COVID-19 Alaska Weekly Case Update: July 12- July 18, 2020

This data summary covers COVID-19 in Alaska from Sunday, July 12th through Saturday, July 18th, 2020. 

Background

The Alaska COVID-19 Weekly Case Update will be finalized every weekend with data from the previous week and the report will be published by the following Wednesday. Data are continually updated on the AK DHSS Data Hub, which reflects the most current case counts. This summary presents data from the previous week and is a snapshot of the information available on known cases at the time. 

Highlights

· Total cases in Alaska residents have risen by more than a quarter in this week alone

·  We see community transmission occurring in almost every business type that involves in-person interaction

·  Alaskans are acquiring the virus from many types of social gatherings: backyard barbecues, funerals, weddings, children's sporting events, camps, churches and any time groups gather with others outside their household

·  Fairbanks has had very high rates of test positivity, reflecting widespread community transmission

·   The majority of new cases are among Alaskans aged 20-29, with cases among Alaskans in their 20s and 30s rising sharply

·  Most nonresident cases have been identified before the person had significant community interaction, so most new cases in Alaskans are acquired from other Alaskans who have not traveled

·  Hospital capacity remains adequate

·  With current rates of physical distancing, face covering use and other measures to prevent transmission, cases are expected to continue to rise rapidly 

·  Alaskans should avoid gatherings with non-household members, wear face coverings in public, keep six feet of distance from non household members and practice good hand hygiene to slow transmission of COVID-19 

New cases

This week saw 399 new cases in Alaskans and 104 in nonresidents, for a total of 1,874 and 403 respectively. 6 Alaskans required hospitalization this week for COVID-19, for a total of 99 since the epidemic began. One additional death was reported this week, for a total of 18. By convention, deaths are counted based on the residency of the patient rather than where they contracted the virus. 

Communities affected this week 

New cases were found in Alaskans who are residents of the following communities:

·         Anchorage (184), Chugiak (6), Eagle River (14), and Girdwood (1), for a total of 205 new cases in the Anchorage Municipality

·         Fairbanks (58) and North Pole (6), for a total of 64 new cases in the Fairbanks North Star Borough

·         Kenai (5), Seward (7), Soldotna (18), Homer (2), Nikiski (2), Sterling (2) and smaller communities (4), for a total of 40 new cases in the Kenai Peninsula Borough

·         Wasilla (28), Palmer (7), Willow (1), Sutton-Alpine (1), and Meadow Lakes (1) for a total of 37 new cases in the Matanuska-Susitna Borough

·         Yukon-Koyukuk Census Area (16)

·         Juneau (11)

·         Valdez-Cordova Census Area (9)

·         Utqiagvik (2)

·         Ketchikan (2)

·         Sitka (2)

·         Bristol Bay plus Lake and Peninsula Census Area (2)

·         Kotzebue (1) and one in a smaller community, for a total of 2 new cases in the Northwest Arctic Borough

·         Bethel (1) and one in a smaller community, for a total of 2 new cases in the Bethel Census Area

·         Southeast Fairbanks Census Area (1)

·         Nome Census Area (1)

·         Haines (1)

·         Kusilvak Census Area (1)

·         Kodiak (1)

 Case rates and alert levels

The 7 day case rate map depicts cases adjusted by population for a given region (cases per 100,000 people). The regions are large because Alaska is a large state with few densely populated centers, so this case rate can only be meaningful across large regions. Currently, the Interior region with the exception of Fairbanks North Star Borough has the highest new case rates in Alaska, averaging 15.8 new cases daily per 100,000 people. Next, Fairbanks North Star Borough, Kenai Peninsula Borough and Anchorage Municipality had 9.4, 9.8 and 9.0 new cases daily per 100,000 people this week.  Juneau City and Borough has the next highest rates, at 4.91. Most states use a 7 day case rate per 100,000 population to estimate trends in community transmission. Roughly, rates of >10 cases daily per 100,000 population correspond to widespread community transmission and >5 to moderate community transmission, but a sharp increase or decrease in these rates can help predict how the next week or weeks will look for the region. 

 

Because of Alaska’s unique geography and smaller population, a 14 day case rate can also be useful. The alert map map below, designed to help long term care facilities including nursing homes decide when it may be safer to allow visitors, uses a 14 day case rate approach. By that approach, both Fairbanks North Star Borough and the rest of the Interior are in the high alert level, with case rates of 10.3 and 11.3 respectively, while Kenai Peninsula Borough and Anchorage Municipality are in the intermediate alert level with case rates of 9.3 and 7.6 respectively. Other regions had case rates <5. 

 

 

More information on alert levels is available on this page. 

 

How Alaskans acquired COVID-19

DHSS monitors how people most likely got the virus. In green in the plot below are Alaska residents who acquired COVID-19 by traveling to other states or countries. In March, a substantial proportion of our cases were related to Alaskans returning from elsewhere, while in April and May, fewer Alaskans traveled. Since June, as travel has started to increase, cases in Alaskans related to travel have begun to occur more regularly. 

In blue below are cases where Alaskans got COVID-19 from a known contact. These are people who did not leave the state, but we could trace their illness back to the person they got it from. The goal is for contact tracing to identify each of these cases where someone got it from someone else they had contact with so they can let all other contacts of both people know to quarantine. As contact tracing expanded in May, more cases from contacts were identified.

In red, however, are cases where Alaskans got COVID-19 and contact tracing was not able to establish a clear source. This demonstrates that there are other cases in our communities that we have not found yet. The biggest increase in cases in Alaska has been in people aged 20-39, with many cases linked to bars and social gatherings of all kinds.

Grey bars show the cases where the investigation has not yet concluded. Since the workload for contact tracers has more than doubled in the last few weeks, they are working as fast as possible to identify and quarantine contacts. Alaskans can help contact tracers move faster and prevent more cases by keeping their contact list small, keeping a diary of who they are in close contact with (defined as within 6 feet for 10 minutes or more), wearing cloth face coverings when around any non-household members or in public, and responding promptly to being contacted. 

 

Case distributions

The majority of COVID-19 cases have been found in adults aged 20-39. Gender distribution has been equal, with about half in males and half in females. 

A majority of cases have been seen in non-Hispanic white Alaskans, although race and ethnicity information for many cases has not yet been reported. Races and ethnicities of cases, when known, are within a few percent of the proportion of those races and ethnicities in Alaska’s overall population, meaning that at this time a disproportionate burden of COVID-19 in one particular racial or ethnic group is not apparent. However, since this information is unavailable for more than a quarter of recorded cases, it is difficult to draw conclusions from these data. 

 

 Nonresident cases

Of the 104 nonresident cases identified this week, 42 were in the Aleutians West Census Area, 26 were in the Anchorage Municipality, 8 were in Fairbanks North Star Borough, 4 were in Juneau City and Borough, 4 were in the Kenai Peninsula Borough, 3 were in the Bristol Bay plus Lake and Peninsula Borough, 3 were in the Valdez-Cordova Census Area, 3 were in Sitka City and Borough, two were in the Ketchikan Gateway Borough, and one each in the Kodiak Island Borough, Denali Borough, Wrangell City and Borough and Petersburgh Borough. Five nonresident cases did not yet have their location identified. 

Of these, 55 were associated with the seafood industry, 17 with tourism or visiting purposes, and 6 with other industries. 

 Hospital capacity

Hospitals remain below capacity, with ventilators and ICU beds available, but use is rising. 99 Alaskans have required hospitalization for COVID-19. There has not yet been a sharp increase in need for hospitalization with the rise in cases. However, other states have seen that it can be several weeks before people who get COVID-19 become ill enough to need hospitalization, so DHSS will monitor hospital utilization closely in the coming weeks.

Please note this includes all hospital beds and all ICU beds across Alaska, some of which may not be useful for COVID-19 patients. For example, it would not be feasible to use an infant-sized (NICU) bed for an adult patient. Also, a rural community may have several open beds but urban hospitals would likely not transfer critically-ill patients to a smaller hospital. 

 

 

Recovered cases

24 Alaskans recovered from COVID-19 this week, for a total of 712, or 38% of total cases. 

 

Epidemic curve

This analysis projects growth or reduction in cases predicted in the coming weeks based on the growth of cases in recent weeks. The most recent 7 days (grey bars) are not included because there can be a delay in reporting data. This model assumes exponential growth or reduction in cases and can be a useful tool to visualize how quickly cases are increasing or decreasing. This curve does not project what might happen if more people start wearing masks or increase physical distancing; it assumes Alaskans and visitors to Alaska do not change their behavior. The dotted line is the average prediction, and the grey shaded area is estimated error for the predicted rise in cases. Currently, cases are predicted to double about every 18 days, improved from last week where cases were projected to double every 10-11 days. 

For a full description of methods, visit https://coronavirus-response-alaska-dhss.hub.arcgis.com/

 

 

Testing update

By Saturday evening, 27,533 tests had been conducted this week in Alaska, for a total of 173,010. Test positivity rate for this week was 1.72%, meaning around 17 in every 1000 tests performed came back positive, increased from about 13 in 1000 last week. Not all positive tests represent distinct positive cases, since occasionally patients with COVID-19 are retested. Retesting did not significantly affect the positivity rate. 

 

Contact tracing

Ongoing contact tracing has uncovered many cases in Alaskans who have had possible exposures related to group activities. These include churches, residential living facilities, workplaces, bars and social gatherings. Alaskans should be aware that any gathering, particularly indoors, poses some risk of exposure and should take steps to minimize their risk and the risk they pose to others by keeping their social circles small, wearing face coverings, avoiding large gatherings, and gathering only if it is possible to remain 6 feet apart, ideally outdoors. Contact tracing has become even more resource intensive in recent weeks with both an increase in new cases and a marked increase in the number of contacts each person has- meaning that people are expanding their social circles even as case rates increase.

 

Tourism, visitors and airport testing

Airports report data on a Friday through Thursday cycle, meaning that the airport screening numbers in this section reflect data collected on Friday, July 10th through Thursday, July 16th. 

Week 6 of airport testing saw 24,924 travelers screened at airports entering Alaska, and 8,048 (32%) opted to be tested on entry. The other options available to them were a 14 day quarantine (selected by 3,775 passengers, 15%) or providing proof of another test performed within 72 hours of landing in Alaska, which 12,809 passengers did (51%). The remaining 292 (1%) provided proof of having recovered from COVID-19, were essential workers following a community and workplace protection plan or were Alaskans who had been gone for fewer than 24 hours. 46 new cases were discovered through airport arrival testing, for a test positivity rate of 0.6%. 

 

Since airport testing began, 103,617 arriving passengers have been screened. 40,055 have tested prior to travel, and 34,539 have been tested in an airport. Of these, 180 tests (0.5%) have returned positive. 

 

Of the 104 cases in nonresidents this week, 17 were linked with tourism or visiting, including 11 in Anchorage, 3 in the Fairbanks North Star Borough, 2 in the Ketchikan Gateway Borough, and 1 in the Kenai Peninsula Borough. 

 

Seafood industry

Of 104 nonresident cases total identified this week, 55 are in workers in the seafood industry, including 42 in the Aleutians West Census Area, 1 in Bristol Bay plus Lake and Peninsula Borough, 6 in the Anchorage Municipality, 3 in the Juneau City and Borough, and 3 in the Valdez-Cordova Census Area. All nonresidents with COVID-19 are quarantined and contact tracing is ongoing for these cases. 

42 cases this week (as well as an additional 43 reported Sunday, July 19th) are associated with an outbreak on the F/V American Triumph which docked in Unalaska Thursday, July 16th. Because all cases have been isolated on the vessel and the remaining 34 crew members who tested negative will be flown via charter to Anchorage to quarantine, the outbreak is not thought to be likely to contribute to community cases in Unalaska. So far in the pandemic, Unalaska has reported one case in an Alaska resident. 

An outbreak associated with Juneau seafood processor Alaska Glacier Seafoods initially presented with three cases in nonresidents and three in Alaska residents as well as one associated case in a resident through community spread. An additional 29 active cases have since been identified among processor employees after all employees were tested late this week. All positive cases are isolated and contact tracing is ongoing. 

 

Reporting of deaths due to COVID-19

18 Alaskans are reported as having died from COVID-19. Although several of these deaths occurred in Alaskans who acquired the disease in another state and never traveled to Alaska during their illness, they are counted as deaths in our reporting by national convention. In accordance with national standards, case counts for Alaska reflect known cases in all Alaska residents, regardless of where they acquired the infection or where it was discovered. This provides consistency and avoids cases and deaths being double-counted between states. Cases found in Alaska that are not among Alaska residents are reported under nonresident cases. 

 

Data timeliness and accuracy

Weekly summaries are published early the following week because that gives the state public health workforce time to collect data, verify accuracy, make sure cases have not been counted in multiple places and verify patient identities. This summary is designed to review a week’s data from the Alaska Coronavirus Response Hub dashboard, which displays same-day or next-day data. The dashboard data occasionally changes as new information is received or as cases are reclassified once verification takes place, since this process takes time. Weekly summaries reflect our most current and complete knowledge about cases in the previous week. 

 

Further information

Please see the State of Alaska COVID-19 information page for more information about the virus and how individuals and businesses can protect themselves and others from transmission. 

For the most up-to-date case information, see the Alaska Coronavirus Response Hub dashboard. Some data may change as more information comes to light through contact tracing and other public health work. 

For questions regarding DHSS COVID response, including mandates and alerts, email covidquestions@alaska.gov. Since DHSS is experiencing a high volume of inquiries, the Frequently Asked Questions webpage can often be the quickest route to an answer regarding testing, travel, health mandates and other COVID-19 information. 

For DHSS media inquiries, please contact clinton.bennett@alaska.gov.