Daily Sitka Sentinel

Providence Implements Prioritized Crisis Care

By MARK THIESSEN
The Associated Press

ANCHORAGE (AP) — Overwhelmed by a surge in COVID-19 patients, Alaska’s largest hospital on Tuesday implemented crisis standards of care, prioritizing resources and treatments to those patients who have the potential to benefit the most.

“While we are doing our utmost, we are no longer able to provide the standard of care to each and every patient who needs our help,” Dr. Kristen Solana Walkinshaw, chief of staff at Providence Alaska Medical Center, wrote in a letter addressed to Alaskans and distributed Tuesday.

“The acuity and number of patients now exceeds our resources and our ability to staff beds with skilled caregivers, like nurses and respiratory therapists. We have been forced within our hospital to implement crisis standards of care,” Walkinshaw wrote.

Alaska, like other places, has seen a surge in coronavirus cases driven by the highly contagious delta variant. State health officials said Tuesday there were 691 new cases and six recent deaths, all Anchorage men ranging in age from 50s to 70s. A woman in her 60s from out-of-state also recently died in Juneau, the department said.

Health officials said statewide that there are 202 patients diagnosed with COVID-19 who are hospitalized, and nine additional patients are under investigation. Officials said 33 of these people are on ventilators.

The percentage of patients currently hospitalized with COVID-19 is 17.5%, the state reported.

At Providence, more than 30% of the adult patients that are hospitalized have tested positive. This also comes at a normally busier time of the year for Alaska hospitals.

Walkinshaw noted that the state’s COVID-19 dashboard, which is routinely updated with numbers related to the virus, “isn’t equipped or designed to demonstrate the intricacies of providing medical care during this unprecedented time.”

At Providence, one of only three hospitals in a city of about 300,000 residents, officials have developed and enacted procedures to ration medical care and treatments, including dialysis and specialized ventilatory support.

The emergency room is overflowing at Providence, and she said patients wait for hours in their cars to see a doctor for emergency care.

Walkinshaw noted that what happens at the Anchorage hospitals affects the entire state since specialty care can often only be provided in the state’s largest city.

“Unfortunately, we are unable to continue to meet this need; we no longer have the staff, the space, or the beds,” Walkinshaw wrote. “Due to this scarcity, we are unable to provide lifesaving care to everyone who needs it.”

That has left patients across the state sitting in local hospitals since Providence can’t accept them for transfer.

“If you or your loved one need specialty care at Providence, such as a cardiologist, trauma surgeon, or a neurosurgeon, we sadly may not have room now. There are no more staffed beds left,” she wrote. 

Walkinshaw said they expect an increase in COVID-19 cases in the next two to four weeks, causing an already stressful situation to possibly “rapidly progress to a catastrophe,” she said.

She said the single most important thing people can do is to get vaccinated. Alaska was the first state to open vaccinations to all residents. As of Monday, 56.5% of eligible Alaskans have been vaccinated.

Alaska Gov. Mike Dunleavy, a Republican who has recovered from COVID-19 and been vaccinated, said employees at Alaska hospitals are working long hours, some have left their jobs and there are capacity concerns.

Dunleavy, who never imposed a statewide mask mandate, has faced criticism in the past from some who say he hasn’t come out forcefully enough in support of vaccination.

“I urge, and I hope you guys print this, I strongly urge folks to get a vaccine, strongly urge them to do that,” he told reporters Tuesday.

Walkinshaw also asked that everyone wear masks, even if they are vaccinated and avoid unmasked activities. She also urged people who are sick or have been exposed to get tested and asked people to avoid potentially dangers activities and situations that may increase the need for emergency services of medical care. 

“Unfortunately, if you are seriously injured, it is possible that there will not be a bed available at our trauma center to save your life,” Walkinshaw wrote.

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Associated Press journalist Becky Bohrer contributed to this report from Juneau, Alaska.