Travel Restrictions: Are we in an Emergency, or Aren’t We?

On Tuesday, the Alaska State House voted against discussing travel restrictions related to the spread of the coronavirus. I had offered the following sense of the house:

Unfortunately, a majority of legislators did not consider the discussion a priority at the time, and voted against having it. The vote went largely along caucus lines, with members of the majority caucus voting against it (legislators who voted to mothball the discussion shown in green).

After deciding not to have the discussion on Tuesday, at 2:45pm this afternoon, legislators and the governor received the following letter from Alaska’s hospitals urging that non-essential out of state travel be shut down immediately:

An open letter to Governor Dunleavy, DHSS Commissioner Crum, Alaska Chief Medical Officer Zink, the Alaska Legislature, and the executives of the airlines serving Alaska from the Emergency Department Medical Directors of Alaska Native Medical Center, Providence Alaska Medical Center, Alaska Regional Hospital, Elmendorf Hospital, Mat Su Regional Hospital, Bartlett Regional Hospital, Central Peninsula Hospital, and Fairbanks Memorial Hospital:

We believe the time to shut down any non-essential out of state travel is now. We also believe restrictions on in-state travel, especially to remote communities should be considered.

In the last few days Alaska has started to see multiple positive tests for Coronavirus. All were out of state travel related. Most were related to travel to the lower 48. With a large influx of state residents returning from spring break we will see many more positive tests in the next week, and soon (if not already) experience significant community spread.

The State of Alaska has taken appropriate measures closing bars, restaurants, and other spaces people congregate, encouraged social distancing, and asked residents who have traveled outside in the last 14 days to self-isolate. Alaska’s medical providers have been directed to avoid direct patient contact if they have traveled within 14 days. Hospitals have been directed to cancel all elective procedures to protect the ability to manage COVID-19 patients and still manage our normal caseload of acutely ill or injured patients. Our resources are limited, and we are geographically isolated from any realistic overload capacity.

This paints a clear picture that all non-essential travel across the state border needs to be put on hold. Now. We need to stop the importation of cases. Most transit in and out of Alaska is through Seattle with one of the highest case counts in the country, as well as the largest number of fatalities. Cases are doubling every 5-6 days. Seattle is mirroring Northern Italy and Wuhan, China. Many destinations for Alaskan travelers are seeing community spread with cases within tourist locations including Colorado and Hawaii. We also need to seriously consider minimizing in-state long distance travel to avoid rapid spread to more remote communities where testing and social distancing may be more difficult due to tighter living conditions and limited medical resources. Our elders are at significant risk.  Our exemplary medevac services are a very limited resource putting our remote community members at higher risk of dying of severe illness without being able to reach the appropriate level of care.

Alaskans are unfortunately but necessarily being asked to make a number of sacrifices to minimize the impact of this disease. The speed of spread in other nations was reduced significantly by a combination of travel restrictions and social distancing. The State and Municipality of Anchorage have done a great job initiating and explaining the need for social distancing. The time for travel restriction is now. We are confident you can develop a coherent policy that maintains our supply chain, maritime industries, and addresses medical, family and business emergencies, while minimizing risk of continued importation of cases. We also recognize the specific difficulty for the North Slope oil industry with their rotating schedule, however this large community of travelers should be held to the same standard as the rest of our population. An outbreak on the slope could be devastating to our state in many ways. Many oilfield workers are coming into the state from areas of high community transmission.

Thank you for your commitment to keep Alaskans safe and healthy. If this message comes from the Governor’s office, DHSS, the legislature, and the airlines we believe it will have the most impact.

We too are 100% committed to caring for our community through this crisis.

Respectfully,

Emergency Department Medical Directors

Anchorage:
Dr. Devin Burrup, ER medical director, Joint Base Elmendorf-Richardson Hospital
Dr. Dan Safranek, ER medical director, Providence Anchorage Medical Center
Dr. David Scordino, ER medical director, Alaska Regional Hospital
Dr. Leigh Martinez Wright, ER medical director, Alaska Native Medical Center

Fairbanks:
Dr. Michael Burton, ER medical director, Fairbanks Memorial Hospital

Juneau:
Dr. Lindy M. Jones, ER medical director, Bartlett Regional Hospital

Mat-Su:
Dr. Tom Quimby, ER medical director, Mat-Su Regional Medical Center

Soldotna:
Dr. Chris Mickelson, ER medical director, Central Peninsula Hospital

Alaska Chapter of American College of Emergency Physicians:
Dr. Nathan Peimann, President, AK-ACEP
Dr. Benjamin Shelton, Immediate Past President, AK-ACEP

3/18/2020

 

 

 

 

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