Daily Sitka Sentinel

Operations Resume At Sitka’s Hospital

By SHANNON HAUGLAND
Sentinel Staff Writer

Under authority of the April 21 Alaska Revised Health Mandate 15, the nonprofit consortium that provides health services to Sitka has started to resume some of the outpatient, dental and surgical procedures that were shut down by coronavirus mitigation regulations.

The comment was made Wednesday by Dr. Elliot Bruhl, chief medical officer of the Southeast Alaska Regional Health Consortium, speaking at a meeting of the Sitka Unified Command, the organization of health, public safety and local government officials overseeing the pandemic response in Sitka.

“This is the first week that we have broadened our outpatient practice in compliance with state mandate number 15, which allows for an increase in different types of medical conditions that we’re seeing in the outpatient departments and in our surgical departments,” Bruhl said.

The first part of the meeting was recorded, with a copy provided to the Sentinel for this story.

Among the topics covered or mentioned were planning for the Sitka high graduation, expansion of COVID-19 virus testing, and access to funding under the federal CARES Act.

Public Health Nurse Denise Ewing said that as of 1:17 p.m. Wednesday Alaska had 373 confirmed cases of COVID-19, and 291 victims have recovered. She said 38 had been hospitalized, and 11 had died.

She gave this list by age and percentage of confirmed cases:

– 30 to 39, 19 percent of confirmed cases.

– 50 to 59, 18 percent.

– 20 to 29, 17 percent.

– 60 to 69, and 40 to 49, 14 percent.

– 10 to 19 and 70 to 79, 5 percent.

– Over 80 and under 10, 2 percent.

Ewing and Assembly member Richard Wein, who is a medical doctor, also discussed other possible health effects of COVID-19.

Commercial labs are performing the highest number of tests at 9,000, followed by 7,000 by public health and 6,000 by hospitals and other facilities, Ewing said.

In his comments, Bruhl referred to the state’s April 21 revision of Health Mandate 15, which allowed health care providers to resume “low-risk routine type services which require minimal protective equipment” on April 20, and to resume “Non-Urgent/Non-emergent Elective Surgeries and Procedures” on May 4.

“One of the first areas that the governor intended to begin cautiously opening back up is medical care, because of the fact that we have so many strictures and routines in place in terms of protecting patients and preventing exposure for staff and patients,” Bruhl said.

Bruhl also told the group that SEARHC continues to expand testing, including all SEARHC employees and others in emergency services.

“The goal of that is to be able to reassure patients and staff that the clinical environment is a safe environment for them to access care as we’re beginning the process of opening up,” he said. In a news release today, he had a similar comment, adding, “By testing all hospital staff for COVID-19, we have an opportunity to potentially identify asymptomatic positive cases

in our communities.”

Bruhl told the group about the increasing interest from commercial entities of all types, including fisheries and other businesses, in testing their workers.

“In response to this, we are in the process right now of erecting a testing environment where a business will be able to identify people who need testing, based on a safety or mitigation plan, and that we will actually go out to that business or to where, whatever that location is and collect the test specimens.”

He said he expects at least another week will be needed to make it operational.

“It’s exciting that the testing supplies are adequate to be able to support that kind of an intervention ... to support our communities,” Bruhl said. Every test costs $175, he said.

“We are certainly willing and able to work with ... the municipality to provide that type of support,” as well as to city contractors and such private businesses as fisheries and childcare centers, he said.

City finance director Jay Sweeney said testing is a “potential valid use” of CARES Act grants to cities, but there are still a lot of questions.

“If you have a private business entity that needs to get employees tested – and they can’t afford it – they’ve been impacted adversely by COVID-19, that is a potential valid use of the funds,” he said. “The question is how do you get there and how do you draw lines. Who gets subsidized and who doesn’t. I don’t know that answer.”

Answering a question about testing costs, Bruhl said SEARHC has been billing for the service through insurance companies, Medicare and Medicaid and writing off the rest of the cost.

“We have not charged a single patient a single penny for any tests we’ve provided,” Bruhl said.

That may change with the potential of testing hundreds of asymptomatic people.

“It’s an enormous question,” he said.

(Editor’s note: The chief of the U.S. Centers for Disease Control, Dr. Robert Redfield, pledged at a congressional hearing March 12 that he would use his existing authority “to make testing free to all Americans.” )

Responding to another question about health care, Bruhl said hospital visits are down across the country because people aren’t going in for emergency as well as routine health care.

“The truth that will be told about this down the road will be excess cancer deaths because of the fact that we’re not doing screening colonoscopies the way that we normally do,” among other routine preventative care, he said. “However, I will say we are in the process of building back both screening mammography and also screening colonoscopy.”

Increased testing capabilities and new safety measures for COVID-19 prevention over the last six to eight weeks is making it possible for SEARHC to reintroduce services, Bruhl said.

“As Dr. Wein was saying they (health problems and consequences) are starting to show up statistically,” Bruhl said. “You and I were both predicting this weeks ago that this was going to become a problem and it is becoming a problem.”

A news release from SEARHC today encouraged patients to “keep up with preventative care plans for chronic diseases, along with treatment for acute and urgent care.” The announcement noted the extra precautions being taken to deliver care during the pandemic.

The group on Wednesday briefly discussed Sitka’s eligibility for funding from the Federal Emergency Management Agency to make up for the amount the City has paid responding to the pandemic.

Phil Burdick. co-assistant school district superintendent, discussed the school district’s work with the Department of Education to continue the district’s lunch program over the summer.

Currently, the district does not have the required 40 percent minimum of students eligible for reduced or free lunches that is needed to qualify for a state-funded summer program.

District Superintendent Mary Wegner added today that the state commissioner of education told her he’s been working on the issue, in light of the increased need due to the financial consequences of the pandemic.

“Stay tuned on that one,” Wegner said today. “We have a lot of logistics to figure out but that’s what we’ll do if we can. Students’ hunger will not go away at the end of the school year.”

Fire Chief Dave Miller praised those involved for “doing an awesome job,” giving particular comments to SEARHC for its preparedness work.

Maegan Bosak, communications director at SEARHC, talked about the community’s reaction to the single positive case, as well as trends in other communities, such as Anchorage, to the COVID precautions. 

“People are sick of it,” she said. “They don’t want to mask any more, they don’t want to hand sanitize, they don’t want to social distance. People are ready to get back to their lives.”

Bosak told the group they should be prepared to see some of the same reactions here. She said she is working with the city to get information out, about COVID prevention.

City Clerk Sara Peterson, who is the acting public information office, said the city is continuing to encourage social distancing and for the vulnerable population to stay at home, among other precautions.

“If folks start to develop symptoms, we’re encouraging them to seek medical attention,” Peterson said.

Bosak also noted that this is National Nurses Week.