Alaska still has one of the lowest coronavirus case counts of anywhere in the country, with roughly three dozen. And experts say the disease’s relatively late arrival in the state, combined with its isolation, could give Alaska an advantage over areas that had less time to prepare.
But as the number of new cases ticks upward — eight on Saturday, 10 on Sunday, four more Monday — uncomfortable questions lurk in the background: Will the restrictive measures already adopted stop the virus’ growth from taking off exponentially, and avert a surge of patients that could overwhelm Alaska’s hospitals?
Or, should we do more?
As the coronavirus inflicts huge damage on the state economy, there’s increasing discussion about how far public health mandates should go, and how long they can be sustained. At the same time, doctors and some community leaders are pushing for even more aggressive social distancing measures and limits on travel.
Some Alaskans following the pandemic argue that in general, it’s better to err on the side of caution. And they say that if more restrictions are necessary, it’s best to adopt them soon, to reduce the risk that cases start growing at a rate that can’t be contained.
“At least in the short term, there’s really only one choice, which is to act aggressively, and to act in the interest of public health. Because if you don’t, or if you dawdle, or if you dither, or if you go halfway, the exponentialism of this thing will just completely overwhelm us,” said Rep. Jonathan Kreiss-Tomkins, a Sitka Democrat who, with engineers and designers, created an online model of the coronavirus’ spread designed to inform policymakers nationwide. “There’s really, morally, one choice we have.”
Experts say it’s probably too soon to judge the effectiveness of some of the initial steps taken to fight the virus, like bans on large gatherings and the closure of in-person food and drink service. That’s because it takes as long as two weeks for people to develop symptoms of COVID-19, the disease caused by the coronavirus.
But doctors, in particular, have been pushing for a ban on nonessential travel in and to Alaska, and for tighter restrictions on social contact. They argue that the longer the state can stave off widespread transmission of COVID-19, the disease caused by the coronavirus, the more time policymakers and providers will have to prepare and learn from the experiences of harder-hit areas.
“We really are moving quickly towards a period where we don’t have an opportunity to limit the spread of this illness. Once it’s endemic in our communities, we do not have that opportunity any more,” Dr. Nathan Peimann, who leads the Alaska chapter of a national emergency room doctors organization, said in an interview last week. “The longer you can wait, the better you can apply those lessons in a way that’s meaningful and helpful to patients.”
At a news conference Monday, Gov. Mike Dunleavy announced a new round of health mandates. Those include a required two-week quarantine for people coming into Alaska, along with closures of hair salons, barbershops and other businesses where social distancing is not possible.
Dunleavy had already closed schools, shut down in-person food and bar service statewide and banned gatherings of more than 10 people. Asked at the news conference whether the response was enough, Dr. Anne Zink, the state’s chief medical officer, said that was the “$1 million question.”
“That’s the real challenge of what we’re trying to figure out. We have a disease that silently spreads with very mild symptoms for a week or more. We have limited ability to test for it,” Zink said. “We are learning as fast and as much as we possibly can.”
Dunleavy’s administration still expects a surge in COVID-19 patients to come at some point, said Adam Crum, the state health commissioner. But its goal remains pushing that surge as far into the future as possible, he said in an interview.
“We want to get to a point that, when our surge does come, it’s something that we can hold within our health-care system,” Crum said.
Crum said Zink has been assessing the effectiveness of the state’s preventative measures through daily conversations with Jay Butler, a former chief medical officer for Alaska who now works as a top official at the U.S. Centers for Disease Control and Prevention.
Alaska officials so far lack a published model of COVID-19’s potential spread around the state that could help guide policymakers’ response, Crum added. But his department is developing one with the help of one of its epidemiologists, Jared Parrish, and data could be released within a couple of days, Crum said.
Dunleavy’s administration has, so far, resisted doctors’ requests that he order residents to shelter in place, though many communities, including Anchorage, have enacted versions of the measure. He’s also resisted instituting a full-blown ban on nonessential travel into and within the state. A spokesman for Dunleavy, Dave Stieren, said travel restrictions are still under consideration as the state’s efforts to fight the spread of the coronavirus evolve daily — though he added that it’s unclear whether the governor actually has the authority to restrict air traffic.
Anchorage Mayor Ethan Berkowitz, who’s imposed his own “hunker down” order inside city limits, said he’s waiting to hear from city attorneys about whether he has the authority to adopt such travel restrictions himself at the state-run Ted Stevens Anchorage International Airport.
Berkowitz said he’s “incredibly mindful” of the impacts of the COVID-19-related restrictions on workers and the economy. But he said his response is guided by health experts.
“It is unfair,” he said. “But the public health considerations are of paramount concern right now.”
The balance between more aggressive public health measures and the pandemic’s devastating effects on the country’s economy have become the subject of increasing debate at the national level in recent days. And some conservatives, including President Donald Trump, have suggested that public health mandates be relaxed soon.
“We cannot let the cure be worse than the problem itself,” Trump said at a news conference Monday.
Dunleavy, at his news conference Monday, said the coronavirus could cause a recession or even a depression, “if we’re not careful.” The economy, he added, won’t function unless people can go to work, and buy products and services.
“I don’t want anyone out there thinking that what I’m saying is the economy is worth more than somebody’s life,” Dunleavy said. But, he added: “It’s going to be an interesting conversation, over the next few weeks, on how we pull ourselves out of this and how we get back to living normal lives.”
One particular challenge for policymakers is that it’s hard to measure the effectiveness of their choices, because the restrictions they put in place are supposed to stop things from happening, said Kevin Berry, a University of Alaska Anchorage economist who’s studied pandemic disease and response.
While Alaskans are painfully aware of the costs of closing schools and businesses, they don’t have a clear understanding of the number of people whose lives might be saved by those steps.
“If things go well, the peanut gallery will have a fine time criticizing everybody as, ‘You overreacted, you did too much,’” Berry said. “But the problem is, if we do less and the truly bad situation occurs, it’s not something anybody really wants to think about.”
He added: “You can write all sorts of criticisms about these policies — which is why this is definitely a moment that calls for political courage.”