Hospital capacity and sick friends: Alaskans rely on new signals to gauge COVID-19 risk as cases rise

Jul. 23—All the signs indicate that Alaska, like other states, is in the middle of another surge in COVID-19 cases driven by new and highly infectious variants.

But the signs are harder to read now.

New cases as reported in Alaska's health data don't necessarily reflect the extent of the ongoing surge. Since testing shifted to an emphasis on at-home kits with results that aren't officially reported, the state's case counts that some Alaskans once tracked obsessively are now thought to drastically underestimate the real numbers.

The drop in hard data comes as many see the virus with less urgency. Some have had COVID once if not multiple times. The current omicron variant is driving up cases and hospitalizations but generally leading to less severe illness, especially in vaccinated and boosted people.

Now, in the absence of specific case numbers, many have turned to a different set of signals as they try to calculate the risks they face from this evolving virus — and what, if anything, they want to do to protect themselves.

Some of those indicators are informal and anecdotal, like stories from friends or co-workers out sick after a positive test result. Some metrics are more scientific, like the number of hospital beds that hold COVID-positive people or broader virus trends and news articles about severity of illness. Other cues hark back to earlier in the pandemic: For example, Denali National Park in early July again started requiring masks in buses and buildings.

Taken all together, the signals indicate the virus is on the rise. And right now, it seems like almost everyone in Alaska knows someone who has tested positive for COVID-19 in recent weeks. The number of COVID-positive hospital patients in the state also rose by more than 25% this week compared to last.

A new Centers for Disease Control forecast predicts hospitalizations of COVID-positive people are expected to rise into next month, a nationwide increase for the first time since May.

A shifting perspective

Many Alaskans are weighing their personal risk by balancing information from indicators besides state case data. But at the same time, a general fatigue has taken root over the many waves of the virus.

Rob Schmidt, a 49-year-old competitive powerlifter and self-described gym rat, used to check the state health department's COVID-19 website like a day trader checking the stock market.

"Especially through the delta wave, the state dashboard — the case numbers, bed occupancy, ventilator usage," he said. "And now it's just ... whatever."

[Just how big is this COVID-19 surge? As reported tests fall off, it's harder to say.]

Schmidt, a professional who's lived in Alaska since the late 1980s, first contracted the virus in late 2020 and became "meaningfully" sick with a fever that topped 102 degrees and oxygen levels that dropped low enough to make him dizzy. He got sick again in June, but this time a much milder case.

Back at the start of pandemic, he followed all the health protocols: wearing a mask in public, avoiding the gym, getting takeout only. Now, life is relatively back to normal. Lifting weights in the gym is too important to him. Wearing masks is uncomfortable.

Schmidt has a new metric.

"I would want to see the hospitals filling up in order to change my behavior," he said. "That's sorta where I'm at."

For the pandemic's first two years, the state COVID-19 dashboard drew thousands of visits as Alaskans checked the numbers to see how the virus was spreading in their home communities. The site updated daily for much of that time.

Starting in April, that site began updating just once a week, on Wednesdays. And as the popularity of at-home tests grew and public testing sites became harder to find, the data also became less of a solid real-time indicator of new cases.

Dr. Joe McLaughlin, Alaska's state epidemiologist, said in a recent interview that while case counts are less of a reliable indicator of COVID-19 risk, there are other metrics he uses to track the virus, which does appear to be fairly widespread in Alaska right now.

Community-wide seven-day case rates are one measure. So is the daily count of COVID-19 hospital patients in the state. Both offer useful clues as to how much virus is spreading, McLaughlin said.

"Our beds occupied have increased pretty steadily since mid-April," particularly among people in their 70s and older, he said.

Alaska's seven-day case rate map, which can indicate broader trends though it's based only on reported test results, shows that most regions of the state are seeing higher levels of virus spread. Alaska's seven-day case rate per 100,000 people was fifth-highest among U.S. states as of Thursday, according to a CDC tracker.

Alaska's hospitalization and death rates remain relatively low when compared to other states and other points in the pandemic, McLaughlin said.

But hospitalizations are creeping up, he said, largely because of the rapid spread of the BA.4 and BA.5 omicron variants, two of the most transmissible virus strains yet.

The bigger picture

The increase in hospitalized COVID-positive people in Alaska is not compromising hospital capacity as it did last fall during a surge driven by the delta variant, according to Jared Kosin, president and CEO of the Alaska Hospital and Healthcare Association.

Hospitals are really busy right now, with summer tourist season combining with an ongoing worker shortage, Kosin said. And yes, employees are testing positive, knocking them out of work for a period of days.

"I think we all have realized at this point essentially everybody seems to be getting COVID," he said. "Of course it is affecting staff. But unlike before, with delta, the bounceback period is a lot faster. They're coming back to work faster. We're able to manage it."

Vered Mares, one of four owners of Writer's Block, an Anchorage bookstore and cafe, relies on a wide variety of national and local sources to track COVID-19 levels.

A sign posted to the store's door in Spenard asks patrons to wear a mask, especially while placing orders for food and drinks. The store is one of few local businesses still encouraging the practice.

Mares said she pays attention to the big picture — relatively high rates of COVID still being reported nationwide — rather than relying on daily or weekly metrics from the state to make those decisions. That's why the store still requires masking to protect staff.

So far, through the course of the pandemic, just two of her team of 12 have tested positive for COVID, Mares said. The store has not had to shut down the store due to an outbreak or being understaffed.

She wants to keep it that way.

"From a business perspective, no business can succeed if their staff and clientele are sick," Mares said. "We all know that the numbers are inaccurate, that whatever is being reported is an undercount. So if we're reporting, you know, over 100,000 cases every day nationwide, we can assume that it's significantly more than that."

Adapting to change

Nearly a year ago, Mat-Su Regional Medical Center emergency physician Dr. Thomas Quimby issued an emotional, desperate plea imploring more locals to get vaccinated during a COVID-19 schools briefing. Quimby, going to work every day into a system overwhelmed by incredibly sick people, talked about the pain of knowing his face could be the last thing some patients saw before being intubated and dying.

Work feels different now that the omicron variants have outpaced the delta variant that drove so much severe illness and death in Alaska, Quimby said.

"One thing that we're all having a really hard time wrapping our minds around is how rapidly the nature of the disease changed," he said. "When it want from delta to omicron ... we just stopped seeing the kind of things we'd been seeing previously."

Quimby said he's admitted very few COVID-positive people recently, and those patients tend to be very old, very sick and not vaccinated. Others with upper respiratory or flu-like symptoms are examined and go home.

Personally, he's not masking as much as he used to. But he's also holding his breath and hoping a new, more virulent variant doesn't come along.

"We're all kind of waiting to see if the disease changes," he said.

[Meet the covid super-dodgers]

Anchorage resident Amy Holonics, who retired last month after a decades-long career as an elementary school art teacher, used to track Alaska's COVID-19 numbers regularly. She stopped in recent months as that data became sporadic and harder to find.

But the real-world information is impossible to ignore: Six close friends recently tested positive. National trends Holonics sees in The New York Times suggest a highly contagious variant of the virus is everywhere.

Throughout the pandemic, she had been cautious. She wore a mask in classrooms long after the school district stopped requiring it and avoided traveling or visiting aging family members for the first two years.

But Holonics said she has become more relaxed about COVID-19 after getting it herself last March — and after missing out on final visits with her father, who died alone in the hospital after staff denied her requests to visit with him due to virus protocols.

She's shifted her perspective on COVID-19 risk. She's planned a college reunion trip with nine friends, accepting that the odds of one or more of them getting COVID seem relatively high given the new variants circulating now. It was exhausting to spend so much time worrying, and she wishes she had broken some rules so that she could have seen her father in the hospital before he died.

Now, Holonics doesn't hesitate to make plans to see friends or get on a plane to visit her mother-in-law in Colorado, who she's visited five times so far this past year — most recently for a birthday party.

"Which I wouldn't have done in the beginning," she said. "But she's 99. She made it. I'm going."