 employees, including 28 hospital staffers, were out across the Foundation Health Partners System — the highest total since the start of the pandemic, according to spokesperson Kelly Atlee. The number of employees missing work has sharply increased in the past week.
And over the past 48 hours, the hospital emergency room saw significant increases in the number of people with COVID-like symptoms, placing added pressure on operations since those patients require certain levels of isolation and protective gear, Ramirez said.
“I read a comment somewhere else that the most challenging piece about this surge is that it comes on the heels of all the other surges,” she said. “That’s absolutely true.”
After each surge, people leave the health care field, and those who still work in it have depleted emotional reserves to go through the whole thing once again, she said.
Since the start of the pandemic, 953 Alaskans and 32 nonresidents in the state have died from the virus. That includes five deaths reported Wednesday, all involving Anchorage residents: a man in his 50s, two men in their 60s and a man and a woman in their 70s.
September and October 2021 were the deadliest months of the pandemic, spurred on by the spread of the delta variant. While recent case counts have exceeded prior records, officials say there are some signs that the omicron surge may not be as severe in terms of hospitalizations or deaths.
At Alaska Regional Hospital in Anchorage, some encouraging news is that providers are generally seeing fewer critically ill COVID-19 patients who require hospitalization than during the delta wave, said Dr. Tim Ballard, the hospital’s chief medical officer.
“We’re still seeing high numbers of COVID patients, but many of them are not sick enough to be admitted,” he said. As with previous surges, the vast majority of patients hospitalized with the virus are unvaccinated, he said.
Rising case counts in the community have translated to noticeable numbers of staff needing to call out because they’ve tested positive for the virus, Ballard said. On average over the last week, between 30 and 50 staff members out of about 1,000 have been out due to COVID-19, he said.
The hospital has also seen an increase in emergency room visits — some from COVID-19 but many from other respiratory illnesses and other chronic health-related conditions, Ballard said.
“As we’ve gone longer and longer into this pandemic, the ability to manage chronic diseases at home may be compromised over time,” he said. “It seems like we’re having more of those lately.”
That could partially explain why Regional’s overall patient census count is currently close to where it was during the delta surge, Ballard said.
“We’re still getting a lot of admissions to our hospital, but it’s not the same proportion of COVID as it was,” he said.
At the Alaska Native Medical Center, overall hospital patient census numbers are now as high as they were during the delta surge — and “on some days, I think it’s even higher than we’ve seen before,” Dr. Holly Alfrey, the hospital’s chief medical officer, said Wednesday.
She said that while there are currently fewer COVID-19 patients than during the height of the fall surge — and patients appear to be generally less sick than during past surges — an influx of other respiratory illnesses combined with staff shortages, lowered bed availability and heavy demand on testing operations have again stretched the facility to its limit.
A “significant” number of staff out sick due to a COVID-19 exposure or illness is a top concern, Alfrey said. The staff shortages spanned across “just about every department,” she said.
As a result, staff have had to work in units they don’t normally work in, the hospital is doing what it can to bring in travel nurses from the Lower 48, and facility leadership have begun to talk about the possibility of again needing to enable crisis standards of care, Alfrey said.
The hospital has also seen a rise in pediatric COVID-19 hospitalizations, likely due to the high levels of community spread, according to Alfrey.
“It’s definitely as difficult as it’s ever been,” Alfrey said.
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