Kenai Public Health Nurse Tami Marsters answered the phone on Tuesday before it even had a chance to ring. She had been taking calls all day from local health care providers and the general public who want to know what to do next when it comes to the new coronavirus.
“I wish we knew more,” Marsters told the Clarion on Tuesday when asked if any new information was available on COVID-19, the disease caused by the new coronavirus.
As of Wednesday at 5 p.m., there were five positive cases of COVID-19 confirmed on the Kenai Peninsula — one each in Seward, Homer and Soldotna, and two in Sterling — and 59 total cases in Alaska. Local health care professionals, including public health nurses, family physicians and hospital administrators are preparing for an increasing number of cases while also continuing to emphasize the importance of social distancing to prevent a major outbreak.
Marsters said one of the reasons that governments around the world are taking the COVID-19 outbreak so seriously is because of the lack of both a vaccine and treatment.
“With the flu, we have a vaccine and we have treatment,” Marsters said. “With this we don’t have either, and it spreads quickly, and so many things change on a daily basis.”
Marsters said that the three hospitals on the peninsula — Central Peninsula Hospital in Soldotna, South Peninsula Hospital in Homer and Providence Seward Medical Center in Seward — are not equipped for a situation where a large number of people get seriously ill and require medical treatment.
“If we end up having to treat five people a day for a couple weeks, then we might be OK,” Marsters said. “But if we end up with 200 cases in a week, we’re in trouble.”
Bruce Richards, who works in external affairs for CPH, said on Wednesday that, with the small percentage of cases that require ventilators for treatment, the peninsula’s hospitals are ready to treat anyone who ends up in critical condition from the virus. Four cases that have so far been identified on the peninsula are being treated at home without the use of a ventilator, Richards said. The fifth case involves a Homer resident who is currently in self-isolation in Anchorage and also did not require hospitalization, according to a Wednesday press release from the City of Homer.
“It would have to pick up significantly for there to be any issues,” Richards said. “Hopefully it doesn’t come to that, and enduring the hardships now will mean we’re avoiding overburdening the system down the road.”
Central Peninsula Hospital has 49 beds and five ventilators, Richards told the Clarion. South Peninsula Hospital has 22 beds, according to their website, and three ventilators, hospital PIO Derotha Ferraro told the Homer City Council at their March 23 meeting. Ferraro also told the Homer News on Tuesday that SPH has nine ER beds and three isolation rooms.
Richards said that, beyond ventilators and beds, there is a national shortage of personal protective equipment for hospital workers, and CPH is “constantly assessing” their needs for equipment. CPH has plans in place for additional surge capacity in the hospital as well as alternative treatment sites within the borough, but Richards said that nothing is set in stone due to the unprecedented nature of the pandemic.
“I wish I could throw down a plan and say ‘this is what we’ve got,’ but unfortunately that’s not the case,” he said.
Richards said Thursday that CPH has conducted a total of 72 tests, with three of those being the positive cases in Sterling and Soldotna. Ferraro told the Homer News on Monday that SPH has conducted 25 tests.
Dr. Kristin Mitchell, a physician at Central Peninsula Internal Medicine in Soldotna, said that the lack of PPE across the state is contributing to the limited amount of testing being done. Even if there were enough tests for everybody who needs one, Mitchell said, there aren’t enough masks, gloves, gowns and eyewear for medical providers to safely conduct the tests.
Mitchell has tested several people already, and she said that the majority of her patients fall into the category of people considered to be most vulnerable to the disease: people over 60 and people with a variety of health complications. Nearly a quarter of the Kenai Peninsula Borough’s population — 23.7%, or 13,779 people — are over the age of 60, according to the 2018 American Community Survey from the United States Census.
As a result, nearly all of Mitchell’s interactions with patients lately have been remote, either over the phone or through Zoom video conferencing, with the exception of examinations that require physical contact.
“Anything that we can do with some distance between us and the patient, we’re doing remotely,” Mitchell said.
Mitchell said that her patients are generally taking the situation seriously, but many are confused about where to turn for the most accurate information.
Mitchell praised the efforts of Dr. Anne Zink, chief medical officer for the State of Alaska, for conducting daily press briefings on the virus, and said that the websites for Central Peninsula Hospital, the State of Alaska and the Centers for Disease Control and Prevention are where she goes to stay informed.
“Other than that, it’s washing your hands with soap and water, using sanitizer that’s at least 70% alcohol, and maintaining social distancing,” she said.
Mitchell, who is the parent of a Kenai Central High School student, said that she has been impressed with the school district’s response as well, especially when it comes to continuing to provide free meals for students even though the schools are closed until May 1 due to a health mandate issued by Gov. Mike Dunleavy.
Mitchell also noted that the medical community is “actively preparing” to coordinate their efforts on the local, state and national level.
Dunleavy said during a press conference Tuesday night that the State would be looking at efforts to increase production of PPE within the state. Mitchell said that she would like to see similar action on the federal level to begin mass production of medical equipment that is needed to test for and treat the virus.
“I just hope it’s not too late for that,” Mitchell said.
Dr. Brandon Hall is a physician at Central Peninsula Family Practice in Kenai, and his practice is also seeing a lot more phone traffic and a lot less foot traffic.
Hall said the State has a difficult line to walk when it comes to mandating social distancing and closures of businesses, and he worries what kind of long-term impact this quarantining will have on the economy.
To explain the importance of “flattening the curve” to his patients, Hall said he uses an analogy of drinking a can of soda. There’s a given amount of sugar in the soda no matter how quickly you drink it, Hall said, but drinking it all in 30 seconds will have a much different — and more negative — effect on the body than drinking it slowly over several hours.
“If we can spread this out over two months, the hospitals can probably handle it,” Hall said. “But when you drag things out for that long in order to flatten the curve it will just cause more anxiety.”
Hall said his biggest worry is people buying and hoarding huge amounts of goods like toilet paper or baby formula, actions which could harm other people more than the virus itself.
“Hoarding masks right now could kill a doctor or nurse. Hoarding formula could mean that another baby starves,” Hall said. “Take care of each other, and take care of the people you don’t know. If we can do this without being narcissistic we’ll be OK.”
Marsters didn’t mince words when asked what she would say to anyone still not taking seriously the health guidelines and mandates laid out by the State and the CDC.
“If you don’t care about your own health, maybe you could think of your parents,” Marsters said. “Or your grandparents, or your aunts and uncles. Maybe think of other folks besides just yourself.”
Reporter Megan Pacer of the Homer News contributed to this story.