COVID-19 response

When COVID-19 challenges met the power of the Consortium care teams

Staff at ANTHC are used to confronting challenges that push us to be innovative, decisive and collaborative. Despite the uncertainties and unknowns, the COVID-19 pandemic was no different in our drive to find solutions that protect Alaska Native health.

In 2020, the Alaska Tribal Health System worked together to respond. Driving the immediacy of our response was the historical knowledge of how previous viruses and pandemics resulted in incalculable losses to Alaska Native people and culture. ANTHC’s COVID-19 response and safety precautions included changes to how we work, how we could help our communities and how our communities could help us.

COVID-19 response: Changes in how we work

When the world first began to hear about the new coronavirus affecting people in Wuhan, China in late 2019, ANTHC knew our preparedness would be an important part of protecting our people. This preparation proved to be crucial. Alaska and specialty teams of ANTHC staff at the Alaska Native Medical Center were brought into the fold, of what would become the global COVID-19 pandemic, much earlier than other U.S. states and hospitals. ANTHC staff were part of the preparation efforts as a flight of American citizens evacuated from Wuhan made a refueling stop in Anchorage in mid-January 2020.

ANTHC infection control teams and medical staff at ANMC were on stand-by during the refueling stop. At the same time, ANTHC leadership enacted our Incident Command system, a leadership structure that would allow us to make important decisions faster and collaborate with more people inside and outside our organization. These early tests helped ANTHC quickly make changes to how we work before the first case of COVID-19 was reported in Alaska. Operational changes were made at ANTHC and ANMC to limit and minimize the potential transmission of COVID-19 among our patients, staff and providers:

Changes for specialty medical care at ANMC (early response)

• Universal mask use in our facilities by patients and staff
• Entrance screening and restrictions on visitors in the hospital to preserve personal protective equipment (PPE) supplies
• Conversion of patient rooms for potential COVID-19 cases
• Closure of gathering areas
• Physical distancing protective measures
• Emergency Department triage moved outdoors to specially constructed tent to prevent virus from entering hospital
• Moved clinic locations out of the hospital to temporary locations for essential outpatient care
• Telehealth appointments encouraged whenever possible
• Preparing contingency housing and isolation accommodations for patients and medical staff
• Limits on patient housing and transportation
• Pausing all non-emergent procedures and appointments at the request of Alaska DHSS and in coordination with other partners

Changes in ANTHC operations (early response)

• Staff reassigned to Incident Command roles
• Business travel suspended
• Additional paid sick leave offered for COVID-19 positive staff
• Remote work arrangements approved for hundreds of employees
• Community environmental health construction projects suspended

COVID-19 response: How we helped our communities

In normal times, the logistics of providing health services across Alaska has plenty of challenges: travel to see specialists, shipping supplies for remote health facilities, access to critical health diagnostics, community utility infrastructure maintenance, and others.

In 2020, ANTHC knew we would have to innovate to ensure logistics affecting health systems across the U.S. – PPE shortages, access to sanitizing supplies, reduction in services – would not disproportionately impact the Alaska Tribal Health System and rural communities. We partnered with State leadership; CDC, Indian Health Service and other federal partners; Tribal health organizations; Congressional delegates; state health, nonprofit, Tribal, military and other organizations; Municipality of Anchorage; and Anchorage-area hospitals to deliver solutions for the Alaska Native people we serve.

ANTHC also utilized the expertise of our staff, which ranges from health care, healthy best practices for our homes, epidemiology data modeling, and other skills to address the most urgent needs of Alaska Native people. Our staff includes infectious disease experts, engineers with knowledge of building systems that keep our health care facilities safe and public health communications professionals all working tirelessly to address the pandemic.

ANTHC staff came together with all the creativity and innovation they could muster to help our communities in response to COVID-19.

ANTHC-led community support

COVID-19 testing: ANTHC stood up its own testing site and invested in additional laboratory diagnostic equipment to ensure our people had access to testing. We also helped secure rapid testing equipment for our regional Tribal health partners.

Securing and preserving PPE and other supplies: ANTHC worked with many partners to secure personal protective equipment (PPE) and sanitation supplies for health care workers across the Tribal health system. Highlights include:

• ANTHC engineers designed and built a mobile trailer unit that uses heat to sanitize and reuse PPE in the case of shortages, and drafted plans for similar use in rural communities.
• Samaritan’s Purse donated 18,000 pounds of PPE and medical supplies to help rural Alaska prepare for the potential impacts of COVID-19, which was distributed to six rural health care providers with the help of ANTHC.
• ANTHC coordinated distribution of dental supplies and PPE for Dental Health Aide Therapists in Bethel to ensure they could provide necessary oral health care.
• Knowing it is in short supply across the U.S., ANTHC secured many sources of hand sanitizer, which is an especially important resource in rural communities without running water. Supplies included 8,000 gallons of hand sanitizer donated from Exxon Mobil for medical use, 18,000 bottles from Johnson & Johnson for homes.

Emergency preparedness support: We worked with Tribal health partners across the state to share our knowledge, expertise and resources for emergency pandemic response. ANTHC hosted regular collaboration meetings with Tribal health partners. Our Tribal health partners, Maniilaq Association and Norton Sound Health Corporation, received triage tents to assist with patient arrival to their facilities. Clinical staff collaborated, shared insights and interpreted new COVID-19 information together across hospitals and clinics.

Distance learning and technology solutions: ANTHC education programs had already been utilizing distance learning solutions to help Community Health Aides and Practitioners get the health training information when they needed it. We were able to quickly pivot to only online health education and create resources specific to COVID-19. In partnership with Yukon-Kuskokwim Health Corporation, Health Aide Training Centers, State of Alaska and ANTHC, we developed new training modules for health aides to detect and care for COVID-19 patients. We developed a series of just-in-time trainings for clinical providers across the state to get refreshers on how to treat COVID-19 symptoms and use equipment, such as ventilators, that providers may not have regularly used.

Statewide mental health support: In addition to the COVID-19 pandemic, the health of our communities was also threatened by stress, isolation, mental distress, political and cultural unrest and other responses to critical incidents that elicited strong emotional responses. For a few years, ANTHC has helped communities and organizations address specific circumstances with our Critical Incident Stress Management team, a group of trained counselors, by deploying teams to locations. With travel limited, the CISM team opened up their services to virtual counseling sessions for individuals, families and organizations across the Tribal health system.

COVID-19 response: How our communities helped us

COVID-19 is a virus and spreads from person to person, similarly to a cold or flu. Early on it was apparent that putting distance between ourselves and other people to prevent the spread of COVID-19 was a necessary strategy to reduce the number of cases we might see through our hospital doors. For ANTHC, an organization that thrives on connection with others and collaboration, physical distancing was a particular challenge.

We also had the unique burden during the pandemic as the only specialty care and tertiary hospital serving Tribal members statewide.

Our communities found other ways to connect with ANTHC and support us. Community support of ANTHC and especially our health care providers was essential to help ensure Alaska had adequate health care capacity. This included support from our staff, business and other donors, and the communities in which we work.

Staff adapt to unexpected needs with flexibility in new roles

When we saw the extraordinary needs that COVID-19 would demand, ANTHC staff jumped into new roles without hesitation. Despite the fear. Despite the unknowns. Despite the many challenges. As health professionals serving Alaska Native people, we know the threats to our health and potential devastation to our communities required immediate response and an extreme dedication to mitigating even the smallest threats.

When we do our jobs well, the results are often invisible. But ANTHC staff know how important it was to get our COVID-19 response right.

Staff joined statewide taskforces. Staff collaborated with colleagues across the ATHS. Providers and staff adapted to offer more telehealth appointments to ensure ongoing care could be performed safely.

Staff stayed apart by working from home, but worked together across departments in ways that led to better solutions. Staff designed and implemented new processes with expertise, kindness, professionalism and teamwork to support each other and our care networks.

Our staff showed up for ANTHC to support our COVID-19 response, our communities and the people we serve.

Community donations supported health care workers, Elders and patients

Health care heroes work here. ANTHC knows that without the handmade signs, food donations, chalk drawings, PPE donations and social media posts of appreciation. But we were taken aback by the ways our communities showed their support for our health care workers when COVID-19 struck.

Restaurants across Alaska prepared hundreds of meals for delivery to nurses working long shifts. Businesses shifted their operations to fabricate face shields and other critical PPE and testing supplies. Other businesses showed their support by requiring masks, adapting service, limiting occupancy and offering discounts to essential workers.

Organizations like the Shift7 Foundation, a nonprofit organization who works with the Alaska-originated band Portugal. The Man, donated masks and medical gowns for Tribal health organizations statewide. The Taiwanese government and an Alaska-based Taiwanese outreach organization donated thousands of items of PPE to ANTHC,the Municipality of Anchorage, and the Frontline Business Safety Initiative to help fight COVID-19.

Our communities also recognized the importance of protecting and providing for Alaska Native Elders. Thanks to the generous support of NANA, Akima and the Healthy Alaska Natives Foundation, ANTHC was able to distribute 1,000 Elder Self Care Kits to Alaska Native Elders throughout the state. Each kit included supplies such as a thermometer and a pulse oximeter to assess oxygen saturation and pulse to monitor ongoing health.

Individuals, families and groups further supported us by putting their crafting skills to work by making homemade masks and surgical caps that combatted COVID-19 infection among our hospital community.

Thousands of masks were donated to ANTHC.

ANTHC received more than $1 million in charitable gifts to support COVID-19 efforts.

Collaborations were created with previous partners and new.

These are just a few of the many different ways our communities supported us in 2020 and continue to support ANTHC going forward.

We’re in this together – how community and personal action supports slowing the spread of COVID-19

For generations, Alaska Native people have protected each other through community collaboration and care. During the COVID-19 pandemic, we were so inspired seeing people work together in our communities as our ancestors did.

Individuals and families now regularly wear masks in public locations to stop COVID-19 spread. Communities and organizations canceled events and limited gatherings to flatten the curve. We all learned about viruses and how simple handwashing helps ourselves and others.

A public health crisis requires help from all of us. We learned. We adapted. We supported each other. ANTHC is so thankful for the ways in which we all stepped up to protect the health of our communities across the state and the health of our health care system.

COVID-19 by the numbers

• 67 staff working in Incident Command structure
• 113,458 tests processed by ANMC lab
• Number of donations to support health care workers
• PPE and homemade mask donations
• Number of visitors to ANTHC’s COVID-19 webpages