Ravn’s bankruptcy leaves medical transport vacuum in rural Alaska

Nearly 20 communities in the Yukon-Kuskokwim Delta have no regular air service. (Katie Basile/KYUK)

Ravn Air Group’s bankruptcy left state officials and health providers scrambling to figure out how to transport rural patients who test positive for the coronavirus. Two weeks later, more than a dozen villages still don’t have regular air service.

While the state plans to use the National Guard to help transport COVID-19 patients from rural communities, the lack of reliable air service is putting a financial burden on rural healthcare providers who pay more for charter flights to get patients to hospitals.

Christina McDonough is a law student in New York right now, but she’s been keeping up with news from her home state of Alaska. She’s Sugpiaq from the village of Perryville, and she worries that the state isn’t prepared for a coronavirus outbreak in rural Alaska. McDonough remembers breaking her arm in Perryville as a kid.

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“And I had to wait for a plane to take me to the hub in Dillingham, and you know, a broken arm is nothing compared to pneumonia,” she said.

McDonough co-wrote an opinion article with Shanelle Afcan, who grew up in Nunam Iqua and Alakanuk, that laid out steps for the state to take to make sure rural communities are not left behind when preparing for a coronavirus outbreak. That includes more training for health aides, and small medical teams that could assist communities who have an outbreak. But reliable medical transport is her biggest concern.

Ravn’s bankruptcy earlier this month left a lot of questions for rural healthcare providers who depend on those airlines to fly patients in for medical care. Heidi Hedberg directs the Division of Public Health at the Alaska Department of Health and Social Services.

“We are hoping and waiting to see the private industry step into the vacuum and serve the needs of the villages who have had reduced flight services into their communities,” said Hedberg.

Eighteen villages in the Yukon-Kuskokwim Delta do not currently have regular air service; Ravn was the only passenger airline that served them. That means the Yukon-Kuskokwim Health Corporation must charter flights from those villages with other airline carriers to bring patients into Bethel for medical care. But not everyone who tests positive for coronavirus will be medevaced into a hub or to Anchorage. If cases are mild, the patient will likely stay in the village.

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Hedberg said that the state emergency center has worked with private airlines to properly transport a patient who has tested positive for coronavirus in a village, but the National Guard will step in should private airlines refuse service or be unable to get the patient out. 

With no regular air service to so many communities, YKHC has had to turn to charter flights to get non-coronavirus patients to medical care in Bethel, as well as deliver medical supplies. But YKHC is still waiting on the state for answers. YKHC spokesperson Mitchell Forbes said that chartering a flight can cost as much as $1,000.

“Right now, we’ve told the state that if a solution is not found there, it is not financially feasible for us to carry that cost,” Forbes said.

RELATED: North Slope Borough backs out of deal with Ravn, reaffirms right to commandeer assets in emergency

Forbes said that so far, the extra costs to charter a flight have not impacted YKHC’s ability to move patients out of the communities they serve or get medical supplies to those villages.

“We’re not going to leave someone in a village and say, ‘We cannot bring you to necessary care because it’s too expensive,'” Forbes said. 

Currently in Southwest Alaska, only one person has tested positive for the coronavirus.