Yukon-Kuskokwim hospital operating under crisis standards of care

A red and white building
Yukon-Kuskokwim Health Corporation Hospital in Bethel. (Greg Kim / KYUK)

The Yukon-Kuskokwim Health Corporation has activated crisis care standards. It issued a written statement on Wednesday saying that the corporation is operating at capacity and has adopted new clinical guidelines for dispensing care.

Under crisis care, resources are limited and health care providers are deciding who gets care and to what extent. The crisis care guidelines provide a framework for health care providers when there are more patients than resources to care for them all. These can be tough decisions. Often in crisis care situations, the patients who receive care first are those who providers consider most likely to recover.

YKHC has announced crisis care as Alaska experiences its worst COVID-19 surge of the pandemic. People in Alaska are contracting COVID-19 at a faster pace than in any other state, according to the New York Times tracker. The majority of infections are in unvaccinated individuals.

For the past month, YKHC has reported delays in medevacing critical care patients to other hospitals. In a written statement, YKHC said that patients could see more of these delays as hospital beds remain filled across the state. YKHC said that patients could also see nurses caring for more patients than usual, and could experience delays for elective procedures.

“Every day we are optimizing patient resources to provide the best level of care that we can at that time,” YKHC Chief of Staff Dr. Ellen Hodges wrote in a statement. “We’re doing the best for every single patient, regardless of what resources are available at any given time. Unfortunately, however, as a result of the current surge in COVID-19 cases requiring hospitalization and limited resources statewide, we are now in a position of making these difficult decisions on a daily basis.”

Last week, on Sept, 22, the Alaska Department of Health and Social Services enabled crisis care standards for the state. The standards limit liability for health care workers during the pandemic’s public health crisis. The state approved these standards after Alaska’s largest hospital, Providence Alaska Medical Center in Anchorage, had already announced that it was rationing care.

“YKHC has done everything in our power to delay the activation of these guidelines,” YKHC President and CEO Dan Winkelman wrote in a statement. “We urge every resident of the Yukon-Kuskokwim region to get vaccinated, wear a mask in indoor public areas, and social distance. With our hospital and our referral hospitals at capacity, this is our last stand against this virus.”

Also in that written statement, Winkelman encouraged tribes and cities to provide financial incentives for people to get vaccinated against COVID-19. The health care CEO asked employers and schools to develop programs for vaccination.

Winkelman declined an interview with KYUK to better explain how crisis care standards will affect access to health care in the region. Instead, YKHC Vice President of Communications Tiffany Zulkosky said that KYUK could submit questions via email.

This is a developing story.

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Anna Rose MacArthur is a reporter at KYUK in Bethel.