Daily Sitka Sentinel

SEARHC Says More Testing Ahead for Sitka

By SHANNON HAUGLAND
Sentinel Staff Writer

Members of the city’s COVID-19 unified command heard reports Wednesday that more testing supplies are becoming available in Southeast, and the state is lifting restrictions on elective medical services.

The unified command team meets every Wednesday afternoon for updates and discussion of coronavirus issues affecting Sitka. This story is based on a recording of the meeting, but the open discussion that followed was not recorded.

The group did not talk about Gov. Duleavy’s Mandate 16, announced on Tuesday, that would allow restaurants, barber shops and other businesses to reopen under certain conditions. The Assembly plans to talk about that mandate at tonight’s emergency meeting that starts at 6 p.m.

The item on the agenda is “Discussion/ Direction/ Possible Action” in response to revised and new state mandates.

City Administrator John Leach said in an interview later on Wednesday, “I’m hoping to get from the Assembly some guidance on whether we want to be more restrictive or less restrictive than the governor’s plan. ... I’m just looking for clarification.”

City Administrator John Leach attends an Assembly meeting at Harrigan Centennial Hall March 14. (Sentinel Photo)

Sitka still has no confirmed cases of COVID-19 disease. Public Health Nurse Denise Ewing reported at the Wednesday meeting on COVID cases elsewhere in Southeast: Juneau has 27; Ketchikan 16; Craig 2; and Petersburg 3. There are 335 cases in Alaska confirmed by the State Department of Health and Social Services.

Ewing said she has received 70 regular testing kits to supplement SEARHC’s supply.

But much of the half-hour discussion was around the increase in testing supplies SEARHC has received, and plans to make testing available vulnerable populations, health care workers and families, and patients needing surgical procedures. At present, only those with COVID-19 symptoms are eligible for testing.

Dr. Elliot Bruhl, SEARHC vice president and chief medical officer, reported on Dunleavy’s Health Mandate 15, which rescinds previous mandate restrictions on elective surgery.

The four-page mandate, signed by the governor on April 15, has many elements related to required testing, personal protection equipment, and screening, Bruhl said.

“It’s quite complex,” he said. “Really, what this reflects is a change in the availability of testing capacity.”

Bruhl gave a few examples of the medical services that are allowed to resume as early as next month. Among other things, the mandate states that COVID testing is required for certain patients within 48 hours of their procedure.

“Most of that is going to roll out the first week of May,” Bruhl said of the new mandate.

Expansion of some walk-in patient care is also planned, as well as some dental-related services.

“There will be careful balancing of the risks versus the benefit,” Bruhl said. “There’s nothing about that that can be codified. It’s going to have to be done with input from physicians.”

The full text of Health Mandate 15 is available at https://gov.alaska.gov/wp-content/uploads/sites/2/04152020-COVID-19-Mandate-015.pdf.

“The question arises: why now? Why this?” Bruhl said. “The answer is we’re in a very different place now as a medical practice than we were six weeks ago.”

Speaking of SEARHC, which is the major health service  provider in Southeast and operates Sitka’s only hospital, Bruhl said, “We now have rigorous screening in place outside all of our clinics. Our staff is very familiar with the use of PPE in their practice. We have universal masking protocol for all patients that should allow some of these things to proceed which we couldn’t do six weeks ago.”

The increase in rapid and routine testing supplies will lead to increased testing in the community and around Southeast, he said.

“The result of that is we’re beginning a process of testing vulnerable and susceptible populations,” Bruhl said. “We’re testing all of our patients in long-term care, and we have offered to test all of the clients in the Pioneers Home.”

SEARHC plans to offer testing to all of its own employees and their household members, and also to Pioneers Home staff, medical support staff and essential service providers such as EMS, fire department and employees of the regional airline Alaska Seaplanes.

“Mandate 15 requires us to test all inpatient populations ...” Bruhl said.

Richard Wein, a medical doctor and Assembly liaison to the group, also gave a report, and posed some questions.

“One of the questions we’re going to have to ask, what is our endgame (for the Pioneers Home and long-term care)?” he said. “Especially if this seasonalizes and becomes a recurrent thing. How are we going to deal with this not only in the short term – which is testing – but also in the long term, which is: if this is going to be coming around frequently, do we keep it on lockdown, how do we maintain that type of environment? I think it’s a very important question.”

Wein noted comments made by state Fish and Game Commissioner Doug Vincent-Lang about the commercial fishing, processing and charter fishing industries.

“And if you were to put it down to a single sentence, it’s the honor system,” Wein said. “If you look at Sitka, by opening the fisheries, it has in essence diluted or negated lots of things we’ve tried to do because of these kinds of things. It’s put us in an odd position as to how to move forward.”

The group talked about testing accuracy and various statistics about the accuracy of COVID tests, studies and reports on tests, with EMS Captain Rob Janik, Wein and Bruhl all weighing in.

“We have tested over 200 people in Sitka; that’s about 2.5 percent of the population and we’ve not had a positive,” Bruhl said. “Regardless of the intrinsic accuracy of the test, what that tells me is that if the COVID-19 virus is present in our community - and it’s entirely possible that it is - it’s present in very, very low numbers. That reflects the isolation of the community of the last eight weeks.”

New people coming into the community will present challenges, he said.

Bruhl said “the direction forward” is with more testing and residents taking the initiative with such things as wearing homemade face masks.

“It’s nice to see people in our community are using face mask coverings in situations where there’s groups of people, and that it’s becoming more widely available,” he said. “And the other thing that’s going to be really, really important is testing, and there is more testing becoming available.”

The increase in testing should lead to making businesses and locations “safer ... for our businesses and citizens,” Bruhl said.

Jay Sweeney, the city finance director and member of the unified command, discussed some of the challenges with the reimbursement process for communities through the Federal Emergency Management Agency, related to the COVID-19 emergency.

“I’m hoping soon to have more by next week as to what we can expect in ... reimbursement from FEMA and what amount that will be,” he said.

In other reports, school district co-assistant superintendent Phil Burdick talked about the continuation of “virtual school” through the end of the school year May 22, the food service program for qualifying families (about one-third of district families), and plans in the works for high school graduation.