There was one bed coming available in the intensive care unit in Alaska’s largest hospital.
It was the middle of the night, and the hospital, Providence Alaska Medical Center in Anchorage, had been hit with a deluge of coronavirus patients. Doctors now had a choice to make: Several more patients at the hospital, most of them with Covid-19, were in line to take that last I.C.U. spot. But there was also someone from one of the state’s isolated rural communities who needed to be flown in for emergency surgery.
Who should get the final bed?
Dr. Steven Floerchinger gathered with his colleagues for an agonizing discussion. They had a better chance of saving one of the patients in the emergency room, they determined. The other person would have to wait.
That patient died.
“This is gut-wrenching, and I never thought I’d see it,” said Dr. Floerchinger, who has been in practice for 30 years. “We are taxed to a point of making decisions of who will and who will not live.”
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Since that night, more grim choices have had to be made as Alaska confronts what is currently the nation’s worst coronavirus outbreak. Nearly two years after the virus began circulating in the United States, some of the scenes here on the country’s northern frontier echo the darkest early days of the pandemic: testing supplies are depleted, patients are being treated in hallways and doctors are rationing oxygen. With emergency rooms overwhelmed, the governor has asked hundreds of medical workers to fly in from around the country to help.
Through much of the pandemic, Alaska’s natural isolation had shielded the state, with the early months defined by strict testing protocols for people arriving from the outside. Many villages locked down. When vaccines arrived, there was a legion of planes, ferries and sleds to bring doses to far-flung communities. The state has maintained some of the lowest death numbers in the country.
But with some pockets of the state wary of taking vaccines — only about half the state’s residents are fully vaccinated — and Gov. Mike Dunleavy resisting restrictions to curtail the virus, the state’s isolation has become a growing liability as the Delta variant sweeps through. The state’s surge has continued even as the virus has receded nationwide, with new daily cases down by about a third and hospitalizations by about a quarter since Sept. 1.
Much of the nation’s hospital system has been stressed, but overloaded facilities in the lower 48 states have had more flexibility to transfer patients to neighboring cities or other states. In Anchorage, most of the help is 1,500 miles away in Seattle, and hospitals in the Pacific Northwest have been challenged by their own disastrous virus outbreak.
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Continue reading the main story
“When your hospitals are full, you can’t just put them into an ambulance and take them to another town,” Senator Lisa Murkowski said of Alaskan patients in a floor speech to Congress on Friday. She described her own trip to an emergency room in Fairbanks, where a loved one needed help for a non-Covid problem. They were told that critical care beds were full and that they might have to fly to Seattle.
Doctors and nurses have started speaking out in meetings, urging the public to take the virus more seriously, but they have repeatedly encountered hostility.
When the Anchorage Assembly considered a mask mandate last week, some of the doctors who came to speak were jeered at. “Do you use ivermectin?” someone in the crowd shouted, referring to a deworming medicine that has been touted as a Covid-19 treatment on social media even as the Food and Drug Administration has warned people against taking it.
As a group of doctors left the meeting, one person followed them outside, heckling. “You guys have sold out and are liars,” he shouted. Others outside holding signs — “Liberty or Tyranny,” one of them said — also mocked the physicians.
Dr. Leslie Gonsette, an internal medicine hospitalist who often works at Providence Alaska Medical Center, said some of her colleagues had debated whether to even go to the meeting.
“There was an element of caution and worry for our safety,” she said. But in the end, she added, they concluded they had an obligation to tell people about the calamitous scenes playing out at hospitals.
At another meeting of the Assembly the following night, one person was arrested on a charge of disorderly conduct and found to be carrying a concealed weapon. Many people in the audience wore a yellow Star of David, likening the proposed mask mandate to the Holocaust, which led other speakers to express outrage. Mayor Dave Bronson, who has vigorously opposed a mask mandate, argued that it was appropriate to “borrow” the symbol and then later apologized for his remarks.
www.nytimes.com
It was the middle of the night, and the hospital, Providence Alaska Medical Center in Anchorage, had been hit with a deluge of coronavirus patients. Doctors now had a choice to make: Several more patients at the hospital, most of them with Covid-19, were in line to take that last I.C.U. spot. But there was also someone from one of the state’s isolated rural communities who needed to be flown in for emergency surgery.
Who should get the final bed?
Dr. Steven Floerchinger gathered with his colleagues for an agonizing discussion. They had a better chance of saving one of the patients in the emergency room, they determined. The other person would have to wait.
That patient died.
“This is gut-wrenching, and I never thought I’d see it,” said Dr. Floerchinger, who has been in practice for 30 years. “We are taxed to a point of making decisions of who will and who will not live.”
Advertisement
Continue reading the main story
Since that night, more grim choices have had to be made as Alaska confronts what is currently the nation’s worst coronavirus outbreak. Nearly two years after the virus began circulating in the United States, some of the scenes here on the country’s northern frontier echo the darkest early days of the pandemic: testing supplies are depleted, patients are being treated in hallways and doctors are rationing oxygen. With emergency rooms overwhelmed, the governor has asked hundreds of medical workers to fly in from around the country to help.
Through much of the pandemic, Alaska’s natural isolation had shielded the state, with the early months defined by strict testing protocols for people arriving from the outside. Many villages locked down. When vaccines arrived, there was a legion of planes, ferries and sleds to bring doses to far-flung communities. The state has maintained some of the lowest death numbers in the country.
But with some pockets of the state wary of taking vaccines — only about half the state’s residents are fully vaccinated — and Gov. Mike Dunleavy resisting restrictions to curtail the virus, the state’s isolation has become a growing liability as the Delta variant sweeps through. The state’s surge has continued even as the virus has receded nationwide, with new daily cases down by about a third and hospitalizations by about a quarter since Sept. 1.
Much of the nation’s hospital system has been stressed, but overloaded facilities in the lower 48 states have had more flexibility to transfer patients to neighboring cities or other states. In Anchorage, most of the help is 1,500 miles away in Seattle, and hospitals in the Pacific Northwest have been challenged by their own disastrous virus outbreak.
Advertisement
Continue reading the main story
“When your hospitals are full, you can’t just put them into an ambulance and take them to another town,” Senator Lisa Murkowski said of Alaskan patients in a floor speech to Congress on Friday. She described her own trip to an emergency room in Fairbanks, where a loved one needed help for a non-Covid problem. They were told that critical care beds were full and that they might have to fly to Seattle.
Doctors and nurses have started speaking out in meetings, urging the public to take the virus more seriously, but they have repeatedly encountered hostility.
When the Anchorage Assembly considered a mask mandate last week, some of the doctors who came to speak were jeered at. “Do you use ivermectin?” someone in the crowd shouted, referring to a deworming medicine that has been touted as a Covid-19 treatment on social media even as the Food and Drug Administration has warned people against taking it.
As a group of doctors left the meeting, one person followed them outside, heckling. “You guys have sold out and are liars,” he shouted. Others outside holding signs — “Liberty or Tyranny,” one of them said — also mocked the physicians.
Dr. Leslie Gonsette, an internal medicine hospitalist who often works at Providence Alaska Medical Center, said some of her colleagues had debated whether to even go to the meeting.
“There was an element of caution and worry for our safety,” she said. But in the end, she added, they concluded they had an obligation to tell people about the calamitous scenes playing out at hospitals.
At another meeting of the Assembly the following night, one person was arrested on a charge of disorderly conduct and found to be carrying a concealed weapon. Many people in the audience wore a yellow Star of David, likening the proposed mask mandate to the Holocaust, which led other speakers to express outrage. Mayor Dave Bronson, who has vigorously opposed a mask mandate, argued that it was appropriate to “borrow” the symbol and then later apologized for his remarks.
In Alaska’s Covid Crisis, Doctors Must Decide Who Lives and Who Dies
Amid the nation’s worst Covid-19 outbreak, patients are trapped in remote communities and doctors are prioritizing treatment based on who is most likely to survive.
