Since March, the Yukon-Kuskokwim Delta’s remote location has protected its residents from the spread of the coronavirus. Other than by barge, the only way to access the area is through the region’s biggest airport in Bethel. But case numbers are beginning to rise as more people travel out of the region, and bring the virus back with them when they return.
“I know that all of us are tired of hearing and talking about COVID-19, but we really have to stay vigilant," said Dr. Ellen Hodges, chief of staff at the Bethel-based Yukon-Kuskokwim Health Corporation, which serves the Yukon-Kuskokwim Delta’s 48 villages.
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She said that the region’s geographic isolation from big cities helped keep the positive case numbers low for a while, but the numbers began creeping up in July, and the numbers tell a complicated story.
Nearly half of the region’s residents who have tested positive did so in Anchorage, which is the biggest city closest to Bethel. A lot of people travel to Anchorage for medical care, for supplies, and to visit family. Anchorage saw a big increase in cases in July, along with pockets of community spread. When people from the Y-K Delta traveled to Anchorage, they were more likely to be exposed to the virus.
"Because their rate of community transmission and the number of people who are infected are high, the possibility that you would come into contact unknowingly with someone who isn't, who's a stranger to you, that could give you COVID is much, much higher," Hodges said.
Hodges said that people aren’t being cautious enough while they are in Anchorage.
"One of the things that we've noticed when we've been doing our contact tracing is large social circles outside of households," Hodges said.
Hodges says that the virus is infecting more young people. Usually they are going out, maybe to bars, maybe to restaurants, maybe to gatherings held indoors. Then they get infected and spread the virus to their family and friends. For the most part, Hodges said that good contact tracing has enabled YKHC to swiftly locate other possible cases and isolate them.
"So, one person, one positive person may generate up to 20 or 30, and in some cases, even 40 close contacts," Hodges said.
But the cluster of cases that happened in Bethel earlier in August meant that even more people had to be located to get tested.
"So, when we say that we have say, you know, 19 active cases, that could mean a couple hundred close contacts that have to be, you know, talked to, reached out to, and then followed up with daily calls," Hodges said.
If the cases continue to rise, that could overwhelm YKHC’s contact tracing capabilities, which would then hurt their ability to swiftly isolate the people who test positive.
Another problem is testing. YKHC has set up free testing at airports throughout the region, including Bethel. But on average, only half the passengers take advantage of it. And even if a passenger does get tested, it doesn’t mean that they are quarantining for two weeks or until they get their results. Businesses who rotate workers in and out of the Y-K Delta, like Grant Aviation, don’t require their workers to get tested at the airports. Hodges says that can make it easy for workers to slip through and expose many people to the virus.
"I truly do believe that if everyone tested at the Bethel airport and quarantined until they got the results, that we could have a much better handle on the virus in our region," Hodges said.
So far, YKHC has reported that 60 people have tested positive for the virus since March, and those numbers are rising fast. The region’s biggest school district decided to move to remote learning at the last minute, and YKHC is calling on state and city leaders to require testing before people are allowed to enter the region.