Good News on the COVID Front: Alaska Rates Declining

Spoiler alert: It is not time for a mask-burning party followed by an evening of bar hopping with a bunch of your friends. However, no matter how you look at it, COVID is declining in Alaska.

• The daily COVID case count in Alaska has declined from an all-time high of 734 new cases November 27, 2020, to 180 new cases January 12, 2021.
• New hospitalizations for COVID patients statewide have plummeted from a high of 21 new cases November 25, 2020, to 2 new cases January 20, 2021.
• Deaths have receded from a high of 80 in the month of December, 2020, to 11 in the first 20 days of January 2021. (source for bullet points: Alaska Coronavirus Response Hub)

Absolutely stunning. Why is this happening? Will it last?

Here’s what Dr. Joe McLaughlin has to say. He is State Epidemiologist and Chief of the Alaska Section of Epidemiology at Alaska Department of Health and Social Services. Impressive title, but what the heck is “epidemiology?” Glad you asked. Epidemiology is “the branch of medicine that deals with the study of the causes, distribution, and control of disease in populations.” Surely, he would know. Here is what Dr. McLaughlin said as part of a Zoom panel January 20, in response to a question about declining COVID rates:

Great question. If you would have asked me two weeks ago, or three weeks ago, we would have all assumed that we are going to see a spike in cases by mid-January, just with holiday travel. Many people did not travel for the holidays, and we really applaud you for doing that, for staying home, hunkering down, not having large gatherings, but some people did. And we were expecting we’d see a spike, and we haven’t seen a spike.

Now part of this could be attributable to lower testing. For sure, that is one of the factors we looked at. Our testing numbers have generally kind of gone down. However, on the whole, if you look at our percent positivity, it’s one of the lowest in the country. It’s less than 5% (percent positivity is the percent of all COVID tests that are positive). “That’s what you want. You want a percent positivity that’s low. So that means that we’re probably not missing loads and loads of cases, like if you look at a place like Utah, I think their percent positivity is in the 20s right now, which is very, very high.

I think some of the factors that have really helped — we’ve talked about the Municipality of Anchorage’s health orders that came out. I think those really helped decrease transmission here in Anchorage. I think the governor’s text message that he sent out really sent a clear message to all Alaskans across the state when our case counts were very high, that were in a very concerning stage of the epidemic, and we needed to all work together to be vigilant about following the mitigation strategies. We did see pretty considerable decline after that text message ran out.

Dr. Anne Zink, Chief Medical Officer for the State of Alaska, was on the same panel. She added her take on the question of declining COVID rates after Dr. McLaughlin’s discussion:

I do think it’s because of a lot of hard work of Alaskans moving forward, and that is huge. I also think that we haven’t identified or found one of these [COVID-19 virus] variants that moves more easily from person to person, so I think that that is likely helping as well, versus we are seeing that in many other states...

If you can identify a case at the airport before they go and spread it to others right away. If you have someone on your volleyball team and you can figure out that that person has it before it spreads to the whole volleyball team, there’s some data from CDC that if you’re doing regular surveillance testing for those who are highly exposed on a regular basis, you can decrease the need for quarantine and isolation by 90%.

I think many of our schools are starting to do surveillance testing on a regular basis; the travel testing, the pre-procedural testing — it’s a lot of testing. It’s a pain in that sense, but I think it’s helping to identify cases early, and then contact tracing to really be able to help support people to be in isolation, so they don’t accidentally spread it to others. And it gets back to what we talked about a lot at the beginning — test, isolate, contact trace, and continue that circle just so that we don’t have that virus moving from person to person.

We’re getting to a point that we can do that much better. We had tons of cases in November. It was too hard to do any one of those parts, but it’s kind of like a snowball, and it’s a snowball effect. When those cases come down, our testing works better, our contact tracing works better, all of those pieces work more efficiently together. So, if we can just keep pushing those cases down collectively while we get vaccine out as fast as we can, I mean, this is really our chance to kind of protect our elders, to thread that needle. I feel like we’re in a race against the virus at this time, and we’re gaining a little bit of the upper leg and see this end in sight. We’re all sprinting to that end collectively, but we need to not let our guard down right now, because we are seeing some just devastating deaths in the Lower-48. We’re losing a person every seven minutes in this country to COVID-19. It’s just hard to watch that loss.

I want to wrap up by focusing on something critical that Dr. McLaughlin mentioned. He referred to “the Municipality of Anchorage’s health orders that came out,” and said, “I think those really helped decrease transmission here in Anchorage.”

In fact, Dr. McLaughlin and a number of other Alaskan researchers recently completed a study, “Evaluation of Public Health Emergency Orders and Reported COVID-19 Rates in the Municipality of Anchorage, Alaska, June – August, 2020.” The study strongly supports the public health value of Anchorage’s Emergency Orders. In the words of the researchers,

This report summarizes changes in the COVID-19 epidemic in Anchorage following Emergency Orders (EOs) enacted to reduce virus transmission and thus prevent excess severe illnesses and deaths. Following an EO to wear facial covering (masks) in most public locations, self-reported mask use increased, and the growth of the epidemic slowed. After another EO that restricted the number of persons allowed in public venues and the subsequent closure of those venues, daily case counts declined and maintained a declining pattern while these EOs were in effect. The data presented here indicate that the local EOs, a mask mandate, and targeted restrictions on gathering locations in Anchorage appear to have contributed to decreasing SARS-CoV-2 transmission rates.

The elevator speech you might take away from the comments of McLaughlin and Zink is that Emergency Orders work, and that’s good because we have precious little more in our tool box with which to fight COVID while we wait for our vaccinations. Meanwhile, legislators take note: Break open the cookie jars! The economy can’t return to “normal” until the virus is defeated, but people have to eat and pay rent right now. We can’t win the public health battle if we do not support those who pay the social costs.

Originally published in Anchorage Press