All of the adult ICU beds at Anchorage hospitals were reportedly occupied Monday. That’s after medical professionals have pleaded for state and local officials to institute masking requirements and other measures to slow the spread of COVID-19.
Anchorage Mayor Dave Bronson told the Anchorage Daily News in a recent interview that he would not issue a mask mandate or other restrictions and said, “I don’t know what more we can do.”
Among those who disagree is Janet Johnston, the city’s former epidemiologist, who resigned after Bronson took office.
Johnston is now senior epidemiologist at the Alaska Native Tribal Health Consortium. She told Alaska Public Media’s Casey Grove that it’s important for any city to have sufficient hospital capacity, but in Anchorage it’s particularly important.
The following transcript has been lightly edited for clarity.
Janet Johnston: Anchorage serves as the backup for the state. And we’re also pretty far removed from any backup for ourselves. So with that limited access to other backup and, you know, really being depended on by other communities, it’s extra important that Anchorage be ready to handle emergencies.
Casey Grove: We’ve seen many places try various public health measures like masking and gathering limits to try to slow case counts. But how do we know that they actually work?
JJ: I’d say there are a couple of ways that we know.
There are some published, well done studies that have shown that they work. There was just a study out looking at community masking in Bangladesh — it was a really large study looking at a number of different communities. It shows that community-wide masking really helps reduce transmission. Back in January 2021, the National Academy of Science published a comprehensive review of all the evidence available at that time.
So there’s a lot of good documentation that things like masking work. But I’d also say, looking at the experience in our own community, we see that it works. You know, we put, at various times, mandates and restrictions in place for things like masking or capacity limits. And I was really watching the case counts at that time. It was always a little nerve-racking right after we did something because it takes a little while for the measures to take effect. But then, you know, two or three weeks later, we would see the case counts coming down. I think UAA did a study looking at the various times that we put things in place and seeing that they did help bring case counts down. And you can see it in other communities too, you know, there’s just this empirical evidence as well as studies.
CG: So I have to ask: Is there any question that a mask requirement in Anchorage could ease the pressure on hospitals?
JJ: There’s no question in my mind that if we had a mask mandate, it would help bring cases down. I’m not saying it would solve everything. We really need increased vaccinations. Vaccines work best when you have a really high level of vaccine coverage, and a low level of cases. But the two together are really what we need. And while we’re waiting to get vaccine rates up, the mask mandate, I think, is the absolute minimum of what we need.
CG: Anchorage Mayor Dave Bronson talked last week to the Anchorage Daily News about how the government can’t do anything more to help hospitals because they’re private entities. What is your reaction to that?
JJ: I guess I take more of a public health approach. So I think what we can do is try to reduce the demand on the hospitals. Right now, the hospitals are just totally buried in their ability to cover the COVID cases, along with the normal health care needs. And we’re really not able to serve as much of a backup for the state right now. So, it’s true, the hospitals are private entities. But we could reduce the number of cases by putting in place things like masking, by being more aggressive in terms of promoting vaccines. And we know that Anchorage has health powers. Anchorage has the ability to do things like putting in a mask mandate. So, to me, it doesn’t quite make sense to say that we can’t do anything. And I’ve been thinking a lot, when I saw that, I was like: When you’re in a hole, the first rule is to stop digging. And right now, I feel like stop digging means we have to figure out a way to reduce transmission. And that’s not really up to the hospitals.
CG: I mean, we know that when you worked for the city, it was prepared for situations like natural disasters where hospitals could be overwhelmed. What’s happening in Anchorage and statewide has been described as kind of a slow moving sort of disaster. So I wonder, what do you worry is coming next, if hospitalizations rise?
JJ: Unfortunately, there’s a lot that I’m worried about. I mean, I’m worried that we’re going to start seeing worse outcomes both for COVID patients and for other patients who need hospital care, you know, when we don’t have sufficient staff, and other resources to meet the needs. We have great hospital staffs here, but there’s only so much they can do. I also worry we’re going to start to see an impact on the schools. I think we all agree that keeping the schools open has to be a really high priority. But again, you know, if we get too many cases, that could impact the ability to keep the schools open. We’ve already seen things like not having enough school bus drivers to be able to do all the school bus routes.
And then I worry about the economic impact. As people get scared, whether or not there are mandates, they’re going to pull back.
And then I worry about the physical and mental health of our health care workers. They’re being exposed to high levels of transmission, but also the mental health. They have just borne the brunt of this pandemic for the past 18 months. And I feel horrible that now that we have vaccines, we know what we need to do to try to keep transmission under check. And we’re not doing it. And so it’s all falling on them. And that just really doesn’t feel fair.
Namely, it’s just, I’d like to see somebody in a leadership position do something at this point. We know what to do, but we’re not doing it. And we’re not talking at this point about trying to eliminate the virus. To me, the issue is the hospitals are overwhelmed. And it’s just not safe to not have any excess health care capacity. So we need to do something to reduce the demand from COVID, so that we can handle just the regular health care needs.
CG: What do you mean by normal capacity and sort of the normal things you would expect to see in a hospital?
JJ: Well, things like, today they’re saying on the hospital dashboard that there are no ICU beds available. So if there’s a major crash, we need to have space for people to go to the hospital, if people are having heart attacks, strokes. The thought of waiting hours in an emergency room, when something really needs to be taken care of. Or even I think of, as a mom, my kid is at a sports event and they break their arm. I prefer not to go into an emergency room that is full of people with COVID who are waiting to be seen. I just think we have an expectation of having, you know, not immediate hospital care available, but relatively quickly.
And then the other thing I could think of that’s typical for Anchorage is to be able to accept cases that need to come in from the bush communities. And we’ve got just really limited ability to do that right now.