Alaska Hospitals are moving to Crisis Standards of Care

Governor Dunleavy announced that hospitals in Alaska will adopt crisis standards of care in a press conference on Sep. 22. Photo Courtesy of Alaska Public Media and Nat Hertz

At a press conference on Sep. 22, Alaska governor Mike Dunleavy announced a move to crisis standards of care for all hospitals in the state. This move came a week after Providence Alaska Medical Center, the largest hospital in Alaska, located in Anchorage announced they would be implementing crisis standards of care, citing both the severity and quantity of COVID-19 patients.

Hospitals moving to crisis standards of care means hospitals are conceding that they can no longer guarantee every patient the standard of care that they may have enjoyed in more ordinary times. Hospitals no longer have the staff or the resources to ensure every patient gets everything they need. This does not mean that Providence or other hospitals are not doing everything they can for every patient. It means that everything they can do is not enough for the staggering quantity of new hospitalizations from COVID-19.

In the letter from the Medical Executive Committee where the move to crisis standards of care was announced, leadership at the hospital state explicitly “we are unable to provide lifesaving care to everyone who needs it.”

The Washington Post interviewed representatives from hospitals in the country that have activated crisis standards of care, including Providence, to try to get a grasp on exactly what it means in practice. At Providence, patients waited in their cars to be seen, and some patients could not receive the care they needed because the equipment was already in use by other patients. As resources become increasingly strained, health officials might be forced to make hard choices and allocate resources towards those more likely to recover, away from other patients.

Providence Medical Center is the largest hospital in Alaska, the first to shift to crisis standards of care, and is located directly adjacent to UAA campus. Photo Courtesy of ADN and Loren Holmes

The announcement by the Dunleavy administration of a statewide move to crisis standards of care does not mean that every hospital is now forced to operate in this way. Rather, the announcement opens the door for hospitals in the state to adopt these practices if necessary.

The New York Times currently reports that Alaska leads the nation in new COVID cases per capita. At the time of writing, the daily average for new COVID cases in Alaska is well over one thousand. The daily average for hospitalizations is more than two hundred. Hospitals cannot keep up.

The Medical Executive Committee at Providence wrote in their letter about steps the public can take to reduce strain on the public health care system. These include continuing to stress the need to wear a mask and get vaccinated, continue to social distance and to isolate and get tested if exposed to someone with COVID-19. Finally, the committee asks that people avoid dangerous activities that may lead them to require emergency medical care, because there may not be a bed available.

Currently, there seems to be little public support for public health mandates of either masking or vaccination. Public deliberations by the Anchorage Assembly over the implementation of a mask mandate have been overrun with opposing protesters. University of Alaska Interim President Pat Pitney mentioned in an email to students that a system-wide vaccine requirement is under consideration, though no steps have been taken at this time.

Case numbers are still rising in the state and other hospitals are announcing moves to crisis standards of care. Hundreds of health care workers are being brought up to Alaska to aid with the crisis.

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