The quality of care is falling in the Yukon-Kuskokwim Delta as cases surge statewide

A red and white building
Yukon-Kuskokwim Health Center (Greg Kim/KYUK)

Alaska is reporting the highest COVID-19 case rate per capita of any state, according to the New York Times tracker. The statewide surge in cases is straining resources and staff, causing patients to receive a lower quality of care than before the surge. Here’s what that looks like at the Yukon-Kuskokwim Health Corporation hospital.

Dr. Ellen Hodges is Chief of Medical Staff at YKHC. She’s been urging people to avoid riding ATV’s or bikes — or taking any physical risks. The concern is that if someone gets injured, medical care might not be available to them.

Recently, Hodges got a call that a young person had a rollover ATV accident and was coming into the YKHC emergency department.

“My heart just sunk, because I knew that if she was seriously injured and required intensive level care, it might be really hard to get her that care right now,” Hodges said during Alaska Public Media’s statewide radio show Talk of Alaska on Sept. 21.

The patient did need intensive care and was medevaced to another hospital that could provide it, but those beds are becoming harder to find and the waits for them are getting longer.

So far, Hodges said, YKHC has been able to medevac out every patient that has needed advanced care. YKHC, like many rural Alaska hospitals, does not have an intensive care unit. Hodges explained the process they go through when a critically sick or injured patient enters the hospital.

“They start calling every single hospital in the state that has an intensive care unit bed until someone can accept the patient,” Hodges said.

A process that once took minutes now takes hours.

“In the meantime, the patients are in our emergency department, which is taking excellent care of them, but not in a specially equipped intensive care unit for the care that these patients need,” Hodges said.

Meanwhile, a nursing shortage at the hospital is forcing nurses to care for more patients than usual, which means that patients are receiving less care from them. This nursing shortage exists across the state and is growing worse as more providers quit or take leave.

“It causes such a stress on our staff that they can’t provide the absolute best care, because that’s what everyone wants to do. But it’s just not available right now and it’s discouraging,” Hodges said.

Most of the intensive care patients in the Yukon-Kuskokwim Delta do not have COVID-19. Hodges said that more often they have other critical conditions like a stroke, accident or heart attack.

But the state’s critical care beds are increasingly filled with COVID-19 patients, most of whom are unvaccinated. At the state’s largest hospital, Providence Alaska Medical Center, half the intensive care and intermediate care beds are filled with COVID-19 patients.

“People are very, very ill, and requiring intense care, which requires a lot of staffing and a lot of attention, and that is where we’re operating in crisis,” Dr. Kristen Solana Walkinshaw, Chief of Medical Staff at Providence, said during Talk of Alaska.

Crisis care means that resources are so limited that health care providers are deciding who gets care, if at all. The patients who receive care first are those who providers consider most likely to recover.

“We should not be here. That is not something that we should accept,” said Jared Kosin, CEO and president of the Alaska State Hospital and Nursing Home Association, who also spoke on Talk of Alaska.

He said that the whole situation is avoidable if eligible people get vaccinated against COVID-19 and wear a mask.

Anna Rose MacArthur is a reporter at KYUK in Bethel.

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