Joyce Johnson-Albert is seen lying on a bed in the trauma room of Upper Tanana Health Center, Alaska, on Wednesday, Sept. 22, 2021, receiving an antibody infusion.
Rick Bowmer | AP
Dr. Jeremy Gitomer, of the Providence Alaska Medical Center in Anchorage, realized last month that dialysis machines were not enough to treat Covidli patients suffering from kidney injury.
She recalled that a 70-year-old intubated woman with kidney failure and on dialysis for six days could not achieve this.
Gitomer and his medical team decided to discontinue treatment to empty the apparatus for the 48-year-old man, who was also on a ventilator and was more likely to recover if dialysis was performed. He said both patients eventually died, adding that up to 95% of Covid intubated patients on dialysis would not survive in Alaska.
“I’m horrified to experience this because I’ve never seen other people die in my life,” said Gitomer, a nephrologist who works at three hospitals at the Alaska Kidney and Hypertension Clinic in Anchorage. “I’ve been doing this for 25 years.”
Providence doctors were forced to choose who could become ill and who could die because the hospital’s capacity was limited.
On Sept. 22, 2021, registered nurse Angie Cliarie was caring for Joyce Johnson-Albert while lying on a bed in the trauma room of Upper Tanana Health Center, Alaska, receiving an antibody infusion.
Rick Bowmer | AP
There are many cases in Alaska that have destroyed the continental part of the U.S. in the summer due to the highly contagious delta option. To ease the burden on the state’s health care system, Alaska officials activated “crisis care standards” in 20 hospitals on Oct. 2, which would provide legal protection to anyone who chooses to get a bed or ventilator. will give. can save their own lives by refusing to treat others who are less likely to survive.
Gitomer said anchor hospitals, where almost all dialysis machines in the state are located, have been forced to refuse to transfer patients with low chances of survival. This not only puts Kovidli patients at greater risk. Hospitals are now struggling to treat patients with life-threatening illnesses such as cancer, accidents and organ failure. Doctors say patients with brain tumors are more likely to delay emergency care, get an MRI, and prolong their chances of seeing a neurosurgeon.
The Mat-Su Regional Medical Center, located 40 miles northeast of Anchorage, is unable to transfer patients with kidney and heart failure to Anchorage as usual. Now the hospital needs to keep some of them overnight and “be good enough to do outpatient dialysis the next day,” said Dr. Ann Zink, the state’s chief physician and Mat-Su emergency physician.
“Instead of one nurse being able to care for patients in four or five emergency departments, they can be treated in 10 emergency departments,” Zink said, adding that Kovidli patients accounted for nearly half of the hospital’s 100 beds. “Patients admitted to the emergency department have a really long wait.”
In Alaska, which managed dozens of Covid cases at any given time, more than 1,200 new cases were recorded on Wednesday, an average of 1,317 new cases over a seven-day period, according to Jones data analysis. Hopkins University. Alaska ranks third in the state in terms of population, but currently, as of Wednesday, there are 120 new infections per person. According to the Department of Health and Human Services, the number of hospitalized patients with cavities is almost twice the national average.
Alaska’s geographical latitude further complicates the state’s ability to fight the epidemic: health centers are so prevalent that the average Alaskan population has to travel 150 miles for medical care, Zink said. The Mat-Su Regional Medical Center itself serves an area the size of West Virginia.
The state brought in 400 out-of-state medical personnel late last month, Zink said.
School rebuilding, snowfall, and people spending more time indoors have made Alaska particularly vulnerable to the delta option this fall, Zink said. Many communities also lacked running water and sanitation, and faced high rates of respiratory illnesses before the pandemic began, he explained, increasing the risk of Covid spreading.
“We’re seeing more deaths and deaths than just these deaths,” said Dr. Angelique Ramirez, chief physician of the Health Health Partners Foundation at Fairbanks. “It happens every day, it happens at a young age, and it happens in spite of everything we know.”
In Alaska, vaccine hesitation is on the rise, making monoclonal antibodies a popular treatment for Covid, Ramires said. But with the decline in antibody deliveries, Ramirez said, Foundation Health was forced to maintain life-saving treatments only for the most vulnerable patients.
Herbi Demit, chairman of the Tanacross Village Council, will pass through Tanacross Cemetery, Alaska, on Thursday, September 23, 2021. In Alaska, there has been a sharp increase in COVID-19 cases in the country, combined with a limited state-wide health care system, almost entirely dependent on Anchorage hospitals.
Rick Bowmer | AP
“When it was hard, we had to make a choice,” Ramires said. “And our choice was that we could just run out of what we have, or consider who is using it and make decisions at the community level, who could benefit and limit it more. To those people.” .
According to Ramirez, staffing at Foundation Health has declined. The hospital delayed non-emergency surgeries and discharged patients with pneumonia earlier than usual, and doctors provided oxygen treatment at home after they recovered, not until they recovered, he said.
Ramirez attributed the rise in Fairbanks to the region’s low vaccination rate and the population’s resistance to wearing masks. Although Ramirez said the growth schools started before the start of the year, he said he hoped a return to private tuition would exacerbate the epidemic.
Alaska vaccinated more than 51% of its population against Covid, which ranks 35thth According to the CDC, all states and Washington on Wednesday. Misinformation and anti-vaccine sentiment have shown major barriers to further immunization of Alaskan people, said Charlo Gribbon, a nurse and infection prevention specialist at Bartlett Regional Hospital in Junau.
“Viruses are pathogens that are difficult to control,” Gribbon said. “So when we remove all the stops, everyone has to help us to prevent the spread of the disease.”
of Nate Rattner contributed to this report.