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Pandemic

Alaska’s COVID-19 hospitalizations top 200 as health care facilities brace for the worst

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More than 200 people are now hospitalized in Alaska with COVID-19, setting another record as health officials issue dire warnings and say the state’s hospitals are treading water.

Through Thursday, hospitals and intensive care units across the state continued to report that they were busy or nearly full as a surge fueled by the highly contagious Delta variant continues in Alaska. The facilities have reported staff shortages and limited bed capacity are their main concerns and say they are not sure how long they can work under such stress.

“The emergency departments remain open for life-sustaining emergency treatment, but they are very tight,” said Dr. Anne Zink, Alaska Chief Medical Officer, during a call with reporters.

Alaska’s health officials have started discussions with providers in other states, including Northern Idaho, who this week issued crisis standards for care, a tool that “enables clinicians to think about how best to help most people.” . limited resources, explained Zink.

Crisis care standards are seen as a last resort as healthcare providers often make tough decisions about rationing care – and Alaska is doing everything it can to avoid that scenario, Zink and others said Thursday.

“We make a new plan every day,” said Dr. Mishelle Nace, a doctor from Fairbanks who described an ever-changing approach to care, even with limited resources. “Every day we see where we need help, where we can take people, where we can give more need, where it is needed.”

[Biden announces vaccine mandates affecting up to 100 million Americans]

Anchorage hospitals are particularly busy right now, said Jared Kosin, president and CEO of the Alaska State Hospital and Nursing Home Association, and that is putting pressure on surrounding hospitals. Hospitals like Mat-Su Regional in Palmer, Central Peninsula in Soldotna and Fairbanks Memorial are particularly hard hit by COVID-19 cases, Kosin said.

The ability to move patients from rural areas to surrounding hospitals while Anchorage remains full will be severely limited, if not depleted, he said.

“The time window to be able to change to a higher level of care is getting smaller and smaller,” said Kosin.

As the surge continues, Kosin said the health system would not collapse and patients would not be turned away, but he said that care will eventually be rationed and prioritized if the state continues on its current path.

“And that’s the scariest of all scenarios, because then you put medical professionals in a position to make the toughest decisions that can be asked of anyone. … Everything goes in this direction. Whether we will ultimately get there or not has yet to be decided, ”said Kosin.

The latest hospital census showed a new record of 206 people hospitalized with confirmed cases of the virus nationwide, including 29 people on ventilators. In Mat-Su, almost half of all hospital admissions were related to the coronavirus, and in Fairbanks, about a third were linked to COVID-19, state data showed.

The most recent count has risen from 197 reported Thursday to more than double what it was about a month ago when Alaska’s hospital leaders first sounded the alarm about the potential impact of the Delta variant on a compromised healthcare system.

Hospitals say these numbers haven’t counted the true effects of COVID-19 enough because they don’t include some long-term COVID-19 patients who have stopped testing positive but are still in need of hospital treatment.

The state’s total hospital capacity went on alarm for the first time Thursday after several hospitals across the state continued to report extremely high levels of COVID-positive and non-COVID patients.

The state also reported an additional 846 new cases of the virus on Thursday, including 809 in Alaskans and 37 in non-residents, according to the Alaska Department of Health and Social Services dashboard. Thursday’s new case count is the second highest single-day count reported for Alaska to date, following Wednesday’s similarly high number of 841 cases.

“The difference is the delta and how fast it can move from person to person,” said Zink.

Even with cases and hospital stays showing little sign of slowing, city guides in Anchorage – where the magnitude of the virus spread often affects COVID-19 trends across the state – have declined to take tougher measures to contain the pandemic. In an interview this week, Anchorage Mayor Dave Bronson said he would not ask residents to be vaccinated, mask mandates, or other COVID-19 restrictions, calling the mask mandate idea “very inappropriate”.

Governor Mike Dunleavy said this week he will not declare a nationwide COVID-19 disaster, despite suggesting two alternative bills that could help provide more resources for the state.

COVID-19 vaccination rates in Alaska have been slowly increasing recently after months of stagnant intake. Zinc said more vaccinations were given in August than in July.

Last winter, when COVID-19 vaccinations first became available, Alaska led the nation in vaccination per capita. By the summer the state had fallen behind.

So far, 56% of Alaskans 12 and over are considered fully vaccinated and 61.5% have received at least one dose.

No new coronavirus-related deaths were reported on Thursday. A total of 442 Alaskans and 14 non-residents have died as a result of the virus since the pandemic first hit Alaska in March 2020.

The state’s seven-day average test-positive rate – total positive tests performed – was 8.8%, an almost all-time high. Health officials say anything over 5% indicates the need for further testing.

This is a developing story. Check back for updates.

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Pandemic

Alaska reports nearly 1,800 new COVID-19 cases and 44 deaths, in part due to backlog

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Alaska broke multiple daily records for COVID-19 case numbers, hospital admissions and deaths on Friday, but public health officials said the high numbers were at least partially due to a lack of data.

Due to backlogs in data entry, the roughly 1,800 new cases reported Friday have been bloated by several hundred older cases, health officials said.

“That doesn’t detract from the fact that we continue to see the tremendous spread of COVID in our communities,” said Dr. Anne Zink, Alaska Chief Medical Officer, on a call to the news media.

The 41 Alaskan deaths from COVID-19 reported on Friday occurred mostly in the past month, officials said. Some even took place earlier this year and hadn’t been added to the list due to a cyberattack that hampered the state’s system of recording deaths.

However, a record of 217 hospital admissions reported on Friday was not part of the backlog and represents the growing number of people suffering from COVID-19 in need of hospital treatment in Alaska.

Last month the state had its “highest incidence of cases we have ever seen, weighing on our public health infrastructure, our hospitals, our businesses and our economy,” said Zink.

The majority of the 44 deaths reported Friday – including 41 residents and three non-residents – were deaths that occurred in August and identified through a standard death certificate check, officials said Friday.

[Alaska health workers face anger and threats from COVID patients and public, chief medical officer says]

Government agencies rely on death certificates to report COVID-19 deaths. If a doctor believes that COVID-19 infection contributed to a person’s death, it will be included on the death certificate and eventually counted in the state’s official toll, according to the DHSS.

Some deaths are reported directly to the state, while other deaths are less clear-cut than others and take longer to review, said epidemiologist Dr. Louisa Castrodale.

“Hospitals will call us and say, ‘Hey, we had this unfortunate death, we really think it’s COVID and we’re going to report it to you,'” she explained.

“Hospitals will also call us and say, ‘Hey, we have this person who died. There is a lot going on with this person, we are not sure what the provider will ultimately write on the death certificate. ‘ So that’s what we’re waiting for, ”she said.

Ultimately, every single COVID-19 death that the state reports has a death certificate listing COVID-19 as a contributing cause of death, and each one goes through a rigorous review process, Castrodale said.

[How do COVID-19 deaths in Alaska get counted?]

About a dozen of the deaths reported on Friday occurred in the spring; for these, reporting was delayed by a cyber attack in May that targeted the state health department and left many of its systems offline for months, officials said.

The continued high number of COVID-19 patients continues to overwhelm healthcare facilities across the state.

Record hospital stays – and long waiting times in the emergency room

As of Friday, a state dashboard reported a new record of 217 people hospitalized across the state with COVID-19 – higher than at any point in the pandemic and well above last winter’s high.

Hospitals say their numbers likely haven’t counted the true effects of COVID-19 enough, as they don’t include some long-term COVID-19 patients who have stopped testing positive but are still in need of hospital treatment.

Earlier this week, state officials announced that they would implement crisis standards for care nationwide, a worst-case scenario that forces hospitals to ration supplies due to resource and staffing constraints.

Hospitals across the state continue to report long emergency room waits, late procedures and limited transfers, and in at least one case, the death of a patient who was unable to receive timely care.

The vast majority of cases, hospitalizations, and deaths in Alaska have been in people who have not been vaccinated.

In August in Alaska, state data showed residents were 8.3 times less likely to be hospitalized if they were vaccinated than if they were unvaccinated, Zink said Friday.

The new record of 1,793 new virus cases on Friday – including 1,735 residents and 58 non-residents – followed Thursday’s previous record of 1,330 cases plus seven deaths.

Fall residue

A few hundred of the cases reported on Friday were from positive test results from the last week and the week before, and some even before that, Castrodale said. She estimated that once the state clears its backlog, it will expect around 1,000 cases a day.

Since the state found ways to automate newer cases, they have been able to examine and catch up on older case reports, Castrodale said.

The delays in data reporting make it difficult to compare daily numbers, and Zink said it may be more helpful to look at the overall trend each week. She stressed that throughout September, the state had the highest number of cases ever.

The delays are also coming from a variety of locations, officials said, including certain overwhelmed testing facilities all of which are sending their results for several days at a time, as well as a limited number of staff amid a host of new cases.

“We only have a limited number of people on the team, so we’re doing our best to get it,” said Zink.

Alaska’s per capita fall rate remains the highest in the country – and about three times the national average, according to a New York Times tracker.

Nationwide, 9.23% of the tests carried out last week gave positive results.

Among eligible Alaskans 12 and older, 62.8% had at least one dose of the COVID-19 vaccine, while 58.5% were considered fully vaccinated by Thursday.

The deaths involved residents from across the state, including 11 from Anchorage, six from Wasilla, four from Fairbanks, three from Ketchikan, three from Juneau, two from Soldotna, two from Bethel, one from Homer, one from North Pole, one from Tok, one from Big Lake, one from Petersburg, one from Palmer, one from Kenai, one from Willow, one from a small community in the northwest of the Arctic, and one from Sitka.

Fairbanks also recorded three deaths from non-residents.

Almost half of the deceased were over 70 years old. Fourteen were in their 50s or 60s, two were in their 40s, two were in their 30s, and two were in their 20s.

A total of 514 residents and 18 non-residents in the state have died of COVID since the pandemic began.

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Pandemic

Booster shot or not? Mixed messaging creates distrust during COVID-19 pandemic

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CLEVELAND, Ohio – Don’t wear masks; wear them. Masks protect you; Masks protect others. The only thing that was consistent about the masking of health professionals at the start of the pandemic was the inconsistency that left many Americans confused and skeptical.

Now the public is experiencing a similar whiplash injury from having the COVID-19 vaccine booster. First, President Joe Biden released a plan to bring Pfizer boosters to everyone. An advisory body to the US Food and Drug Administration rejected the plan.

Then an advisory panel from the U.S. Centers for Disease Control and Prevention changed the game again on Thursday, recommending boosters for people 65 and over, people with pre-existing conditions and residents of nursing homes. And late at night, CDC director Dr. Rochelle Walensky prompted the committee’s decision to exclude frontline workers at increased risk of exposure.

What are the implications of all of the rapidly changing health policies and conflicting messages? Another type of pandemic – an increase in conspiracy theories, disinformation and a lack of confidence in the system that was created to protect us.

“The uncoordinated news that has occurred may be the biggest public health failure we’ve seen with COVID-19,” said Scott Frank, director of the public health program at Case Western Reserve University School of Medicine. “In public health, the first rule of a pandemic is always to present a single message.”

Frank said the idea that the booster was ready for a widespread release is premature and a good example of what he calls “news drift”.

Frank said it was important to come up with a coordinated response. Advances in science have helped the medical community fight COVID-19 in unprecedented ways, but it’s not without its consequences.

“Before, we wouldn’t have had the science that would have allowed us to change course in the middle of the stream. We would have stayed with our original plan and had a consistent message, ”said Frank. “But it would have been the wrong message. The fact that we had a change in science doesn’t mean scientists are upset; it means we are discovering new information that will enable us to take a more effective course in fighting the virus. “

Raed Dweik, a Cleveland Clinic doctor and a member of the hospital’s COVID-19 response team, said one of the most troubling aspects of the pandemic had been uncertainty.

“This uncertainty has been tough for a lot of people not only in the community but also in the medical field because we have to understand it ourselves so we can convey it to the public,” said Dweik. “I know it is awkward for people not to have definitive answers, but this is a sign of the times.”

For ethnic and ethnic minority populations, the insecurity and fear caused by inconsistent messaging are compounded by a lack of trust stemming from years of public health inequalities while being disproportionately affected by COVID-19, Frank said .

And since the early days of the pandemic, the interface between politics and medicine created a power dynamic that led to contradicting messages. Around the world, each country set its own safety plan, while here in the US, states advanced with different approaches, each backed by unique scientific research working with a variety of medical experts.

“The push-and-pull between science and politics has contributed most to the distrust,” said Frank. “Scientists have been asked to justify or rationalize some policy decisions that were not based on rational science.”

As this decision and scientific information evolves, the Internet provides a breeding ground for misinformation and disinformation – arguably more damaging as it is shared with the intent to deceive. Although the problem plagued online platforms long before the pandemic, COVID-19 exacerbated the problem as disinformation was turned into weapons to serve individual agendas rather than serve the health of the community.

“It can land on ears that may have a basic distrust of vaccines, healthcare, government, or science,” Frank said. “These messages are amplified by people on social media who have a tendency to believe these messages and convey them to others. It is quite painful to see people you know and trust spread messages that actually harm their neighbors and the people we care about. “

The challenge for the public health system is to maintain the public’s beliefs while mixed messages increase suspicion. For Frank and Dweik the answer is simple: create trust through coordinated and systematic communication.

The Cleveland Clinic has developed a strategy of communicating quickly and frequently while their experts share their knowledge of COVID-19 – and most importantly, what they don’t know – based on the latest data.

“A lot of things come out that are speculation or guesswork,” said Dweik. “It is not easy for us as doctors to say that we do not know. But it’s better … than saying something that isn’t backed up or supported by science and evidence. “

Cuyahoga County Health Department will decide its recommendations and the timing of their release based on the best possible way to prevent hospitalizations and death. However, these decisions can be at the expense of public opinion, according to Terry Allan, health commissioner for Cuyahoga County.

“Information comes out quickly, and a fog can build up when people try to understand the steps,” Allan said. “Sometimes it’s not popular. That comes with every emergency and we have to live with it. “

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Pandemic

Turkmenistan claims it hasn’t had a single Covid-19 case. Activists say that’s a lie

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At least that is what the mysterious, authoritarian government of the Central Asian country claims.

However, independent organizations, journalists and activists outside of Turkmenistan say there is evidence the country is fighting a third wave that is overwhelming hospitals and killing dozens of people – and warn that the president is downplaying the threat posed by the deadly virus to get its public image.

Ruslan Turkmen, an exile from Turkmenistan and editor of the Netherlands-based independent news organization Turkmen News, said he personally compiled the names of more than 60 people he claimed to have died of Covid-19 in the country, including Teachers, artists and doctors.

Turkmen said he had checked all recorded deaths with medical records and x-rays, which revealed severe lung damage and medical treatment consistent with coronavirus victims.

“Instead of accepting it and cooperating with the international community, Turkmenistan has decided to bury its head in the sand,” said Turkmen.

The Turkmen government did not respond to CNN’s request for comment.

How it unfolded

When Covid-19 spread around the world in early 2020, Turkmenistan insisted there were no cases even as neighboring countries reported exploding outbreaks.

Iran, with which Turkmenistan shares a long land border, has reported one of the world’s largest Covid-19 outbreaks, with almost 5.5 million total cases, according to the World Health Organization (WHO).

“You are looking at what is happening in other countries in the region and how different Turkmenistan could possibly be?” said Rachel Denber, assistant director for Europe and Central Asia at Human Rights Watch.

According to the UK and Australian Foreign Ministry websites, all flights to Turkmenistan are currently suspended and only Turkmen nationals are allowed to enter the country. Turkmen said his sources in Turkmenistan began contacting him about cases around May 2020 – around the same time Covid-19 spread around the world. He said the first messages he received spoke of a “strange lung disease, like the flu,” which affects many people.

“It was at least 40 degrees Celsius (104 degrees Fahrenheit) outside – not a typical flu season,” he said.

In June 2020, the US embassy in the capital, Ashgabat, issued a health warning that “reports from citizens with symptoms have been subjected to Covid-19 testing for Covid-19” and quarantined for up to 14 days according to the Turkmen The government immediately dubbed the statement “fake news”. A WHO mission to Turkmenistan in July 2020 did not confirm any coronavirus infections in the country, but said it was concerned about “an increased number of cases of acute respiratory infections and pneumonia”. A WHO official said Turkmenistan should pretend that Covid-19 was floating around.

By that time, the Turkmen said the situation was out of control. The government advised citizens to take bizarre public health measures, such as eating a certain type of spicy soup.

In January of this year, Turkmenistan announced it had approved Russia’s Sputnik-V coronavirus vaccine for use in the country. Then, in June, the World Bank agreed to lend the Turkmen government $ 20 million, mainly for health facilities and construction, as part of a program to “Prevent, Detect and Respond to the Threat of Covid-19”.

As recently as Tuesday, President Berdymuhamedov said the efforts of the global community in combating the Covid-19 pandemic were “insufficient”, although he did not mention the situation in his own country.

“The pandemic has exposed serious systemic failures in the international response to this challenge,” he said.

“Turkmenistan is on fire”

Despite Berdymukhamedov’s claims that his country is Covid-free, the reality in Turkmenistan is very different, according to independent journalists and activists.

Diana Serebryannik, director of the Europe-based exile group Rights and Freedoms of Turkmenistan Citizens, said her organization learned from contacts in the country that hospitals there are currently struggling to deal with the influx of cases.

Serebryannik said that Turkmen doctors from her organization who now lived abroad had contact with their former colleagues in the country so that they could find out the real situation and offer advice.

She said doctors in Turkmenistan had told her that both oxygen and ventilators were hard to come by in the country, treatment was expensive, and deaths from the virus could run into the thousands.

“Turkmenistan is on fire, Covid is on fire … Sometimes they don’t even take patients to hospital, they just send them home,” she said.

A hermit state ruled by an egomaniac: is Turkmenistan on the brink of collapse?

According to Serebryannik, the official cause of death in these cases is not Covid-19 or even pneumonia – instead, a separate condition, such as a heart attack, is recorded in medical certificates.

When health professionals tried to speak out about the realities of the area, they were silenced, according to nonprofit Human Rights Watch. Press freedom and independent control are not allowed within the country – Turkmenistan was ranked 178th out of 180 countries and territories on Reporters Without Borders’ World Press Freedom Index 2021, just above North Korea and Eritrea. Turkmen citizens who peacefully criticize the government have faced severe penalties, including reports of torture and enforced disappearances, according to Human Rights Watch. Foreign residents are also affected by the denial of the coronavirus by the Turkmen government. In July 2020, Turkish diplomat Kemal Uchkun was admitted to a hospital in Ashgabat with Covid-like symptoms but was denied permission to evacuate to his home country, according to the Journal of Asian Affairs. X-rays sent to Turkish hospitals by Uchkun’s wife have been confirmed as evidence of Covid-19, according to the BBC.

The Asian Affairs Journal said Uchkun died on July 7th. His official cause of death was heart failure.

Most recently, Turkmen said he had confirmed the death of a 61-year-old Russian language and literature teacher who had been in hospital since August, according to Turkmen News.

Undermine the rosy picture

Have multiple authoritarian governments around the world announced their Covid-19 outbreaks and received international aid including China, the earliest hit country.

So why is Turkmenistan so stubborn that it still hasn’t seen a single case?

Both Turkmen and Serebryannik said it was up to President Berdymukhamedov, who, as a dentist by profession and former health minister, placed great emphasis on effectively governing the well-being of his people – at least in principle.

Turkmenistan's President Gurbanguly Berdymukhamedov speaks remotely at the 76th session of the UN General Assembly on September 21, 2021.

Serebryannik said Berdymukhamedov, 64, wants to appear as the country’s savior and formidable world leader by keeping Covid-19 out.

“Turkmenistan is a country where everything looks rosy in the garden … They have these marble, ultra-modern (health facilities) with German, French, Japanese, whatever, equipment,” said the Turkmen journalist.

Admitting a deadly virus would undermine the president’s idealized image and leave Berdymukhamedov vulnerable to criticism – and possibly held accountable.

“It would be someone’s failure, someone would have to be responsible for it and who has the last word for it? The President,” said the Turkmen.

There has been no sign yet that Turkmenistan is preparing to reverse its position and admit that Covid-19 cases have occurred in the country, but Serebryannik said she believed the government should eventually.

She said there was just “too much death”.

Human Rights Watch’s Denber said international organizations interacting with Turkmenistan, including WHO, have a duty to be honest with the world about the situation in the country.

“At some point you have to say what is the price at which you are protecting this presence (in the country)? Are the measures you are taking to protect your relationship undermining your core business? ”She said.

Denber said in a global pandemic with many outbreaks linked across international borders, nations are required to provide accurate testing and accurate public information.

“We’re all connected,” she said. “If one of us fails, we all fail.”

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