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‘One eye on Anchorage, and one eye on your village’: Rural hospitals feel effects of urban infection rates

Nome's port, pictured in May 2021.
Nome's port, pictured in May 2021.(KTUU)
Updated: Sep. 26, 2021 at 8:00 AM AKDT
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ANCHORAGE, Alaska (KTUU) - While COVID-19 cases continue to rise, hospital beds are still hard to come by. As the largest hospitals in Anchorage struggle to keep up with patients coming in, rural hospitals watch closely to ensure they can still take care of the patients in their communities.

Recently, hospitals in outlying communities have found it difficult to transfer patients to Anchorage in situations where they normally would be able to.

At Providence Kodiak Island Medical Center, Administrator Karl Hertz said they have the resources to do most kinds of procedures and take care of most kinds of patients. Just not a lot of them.

“We can handle about anything, stabilize anything here,” Hertz said. “It’s just we’re not prepared to take care of patients — real sick patients or really injured patients — for the long term.”

Providence Kodiak has just 25 beds, two of which are ICU beds, Hertz said. Like most facilities, he said Kodiak’s hospital deals with staffing shortages. He said they have 76 positions open for hospital staff.

That doesn’t include a large number of support staff the hospital is short on as well, also trickling down to affect patient care.

“It does impact how quickly we can turn a room over so the next patient can get in, how fast we can get meals up to patients, how fast we can get the snow off the sidewalks and the lawn mowed,” Hertz explained.

In Nome, Norton Sound Regional Hospital also faces staffing shortages according to Dr. Tim Lemaire. He, like most of the doctors in that hospital, wears several hats, like being a family medicine physician and on the COVID-19 incident command team, among other positions.

He said Norton Sound Regional has 18 beds, but they have plans in place to have up to 47. However, he said staffing limitations would impact if they could proceed with that plan.

Lemaire said there are two doctors in the emergency department, one overnight doctor, and two doctors in the hospital, who help cover each other’s areas in the hospital. He said they also have psychiatric, primary care, and an OBGYN who operate their own teams in the hospital separate from other patients. He said they depend heavily on travel nurses, who are hard to come by.

He said Norton Sound Regional is a capable hospital, but it has limitations.

“We don’t have an OR, and we don’t have ICU-level care,” Lemaire said.

Norton Sound Regional and Providence Kodiak are critical access hospitals. Lemaire and Hertz described that role as a place where patients are stabilized and sent to bigger hospitals in places like Anchorage. Because the hospitals in the state’s largest city are full, it’s harder to get any kind of patient to a bed where they can get the care they need.

“Because of the situation in Anchorage, it means that if someone comes in with an ATV accident, or a heart attack or a stroke, or they just have a really bad pneumonia, those folks are experiencing the same delays in their care,” Lemaire said.

“We’re used to holding folks for a day or maybe two. But now, you know, we’re holding folks for a week, or maybe two weeks,” Hertz said.

They said they’re maintaining their standards of care right now, aside from delays in moving patients to hospitals with more resources. There are far fewer COVID-19 cases in their areas compared to Anchorage, but it’s a fragile situation where they know they could be in trouble if an outbreak happens in a rural community they serve.

“It’s kind of scary. We’re all hands on deck,” Hertz said. “And usually those things come once in a while, and now it seems like they’re here all the time.”

“Kind of keeping one eye on Anchorage, and one eye on your village, and one eye on your resources in Nome and trying to find that balance,” Lemaire said.

On Friday, the state reported there were a new record high of 217 people being hospitalized with COVID-19 statewide. Providence Alaska Medical Center in Anchorage, the state’s largest hospital, is operating under crisis standards of care, with resources and staff so overwhelmed the facility now needs to prioritize care and treatment.

Gov. Mike Dunleavy recently enabled crisis standards of care for all Alaska hospitals, should circumstances force them to need it.

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