SCOTT SIMON, HOST:
This week, the United States exceeded 675,000 deaths from COVID-19. That is more than the estimated number of people who died in the great flu pandemic of 1918, before there were vaccines. On average, over 2,000 Americans die each day from COVID. In Alaska, new daily cases are higher than at any other time in the pandemic. Hospitals are in crisis, and 400 medical workers have been called in from out of state. We're joined now by Anne Zink, who is chief medical officer for the state of Alaska and an ER doctor at Mat-Su Regional Medical Center. She joins us from Palmer, Alaska. Dr. Zink, thanks so much for being with us.
ANNE ZINK: Yeah. Thanks so much for having me, Scott. I wish it was under better circumstances.
SIMON: Well, tell us what it looks like from your perspective around the state.
ZINK: Alaska's really experiencing the worst surge that we've had during the entire pandemic. We've seen unprecedented hospital cases. Approximately 20% of everyone in the hospital right now, or 1 out of 5, are COVID-19 positive. We just have really limited health care capacity in our state. Average Alaskan travels over 150 miles to access care. We're really seeing strain on our health care system like we've never had before with this current surge of cases.
SIMON: Alaska has so many villages. How do they get help?
ZINK: It's a great question. We live in a big and beautiful and wondrous state. We're bigger than Montana, Texas and California combined. And so with this current surge of cases, we're seeing delays in care in all sorts of areas. So even in fairly populated islands like Kodiak, you know, physicians are spending nine hours calling around between different systems, trying to find a bed available and trying to get care for their patients. We're seeing patients needing to stay in regions where they would normally be transferred.
The YKHC Delta, which is this big, beautiful region, serves 60 villages in that region. And so they are really struggling with, who do they ship in via flight to their hub hospital, Bethel? And then who do they get out into Anchorage based on just the lack of bed availability, the lack of staffing? So physicians, nurses, community health aides in these villages are making challenging decisions right now. And we continue to find ways to support the regions with additional tools and resources - oxygen, staffing, dialysis machines, things like that.
SIMON: When you talk about making difficult choices - and I want to pose this very carefully - to some people, that'll sound like rationing care.
ZINK: Yeah. I think when I think of rationing care, I think of having a set of resources and choosing who gets it and who doesn't. And I think what can be lost in this conversation is the many nuances of what happens when a system becomes full and delayed. I think of it kind of like standing at the beach with the tide, you know. Initially, there were different beds that we could have to, different resources that you could move to, and you could pivot. But as our COVID cases have risen, kind of like the tide, there are less stones to jump to. There are less resources out there. One nurse might typically be caring for two ICU patients. And then, with the current surge, they may have to care for three or four patients. And as a result, they aren't getting the same care that they used to have to. For things like dialysis, which helps to filter out your blood if your kidneys are shutting down, there's only so many of those that are available in the state and really and only in our most populated regions. Who gets it first? Do you try to speed up their time on that machine so you can fit more people in?
SIMON: I have to ask, are most of the COVID patients you're seeing unvaccinated?
ZINK: Oh, yeah, by far the vast majority. So our Alaska state data in our hospitalizations - 88% of people who are hospitalized in Alaska are unvaccinated individuals.
SIMON: I know you're incredibly busy. You're also a working ER physician, but I wonder if any of your COVID patients who are unvaccinated have indicated to you why they are not vaccinated.
ZINK: You know, I think that the most consistent theme I see is that people underestimate the risk of COVID, and they overestimate the risk of the vaccine. I haven't met a patient who hasn't gotten vaccinated because they want to get sick. People are trying to make the best decisions they can in really challenging times with a lot of misinformation. And so I think it's beholden on us as providers to continue to reach patients with compassion and help to really show that vaccines are our best tool against this virus. They're safer than almost anything else we do in modern medicine, including most over-the-counter medications.
SIMON: How are you and your colleagues in the ER doing?
ZINK: It's rough. Our public health nurses have been - you know, we had a recent public health center that was vandalized. We've had them, you know, followed in the grocery store. We've had providers stop asking about vaccine because people are frustrated and angry and don't want to escalate that situation. I think many of the health care providers who are actively caring for COVID-19 patients are also exhausted. And it's been almost two years now of responding to this pandemic. It's heartbreaking to, day after day, see patients sick. And I ask myself every shift, you know, what could I have done differently to communicate more clearly to help break through all of the misinformation out there, so they're not so afraid, and we can offer treatments earlier and ultimately help prevent such severe disease, primarily through vaccination.
SIMON: Dr. Anne Zink is Alaska's chief medical officer and an ER doctor at Mat-Su Regional Medical Center. Thanks so much for being with us, Doctor.
ZINK: I appreciate it. Thanks for having us. Transcript provided by NPR, Copyright NPR.
