Alaska’s largest hospital is now implementing crisis standards and rationing medical care amid a crush of COVID-19 patients and staff shortages that have forced providers to prioritize patients most likely to recover.
Providence Alaska Medical Center’s chief of staff announced the decision in a two-page letter Tuesday that urges Alaskans to wear masks regardless of their vaccination status, get tested, get vaccinated if eligible and avoid potentially dangerous activities or situations that could result in hospitalization.
More than 30% of the adults hospitalized at Providence were COVID-positive as of Tuesday. Patients with the virus demand more time-consuming care than most others, providers say.
“The acuity and number of patients now exceeds our resources and our ability to staff beds with skilled caregivers, like nurses and respiratory therapists,” states the letter, signed by Providence chief of staff Dr. Kristen Solana Walkinshaw on behalf of the hospital’s medical executive committee, more than 1,000 doctors, nurse practitioners and physician assistants. “We have been forced within our hospital to implement crisis standards of care.”
The policy was enacted over the weekend.
Hospitals around the state report operating at or near capacity, with very limited options for transferring patients to Seattle or other Lower 48 hospitals that usually provide care for patients from Alaska.
Gov. Mike Dunleavy on Tuesday urged more Alaskans to get vaccinated against COVID-19 as the highly infectious delta variant continues to drive a meteoric wave of new cases and hospitalizations at some of the highest levels in the country. The state on Tuesday reported seven more deaths linked to the virus, near-record hospitalizations and nearly 700 new cases.
“We’re out of beds. Life saving measures are not going to be possible in every case,” said Dr. Leslie Gonsette, an internal medicine hospitalist and member of Providence’s executive committee board who helped draft the letter. “And that’s what we’re trying to emphasize.”
Last year, Anchorage enacted strict COVID-19 mitigation measures including mandatory masking and capacity restrictions under prior administrations. Anchorage Mayor Dave Bronson has made it clear he opposes such requirements.
‘We are in a crisis at the hospital’
At least 30 health care workers, including Solana Walkinshaw and Gonsette, attended the Anchorage assembly meeting Tuesday evening. They were praised by some Assembly members and grilled by others. They were occasionally interrupted by murmurs of disagreement and discontent from others in the crowd.
Bronson praised the municipality’s work on testing and monoclonal antibody treatment sites and reiterated his opposition to any vaccine requirements as the meeting got underway. Several people testified in opposition to vaccination and other mitigation policies. At least one suggested the virus was nothing to be afraid of.
“We are in a crisis at the hospital,” Solana Walkinshaw testified, meaning care had to be rationed. “That means when we have four patients and two machines, two people are not getting that care. It’s happening now.”
Gonsette said as she walked into the meeting, she was trying to find an intensive-care bed for a patient in critical condition.
“’My patient is going to probably die. I need an ICU bed,’” she told doctors on the ICU. “And the answer I got was, ‘We are doing our best. We do not have a bed.’ This is what is happening every day. But … this person doesn’t even have COVID. This person is vaccinated.”
(Video above: Dr. Leslie Gonsette, an internal medicine hospitalist at Providence Alaska Medical Center, speaks to members of the Anchorage Assembly.)
Hospitalist Dr. Ryan Webb called a nursing supervisor while waiting in line to testify after Assembly member Jamie Allard pressed for more information about how many Providence beds are staffed versus unstaffed.
Out of 223 adult beds at Providence, two are unstaffed and one more is temporarily out of service because of a leak, Webb said. The rest are staffed. The hospital as of Tuesday evening had 10 people waiting in the emergency room for a bed, including three waiting for an ICU bed — with none available, he said.
“I would just briefly respond to this suggestion that we should not be afraid,” he said. “I would say that we are terrified as…