Alaska Hospitals Lack ICU Resources to Cope With COVID Surge

Printed in Anchorage Press

Most Alaskans, and I was one of them, were satisfied getting our COVID-19 numbers from the dashboard, and tuning in for a press conference when we thought it was necessary.

We’ve all been repeating the mantra instilled in us over the past several months that we must follow science, social distance, and wear our masks, but Alaskans have become complacent, and we now face a surge in COVID-19 cases across the state with 1,436 new cases of COVID-19 just in the past eleven days.

Alaska’s healthcare system simply isn’t built for a surge of complex medical conditions, such as COVID-19, and Anchorage residents should know that the reported ICU capacity in Anchorage, which has suddenly ballooned to a whopping 164 ICU beds, is a farce.

The newly reported capacity of ICU beds in Anchorage I wrote about this past week, and whose inflated numbers recently appeared on the COVID-19 dashboard, now includes neonatal and pediatric ICU beds which are not helpful for treating the vast majority of COVID-19 patients.

Anchorage Mayor Ethan Berkowitz confirmed my reporting reprinted in the Anchorage Press last week during his Hunker Down Anchor Town radio address, when he said, “NICU’s are not suitable for adult COVID-19 patients and to count them I think skews what the true situation is. We do not have a lot of ICU beds.”

The inclusion of NICU and pediatric beds into the overall ICU bed capacity on the dashboard gives the false impression that Anchorage has more ICU capacity for the treatment of adult COVID-19 patients than we do, and is a direct result of Donald Trump’s Health and Human Services agency mandating hospitals around the country to report NICU and pediatric beds to them on a daily basis.

On October 2 at the Municipality of Anchorage’s weekly COVID-19 Press Briefing, the explanation for this change which I first reported on was explained in further detail. You can watch the pertinent part of the briefing by clicking here.

If you would like a rough picture of the ICU capacity in Anchorage, take the total number of Anchorage ICU beds on the dashboard and subtract it by the inflated number of 72 which is the difference between the old reported ICU capacity and the new reported capacity since hospitals began reporting their data directly to the department of health and human services.

One Anchorage emergency room doctor, who is allowing me to use their comments on the condition of anonymity, wrote: “Anchorage hospitals are most definitely at or approaching capacity in their ability to handle ICU patients. Joint Base Elmendorf even took on an ICU patient recently from Mat-Su Regional, which is almost unheard of.” 

Staffing in Alaska hospitals is an issue, and it has been for years. A hospital can have all of the ICU beds in the world, but they are worthless without enough trained healthcare professionals to operate them.

A local Anchorage hospital reportedly has 22 adult ICU beds but only “has the staff to operate a portion of them, roughly 18,” according to the same source who also tells me that “ICU level patients without ICU beds are held in the emergency department, which means patients presenting to the emergency department for acute issues are waiting longer and longer to be seen.”

Hospitals have been on ambulance diversion for critical care patients in recent weeks. Ambulance diversion can be a controversial strategy for temporarily relieving overcrowding in emergency departments. When a hospital invokes diversion status, incoming ambulances are directed to other facilities.

Unknown to many residents, myself included,  Anchorage hospitals have been running at or above capacity for years, so the issues facing hospitals now isn’t something that suddenly appeared since we’ve begun dealing with COVID-19, but when hospitals are regularly running at high capacity, they lack room and staff to cope with a sudden surge of patients which, in the age of COVID-19, certainly is not ideal.

Alaska residents on social media often point to the Alaska Airlines Center (AAC) as being a facility set aside to deal with a surge of COVID-19 patients should it ever become necessary to use, but it’s important to note that AAC would not provide Anchorage with additional ICU bed capacity but would rather be used for triage and inpatient beds.

There’s also the issue of revenue, the true elephant in the room.

Hospitals cannot continue elective surgeries if they report being at or above capacity for inpatient admissions. Hospitals are in need of revenue since elective surgeries were shut down for months this year and are reportedly struggling financially.

“From a hospital standpoint, elective procedures represent anywhere from 40 to 60% of their overall revenue,” Jonathan Wiik, says principal of healthcare strategy at TransUnion Healthcare.

Many healthcare professionals believe hospitals are taking a very risky gamble to keep highly-profitable elective surgeries and procedures going at the expense of not having enough beds for non-surgical patients.

KTOO reported over the weekend that the disaster declaration Alaska has operated under since March is scheduled to expire in mid-November. It gives the state special powers to protect public health, using mandates. With case counts rising significantly in the state, hospitals are concerned about what comes next.

On April 9 the percentage of daily tests with positive results in the Municipality of Anchorage was 3.39%. On October 4, that number was 4.64%, the highest test positivity reported in Anchorage since the pandemic began.

Staffing and capacity issues are already affecting hospitals at a time when Anchorage is experiencing a surge in COVID-19 cases across the state. In mere weeks some of those cases will translate into Emergency Room visits which will translate into a need for ICU beds which will require staff to operate them.

With hospitals largely running at capacity now, our state simply cannot afford an increase in critical care cases.

What can you do to alleviate the burden on our healthcare workers and our medical facilities?

  • Wear your masks properly. We’re all tired of seeing noses in grocery stores.
  • Stay away from people not already in your immediate familial social bubble.
  • Wash your hands. Carry sanitizer. Use sanitizer.