Jeff Cook, a longtime Fairbanks business figure and the president of the board of the city’s hospital foundation, heard about a case last week that shook him.
A woman in a rural hub town had COVID-19 and needed to be evacuated, but hospitals in Anchorage and Seattle wouldn’t accept her. She was flown to Fairbanks, where she died without family or support, Cook said.
Cook drafted an email to the office of GOP Gov. Mike Dunleavy, pleading for a statewide mask mandate and asking for phone call. When he got no response, he took the unusual step of sending it to local media outlets to publicize.
“I do not want to see emergency surgeries that get compromised because we’re overwhelmed with COVID patients. And absolutely, it’s a moral, ethical and real responsibility to try to do everything we can to avoid that,” Cook said in a phone interview this week. “We can’t keep doing what we’ve been doing and expect a different outcome.”
Cook and other municipal and health care leaders are now pushing Dunleavy to take a new approach to contain Alaska’s COVID-19 outbreak, as case counts keep rising, many schools remain closed, businesses clash with customers over face coverings and hospitals warn that their staff and bed capacities are stretched thin.
So far, instead of creating new mandates himself, Dunleavy has pushed municipal officials to adopt them at the local level.
But outside of Anchorage, an array of local governments have firmly rejected that approach in recent weeks. Many Alaska boroughs say they lack the legal authority to require mask-wearing, while two city councils in hard-hit areas voted against such measures last week.
In the Southeast Alaska community of Wrangell on Tuesday, the city council let its mask mandate expire, with the mayor saying he was awaiting direction from Dunleavy and calling the governor “AWOL.”
“It appears that we’re at a stalemate, which doesn’t contribute to the public health and welfare of Alaskans,” Nils Andreassen, the director of the Alaska Municipal League, wrote in an email to top state health officials last week. He added: “Based on current CDC guidance, state data, and concern we’re hearing from local governments, it appears that more needs to be done.”
Dunleavy was preparing to release his new budget proposal next week and was too busy for an interview, said spokesman Jeff Turner.
“The governor’s position on local control and face masks has not changed,” Turner said in an email. “While some local governments have decided to implement a face mask mandate, elected officials in other communities have decided against a face mask mandate for their residents. The governor continues to encourage Alaskans to take personal responsibility for their health.”
Dunleavy’s administration is “always monitoring” hospital capacity and is in “constant communication” with hospital officials, Turner said, though he didn’t respond to a question about why Cook’s letter had been ignored.
“Additional health orders and other measures to slow or prevent the spread of the virus will be made based on the data,” Turner said.
Masks are an effective measure to help limit the amount of virus spread by sick people, and after they were first required in Anchorage, transmission fell by 18%, said Dr. Tom Hennessy, a former CDC epidemiologist who now teaches at University of Alaska Anchorage.
Other policies can reduce the spread of COVID-19 by limiting the amount of time that infectious people mix with others, and by limiting the number of people they contact, Hennessy said.
But those measures — steps like closing schools and restaurants, and paying for social programs and public health infrastructure like contact tracers — can also be more costly than masks, Hennessy added. Ultimately, mask requirements should be part of a “layered approach,” because each tactic by itself isn’t 100% effective, he said.
“Multiple strategies are needed to prevent transmission, and leaving masks out ignores what we know about the basics of the virus,” Hennessy said. “It’s like wearing your seatbelt and driving your car, and thinking you were safe if you didn’t have brakes.”
Every single region of Alaska is currently in the “red” zone for the spread of COVID-19, according to state data. And case rates in the Mat-Su, Kodiak and Southwest Alaska are among the highest in the country — although one driver of those rates could be that Alaska is also testing more people, on a per capita basis, than any other state, according to data collected by Johns Hopkins University.
Health care leaders say more action is needed to get the virus under control.
“If the governor’s plan is working, we wouldn’t see increasing case numbers,” said Dan Winkelman, chief executive of the Yukon-Kuskokwim Health Corp., the Southwest Alaska tribal provider. “We’re not doing enough to strengthen our public health strategies.”
But additional mandates in some of Alaska’s hardest-hit areas appear increasingly unlikely, following the recent rejection of municipal mask mandates by local governments in the Mat-Su city of Palmer and the Kenai Peninsula city of Soldotna.
In Palmer, “masks would have been, probably, the only thing that we could mandate that would have had a chance of passing,” said Sabrena Combs, a city council member who sponsored the failed proposal.
Combs ultimately voted against the measure after hearing a deluge of opposition from constituents. But now she’s worried that Mat-Su residents are behaving in a way that will allow the virus to continue to spread unchecked, and ultimately force policy makers into another closure of local businesses.
“It doesn’t feel any different here right now than it did a year ago. There’s just such a sense of normalcy and sitting around and gathering in large groups,” said Combs, who’s also the deputy mayor. “I feel like we’re getting to a point where if we don’t do something, we’re going back to March and April, and everything’s just going to be closed.”
Like other local government officials, Combs pointed out that Palmer’s mask mandate would have applied only to a few square miles — not to the next-door city of Wasilla, nor to immediately adjacent areas of the surrounding Matanuska-Susitna Borough.
“So few people actually live within the city limits of Palmer or Wasilla,” she said. “Something would have to be done to lower those numbers at a borough level, and that would have to come from the state.”
In Soldotna, even after the city council rejected a local mandate, the community’s mayor, Paul Whitney, also said he thinks Dunleavy should put a statewide mandate in place.
“I’ve thought that for quite some time,” he said in a phone interview. “If a mask mandate is going to work, it’s going to have to be areawide, statewide — not just islands here, an island there. It needs to be everywhere if it’s going to be a mandate.”
Turner, Dunleavy’s spokesman, did not respond to a question about what other policy measures the governor could use to control the spread of COVID-19 instead of a mask mandate.
In many of his public appearances, Dunleavy has asked Alaskans to wear face coverings, and his office has said he believes mask wearing is a “very important COVID-fighting tool.” But in a podcast with a conservative news website earlier this week, he complained about them.
“Quite honestly, I really can’t stand masks, and I’m sincere when I say that,” he said. But, he added: “I think we’re on the verge, the cusp, of getting the worst behind us. We’re going to have a tough couple weeks here, but with the advent of the vaccinations and therapeutics, etc., I think we see light at the end of the tunnel.”