UAA study: To prevent deaths, Alaska will need strict interventions for many months

A recent paper by the University of Alaska Anchorage’s College of Health’s Division of Population Health Sciences predicts the effects different containment strategies could have on hospitalizations and mortality. Here a chart comparing strategies in Anchorage/Mat-Su. (University of Alaska Anchorage’s College of Health’s Division of Population Health Sciences)

A new academic study of the coronavirus’s likely impacts on Alaska is clear: to prevent thousands of deaths, strict interventions will be necessary for months. 

A recent paper by the University of Alaska Anchorage’s College of Health’s Division of Population Health Sciences predicts the effects different containment strategies could have on hospitalizations and mortality. It gives figures for the Anchorage/Matanuska-Susitna Borough, as well as the state overall.

In no uncertain terms, the study’s authors recommend maintaining firm “shelter in place” measures, similar to what’s been recently enacted by the state and Municipality of Anchorage, to curtail widespread contagion and death.

“The social and economic effects of the measures which are needed to achieve this policy goal will be profound,” they write.

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Social distancing measures like school and university closures will significantly help reduce transmission. 

“The more we do to slow down (COVID-19) transmission, the more lives we save,” said Dr. Tom Hennessy during a press conference Monday morning held by the mayor’s office.

The study is based on two different data-based models of coronavirus spread, and is meant to demonstrate to Alaska policymakers the potential outcomes from different approaches to dealing with the virus. 

“What the university team has done is incredibly helpful,” said Mayor Ethan Berkowitz during the press conference.

“If no action is taken,” the study authors write, “the model predicts that new cases will rapidly overwhelm Anchorage/MatSu’s medical capacity within weeks and will result in approximately 5,800 deaths in Anchorage. Anchorage/Mat-Su currently has just over 982 hospital beds, and in this scenario, we could need capacity to care for up to 7,400 hospitalizations at the peak of cases.”

The only scenario examined in which hospital capacity is not at some point overwhelmed is a Wuhan-style lockdown.

Moderate social distancing measures have the potential to push out the peak of hospitalizations in the Anchorage area by three to four weeks and reduce the volume of hospitalizations substantially. That would buy medical providers a little bit more time, but still overwhelm facilities by late April.

The “shelter in place” measures outlined by the study’s authors are similar to what most Alaskans are living with right now. Mayor Berkowitz has called it “hunkering in place.” The good news under the academic model is that the strategy is effective while it’s in place, limiting the pace of hospitalizations and deaths. “This scenario predicts very few cases while the response is in place,” the report says. 

“We have done a lot to stop the virus,” Hennessy said of the state and municipality’s approach so far, adding that as a result the number of deaths from the disease could ultimately be much lower.

However, should the policies be lifted all at once, the volume of hospitalizations will climb rapidly, as if no measures had been enacted at all. It would, in effect, merely put off a surge in COVID-19 cases, buying time for healthcare providers. That could be mitigated by a phased approach to lifting restrictions on social movement, the authors offer.

The predictions for the state on the whole are not significantly different. With no containment measures, the authors caution, the number of virus cases will overwhelm the state’s hospital capacity in a matter of weeks, leading to “approximately 11,000 deaths.” 

Idiosyncrasies in Alaska’s geography, the small population size of many communities, and its unique healthcare system make it harder to model than larger metro areas. The relative isolation and early adoption of containment measures, however, may help limit the spread. 

In effect, the study outlines different ways Alaskans can delay the worst impacts of the coronavirus and keep medical facilities from being dramatically overwhelmed, plus some of the tradeoffs the authors believe are necessary to facilitate that. But, they concede, the measures are no silver bullet.

Asked how long he expects the city to maintain restrictions, Bekowitz said, “We are closer to the beginning than the end.” 

Hennessy echoed that perspective.

“To avoid a rebound in transmission,” the UAA study concludes, “these policies will need to be maintained until large stocks of vaccine are available to immunize the population – which could be 18 months or more.”