How Alaska public health brainiacs cope personally with COVID

Sometimes it feels like a lot of blah, blah, blah...the same stuff discussed week after week. Other weeks I am gob smacked. That’s what happened at a press conference the end of July. Gob-smacking clarity. I thought about it off and on for a couple of weeks, and finally realized, “Well, if it has been that interesting and thought-provoking for me, perhaps the readers of Anchorage Press would find it interesting as well.” So, here’s the story.

For the last year or so I have been attending a Zoom weekly COVID press conference for Alaska media. It is often interesting, candid, and alternatively depressing or hopeful. The forum, known as the Media ECHO, features a panoply of Alaska public health experts. Typically, there is a brief but info-rich report on the ever-changing status of COVID in Alaska, followed by written questions from the media. 

Here’s how it started. Toward the end of the 45 minutes allotted for the forum, the moderator read a question from an inquiring attendee, “How much does DHSS [Dept. of Health and Social Services] know about where coronavirus infections are spreading most often at this point in the pandemic? Are there any trends that you could share?” Juicy question. Several experts on the panel wanted a piece of the action. Louisa Castrodale, epidemiologist, started the discussion by focusing on

...the overriding theme as it has been for the whole pandemic is people in close quarters, who are sick, sharing space – that is workplaces, that is private gatherings, that is some public gatherings.... So there isn't one single event that has caused the numbers to rise. It's a lot of activity in a lot of different places, and a lot of different spaces, but with that overriding theme of people passing it to each other in close contact.

 Then Joe McLaughlin, also an epidemiologist, chimed in with a different emphasis, 

On a broader spectrum, it's groups that have lower vaccine coverage rates are groups that tend to see higher infection rates. And that includes geographic communities. So the communities that have lower vaccination rates tend to have higher infection rates.

Dr. Anne Zink, popular and redoubtable State Medical Director, continued with yet a different focus,

We're concerned about communities where you have large, multi-generational houses living together in a close space, because that's where COVID spreads really quickly. And we know that we have many communities that do have multi-generational houses all living together. And so we would love to get everyone who's eligible in those houses vaccinated now, so that if it enters your village or your community, you are less likely to be hospitalized, you're less likely to be sick, you're less likely to die, but that indoor close contact space of households is really clearly a risk factor with adults.

Ok, so the COVID brainiacs see risks in the real world all over the place. At the same time, the Centers for Disease Control and Prevention (CDC), our governor, and our mayor each seem to have a different take on exactly what we are supposed to do about it in practical day-to-day terms. This unstated question begged an answer, but just then the moderator stopped reading questions submitted by attendees and announced, “Alright, thank you so much team. I believe that those are all the questions that I'm seeing here...” Suddenly a disembodied voice, gentle but firm, reaches out over the orderly stacked Zoom boxes, seeking the ever-elusive clarity, 

“Can I throw in one more?”

The gracious moderator relented, “Sure.”

Thanks. This is Nat Herz [Alaska Public Media]. I'm wondering, um, maybe for Dr. Zink and the folks from epi that are on the call as sort of the maybe best subject matter experts. Um, can you tell us what your own personal COVID mitigation protocols have gone back to at this point, and how serious you're getting in your daily lives?

Good question Nat! In their actual personal domestic lives, what do the COVID experts do? First up, the irrepressible Dr. Zink, 

Sure, I'm happy to start and others can chime in as they feel comfortable. I'm fully vaccinated, and I feel very fortunate that my children are 13 and 16, so they are fully vaccinated as well. And so that was our number one mitigation strategy. But in watching the Delta [variant of COVID-19] and watching vaccine breakthrough cases, we have made a decision to only eat outside – but not eat inside – at restaurants because of the risk of transmitting in that space, and to mask when we're in indoor spaces where we don't know other people's COVID status. So that may be the grocery store, that may be the hairdresser, or that may be other things. 

Also, I've lowered the threshold for testing. So, if they had an exposure or any sort of concern, even with their masks and vaccinated, I'm using the testing as an option to make sure that they didn't pick up COVID so we don’t spread it around the family overall, and continuing hand washing and encouraging just enjoying this beautiful state outside in as many ways as possible. So those are some changes that we have made. My eighth grader is not super excited about wearing her mask all school year, but she gets to while we have cases moving quickly amongst the state. So that's how my family is choosing to act.

 Next up, Joe McLaughlin, epidemiologist,

Very similar. Pre-Delta, when our case counts were really low, I was going around without a mask pretty much almost everywhere, except for here in the office. We tend to wear masks in the halls and whatnot. Now I'm wearing masks anytime I go into a grocery store or large indoor setting where I've got a lot of people in there that I don't know. So, I personally started doing that again. I also probably will be avoiding crowds, even outside, personally more than I would have a month ago, and just really trying to keep my distance a little bit more. Still going out hiking with friends and things like that. I'm fully vaccinated and almost all my friends are fully vaccinated, I think, so still doing that without masks. And so that's kind of, I guess, what's changed for me.

 Then Heidi Hedberg, Director of the Alaska Division of Public Health Leadership,

And I would just chime in that when we go to the grocery store, we're all wearing masks. I have a kiddo that's not old enough to be vaccinated yet, so we've always been super cautious. This summer we said, "You're going to go to an outdoor camp all summer." And definitely, I'm playing outside a lot more. I'm traveling now, so I'm choosing to test before travel, and I'm choosing to test after travel, and to always wear a mask even if there's low transmission in that community, because I don't want to be that one person that introduces it – and I am fully vaccinated. So, I'm still working. I'm still out in the community, but definitely wearing a mask and definitely testing more, just to make sure.

Well, there it is. A lot to process, but I think these practical strategies bring focus to practical action in these difficult Delta times. Hope you also have found some clarity here.

Originally published in Anchorage Press.