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YKHC urges month-long regionwide lockdown and prepares to implement crisis capacity care strategy

The Yukon-Kuskokwim Health Corporation urges all communities in the YK Delta region to immediately enter into a month-long shelter-in-place, or lockdown, to curb the spread of COVID-19 as it prepares to implement crisis capacity care strategies for the region’s healthcare facilities.

On October 12, and again on October 28, YKHC issued public health alerts urging the public to follow all COVID-19 precautions to break the cycle of transmission in the region, in every effort to warn the public of actions needed immediately to prevent exceeding local healthcare capacity. As part of the October 28 alert, YKHC provided Dr. Tom Hennessy’s modeling of the COVID-19 pandemic in the YK Delta, which predicted continued rates of transmission could overwhelm local medical capacity within 2-3 weeks.

“With continued exponential transmission of COVID-19 across the region, a growing number of YK Delta residents requiring hospitalization, and increased unavailability of ICU beds in Anchorage, YKHC is forced to prepare for providing care using the State of Alaska’s guidance for crisis capacity,” said YKHC President & CEO Dan Winkelman. “Although YKHC prepared for this scenario in March of this year, we have been asking the public to follow all prevention measures in order to avoid it.”

“When there is no overflow capacity available for YKHC to transfer critically ill patients that need intensive care to hospitals outside the region, we may be forced to make difficult choices when it comes to activating medevacs, providing care, and allocating scarce patient care resources,” said YKHC Chief of Staff Dr. Ellen Hodges. “YKHC continues to treat older, sicker patients requiring hospitalization and we are highly concerned as COVID-19 infection rates show no signs of slowing.”

Patient Care Strategies for Scarce Resource Situations are protocols adopted by the State of Alaska Department of Health and Social Service to provide Alaska hospitals guidance and strategies for patient care under scarce resource situations. Crisis capacity care standards guide decision making about how to allocate oxygen resources or medevac priorities, for example. Additional categories of guidance for patient care include: oxygen, staffing, nutritional support, medication administration, IV fluids, and blood products. Under crisis capacity, adaptive spaces, staff, and supplies are not consistent with usual standards of care, but provide sufficient care in the setting of a catastrophic disaster.

“It’s important to remember that hospitalizations are a lagging indicator, meaning they are resulting from COVID-infections that occurred days or weeks ago,” said YKHC Infection Prevention physician Dr. Elizabeth Bates. “Unfortunately, we are appropriately preparing for crisis in the next 1-2 weeks. Crisis capacity strategies provide the best possible care to patients given the circumstances of the disaster and resources available. I cannot stress enough the importance for communities and individuals to take action now to slow the spread of COVID-19, to help limit broad use of these crisis capacity measures.”

Effective the week of November 16, YKHC will also shutdown non-emergent operating room procedures for a month-long period to preserve staff, PPE, and other medical capacity.

“Although this is the first regionwide shelter-in-place recommendation YKHC is providing, it may not be the last,” said YKHC Vice President of Hospital Services Jim Sweeney said. “We will be closely monitoring and evaluating infection trends over the next month. If current transmission rates continue, YKHC may suggest communities extend the lockdown. If transmission slows, but COVID-19 cases begin to re-emerge at a later time, YKHC may make a similar recommendation at that time in order to protect life, health and safety of all YK Delta residents.”

The Alaska Healthcare Preparedness Program’s Patient Care Strategies for Scarce Resource Situations protocols were adopted from the Minnesota Department of Health Emergency Preparedness & Response Patient Care Strategies Protocol for Scarce Resource Situations, version 5.0, April 2019.

Get the latest information on COVID-19 from YKHC at www.ykhc.org/covid-19.

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COVID-19: Call Before Seeking Care

If you have symptoms like a fever, cough or shortness of breath, do not go to your village clinic and do not go to the Emergency Room in Bethel. Instead, call your village clinic, or in Bethel, call 543-6949.