On the road with Anne Zink: Alaska's chief medical officer continues the COVID-19 fight and looks ahead as vaccine demand tapers

Jun. 5—SOLDOTNA — Dr. Anne Zink stepped to the microphone in a park pavilion and looked toward hundreds of people who had gathered for live music, food and beer. It was a near-perfect early summer evening, and it was the biggest crowd Zink had addressed in person since the coronavirus first reached Alaska.

"It's so good to see you all," she said to cheers. "Yay vaccine. Yay (to) putting the pandemic behind us!"

Zink, Alaska's chief medical officer and the state's most recognizable leader in the COVID-19 battle, said it felt different. Though she has spoken to the public countless times during the past 15 months, it's usually been by video livestream and conference calls.

Soldotna, like the rest of Alaska, hasn't reached the pandemic finish line yet. State data shows less than half of eligible people on the Kenai Peninsula have received one dose of COVID-19 vaccine. Coronavirus infections are dropping statewide, but the virus is still causing hospitalizations and deaths — primarily among unvaccinated people. Outbreak risk remains, especially in communities with low vaccination rates, Zink said.

That's why going to the places Alaskans are now gathering is part of the state's approach to keep Alaska inching toward greater protection. For Zink, that strategy includes face-to-face conversations, when possible, to encourage vaccine confidence and to fight misinformation.

"You hear different things when you're in person," she said.

Adam Crum, Alaska's Health and Social Services commissioner who joined Zink in Soldotna, called the effort "a sincere approach" to provide reliable information at the community level. That's more effective than top-down directives from Anchorage or Juneau, he said.

"Telling an Alaskan what to do never works, no matter what the subject is," Crum said.

"Talking about vaccine is really fun for me," Zink said before the event. "That might be my little dorkiness, but it is super exciting to talk about something happy, and be on the offense against this virus instead of the defense."

Her message through the loudspeakers in Soldotna was more inviting than demanding.

"The sun is out. The fish are coming. We have things to do ...," she said. "The tent is back there. I'm happy to give you your vaccine. I'm happy to answer questions."

A matter of confidence

Shanon Davis, executive director of the Soldotna Chamber of Commerce, said she was thrilled when she found out Zink was coming for the city's first full-scale Wednesday Market and Party in the Park events since 2019. Word of Zink's participation, she thought, would encourage more people to come, and more people to have a conversation about getting the shot.

"She is an Alaskan celebrity now," Davis said. "I don't think there's anybody that would say different."

But even for Zink, 43, who also works as an emergency room doctor at Mat-Su Regional Medical Center, the fishing was slow for recipients early on as fairgoers streamed by the public health tent.

"Would you like information about the vaccine?" Zink said to a passing woman.

"Nope," the woman said.

Zink gave free sunglasses to teen girls, who paused for a moment and then darted away.

Pauline Montagna, of Nikiski, waved off the vaccine station before she reached Zink.

"I'm not gettin' it," Montagna said. "I figured I'm 81 years old. If the Lord wants me, he'll take me."

As the crowd grew throughout the day, so did calls for Zink's attention. After she spoke onstage, she made it just a few steps before people lined up to meet her. Some heaped praise for her leadership. Others leaned in for a selfie. One got her autograph on his vaccine card.

Several wanted to discuss their vaccine concerns. Those are the conversations Zink said she loves. "I take every one of those as an opportunity to hear where people are and challenge what I know and don't know," Zink said.

They also demonstrated her knack for disarming skeptics with empathy, even as she dispels misinformation.

"I don't want it," one woman told her.

"You don't want COVID or you don't want the vaccine?" Zink asked.

"Both ...," said the woman. "I haven't seen a doctor in 13 years."

"It sounds like you take care of your immune system," Zink said.

"I do, but I don't want COVID."

"I don't want you to get COVID either," Zink said, eyes locked on the woman. Beside Zink stood her daughter, Lily, who joined her for the road trip.

"I mean honestly, I also work in the emergency department, and it's heartbreaking when I see people every single shift who say, 'I don't want COVID and I didn't want to get the vaccine.' And now they're sick. Most people do OK. But the older we are, the higher the risk of having complications. That's why everyone, from my 13-year-old daughter to my parents, I recommend it for."

Ron Levy, 63, had several thoughts to bounce off the doctor. He asked about natural versus vaccine-created immunity. He questioned the thoroughness of the vaccines' trial periods. And he told Zink it seemed that the public health emphasis on vaccines seemed wrongheaded, considering the rate at which lifestyle choices contribute to death in this country.

Zink listened patiently and discussed each point, one by one, finding common ground and adding food for thought. Levy said Zink mentioned a study showing a higher incidence of stroke in men who get COVID-19, whether or not they have symptoms. Levy said it felt like he was talking with a neighbor or a friend.

"She was not talking gobbly-government political speak," he said.

"She changed my mind a little bit," Levy said. "Let's say I put a lot more faith in the honesty of the people, at least in this level of government."

Zink credits her years of experience working in the emergency department with helping her hone her communication skills.

"If I say it in a way that's offensive, I'm failing as a physician. I'm not doing my job. My job is not to offend patients," Zink said. "And I see it the same in this larger public health role."

Two things have surprised her most about the course of the pandemic, she said. One is how highly effective the vaccine has proven to be. The second is damage done by misinformation and active disinformation about the virus and vaccines.

"It's heartbreaking to see the ways that social media and media platforms have been used to promote disinformation which is literally and figuratively harming Alaskans and Americans as a whole," she said.

One of the most common misunderstandings she encounters includes the false belief that the vaccine is made with live virus. Another is that the risks from the vaccine and the disease itself are roughly equal. Data clearly show they are not, she said.

More than 294 million doses of COVID-19 vaccine were given in the U.S. through May, according to the CDC. Serious side effects are rare, and long-term side effects are unlikely, it says. COVID-19 has killed about 3.7 million people worldwide as of June 3, according to the World Health Organization.

"It's interesting to me. When someone comes in septic and sick in the emergency department, they usually don't say, 'I'm worried about the long-term side effects of antibiotics,' " Zink said.

Zink said she often hears the same questions phrased the same way from different people, which leads her to think relatively few sources of misinformation are having the most impact.

"There are not many new questions, I will say that," Zink said. "I have not heard any new ones today."

Back near the vaccine tent, Lisa Hanson and Matt Potter waited for Zink to finish an interview before they approached. "I hear some of the things come at you, and you handle it with a lot of style and grace," Potter told Zink. Hanson said Zink has influenced her work as a contact tracer.

"I think I've heard a million different conspiracy theories, and also people still just thinking 'This isn't real. This is ridiculous. This is made-up,'" Hanson said. "And sometimes I'm just dumbfounded at the other end of the line."

"I wish I had the grace that Anne does, and the knowledge obviously," she said. "All we can do is our best, and keep repeating the things she said."

Zink admits that there's a limit to the number of people she can reach in this one-at-at-time way. Some people will never be convinced to get the vaccine. But for many others, building vaccine confidence is simply a slower process than it was for early recipients.

It was for Anna Eason, who said she had been conflicted about getting the shot. Zink answered Eason's questions for several minutes and knelt beside her as a public health nurse gave the Johnson & Johnson vaccine that afternoon.

"I care about my elders. I care about my babies. And that's what it came down to," Eason said.

Each individual she speaks to who eventually chooses to get vaccinated is a meaningful win, Zink said.

"If that was my dad or my mom or one loved one in my household, that one is all that matters," Zink said.

Sixty-five doses of vaccine were given in the park that day, according to a state public health nurse manager.

"One of us"

Lending a hand to the street-level effort was one reason for Zink's road trip. But she said her primary goal was to laud health care and community workers, whose work must carry on and evolve as vaccine demand declines. In Soldotna, she saw two new approaches at work.

The Kenai Fire Department uses one of its ambulances as a mobile vaccine clinic. Chief Tony Prior said it's a flexible tool to reach homebound people, cannery workers and the commercial fishing fleet. Later this summer, it will hit the busy salmon dipnetting scene at the mouth of the Kenai River.

"We're not going to get 300 people at a time anymore," he said. "We're hoping to catch whoever wants one."

The city of Soldotna and Soldotna Professional Pharmacy recently opened a walk-in vaccine clinic in a strip mall at the high-traffic intersection of the Sterling and Kenai Spur highways. Zink gave a high-five to a teen recipient during a brief visit. Pharmacist Justin Ruffridge said Zink's appearance is likely more meaningful to front-line staff than its clientele.

"I'm not sure how many minds she'll change as far as people getting the vaccine or not," Ruffridge said. "I think it's a morale boost for people that have been putting in a lot of effort and a lot of time."

"It makes me feel validated for the work I do," said Tracy Silta, a nurse at the walk-in clinic. "When I heard that she was here, I was thrilled. And I'd like to get a selfie."

"This is the deal with Dr. Zink: She talks straightforward, she's scientific, she's facts, she's real, she's one of us, and she knows her stuff," Silta said.

Silta said Zink is credible, in part, because she doesn't seem to be on a political mission.

"I hope that I'm seen as a nonpolitical figure. I see myself as nonpolitical. I'm not a political candidate. I'm not a political appointee. I am unaffiliated," Zink said.

Zink said she was hired by Crum in July 2019 after a recommendation by Dr. Jay Butler, now deputy director for infectious diseases at the CDC. Butler previously held the chief medical officer job in Alaska. Zink had no authority to mandate masks or close businesses during the pandemic, she said. On a state level, that power rested solely with the governor as part of the state's disaster declaration, she said.

"From my perspective, the same things I told the public were the same things I told the governor, which were the same things I told the commissioner, about everything from masking to risk of COVID and the rest of it," Zink said. "It made it so that I could just speak to the science of it, regardless of who I was speaking to."

Zink's popularity with clinical staff was evident everywhere she stopped on her two-day tour. At South Peninsula Hospital in Homer, Rachael Kincaid, a nurse practitioner, spoke up from the back of the room.

"I've had this date on my calendar for a long time because I'm a big fan of your work," Kincaid said. No one questioned to whom Kincaid was referring.

"So am I," Crum said.

Dr. Christina Tuomi said the visiting state leaders deserved praise for their response to the pandemic, and Zink has been key.

"I think that the state and the government in public health has really stepped up into a void that we were looking for," Tuomi said. "When we had questions, we called. They may not have had the answers, but at least they listened, which is huge. Sometimes you just need to be heard."

Anna Lewald, a nurse at South Peninsula Hospital who gave vaccine shots at a pop-up clinic on the Homer Spit, said it's been noteworthy to have a woman in such a prominent role at a critical time.

"It means a lot to us. The medical field is, I think, 70 percent female, especially in nurses. We are the front lines of the people doing the vaccines in our community. And it's really nice to see a strong woman out there representing it," Lewald said.

Zink jokes that she's not just the CMO of COVID, though that's often how she's viewed.

The pandemic has exposed ways the health care system falls short, she said. She sometimes writes in her journal to remember challenges faced, goals reached and battles won.

"Today was a day of fighting dragons," she wrote one day last year.

"I'm really excited to think about what ways we can take the newfound or improved relations and really think about what does this mean to be healthy and well?" she said. "How can we really be thinking about how to decrease health care costs and increase preventative care? How can we increase the way we're thinking about the whole person?"

Those considerations should include both physical and mental health, she said.

Zink said she's not sure how long she'll hold the job. She said family members sometimes jokingly ask her if she got fired yet. "Maybe tomorrow. I don't know," she said she replies.

"I am happy to work in this job as long as I don't feel like I'm compromising my own values and I'm serving the people of this state," she said.

At one of her last stops in Homer, Zink visited the vaccine clinic at the top of a ramp leading down to the harbor. There, Kayden Grasteit stopped to get a shot before leaving for his three-month stint on a commercial fishing boat. Grace Withers got vaccinated to help protect people in Halibut Cove, where she works. Donovan Goforth got his second dose so he could visit his grandparents in California. Shawn Downes said she went against the advice of her daughter, a nurse in another state.

"Today's the day," Downes said.

Zink said her road trip, though busy, had been one of the most vacation-like experiences she's had since the nonstop work of the pandemic began.

"I think it'll be a long time before I really fully process what this year, year and a half, has been like," she said. "It will be a journey and a story I'll always remember."

The work isn't done yet, she said, but there's also reason to feel good about what has been accomplished so far.

"The fall may come with some more bumps," Zink said. "But I think we're better prepared."