COVID-19 Alaska Weekly Case Update: Aug. 2 - 8, 2020

 

 This data summary covers COVID-19 in Alaska from Sunday, August 2nd through Saturday, August 8th, 2020.

 

Background

The Alaska COVID-19 Weekly Case Update will be composed 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

·         Alaska continues to see rapid increases in resident and nonresident new cases 

·         The biggest increase this week was in Anchorage, which had 272 new cases, or 62% of this week’s increase

·         Fewer new cases were seen this week than last week in Anchorage, the second full week since Anchorage reinstituted restrictions July 22 on restaurants, bars and other gathering places in response to community-wide spread; Anchorage also closed bars and restaurants to all in-person service August 3rd.

·         Total cases among Alaska residents rose 14% this week with 442 new cases

·         The majority of new cases continue to be among Alaskans aged 20-29, with cases among Alaskans in their 20s and 30s still rising 

·         Most nonresident cases have been identified before the person had significant community interaction

·         Most new cases in Alaskans are acquired from other Alaskans who have not traveled

·         Transmission between Alaskans at social gatherings, within families, at community events, churches and bars has significantly contributed to the rise in cases

·         Hospital capacity is currently adequate, but hospitalizations and deaths are increasing 

·         Alaskans should avoid gatherings, 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 442 new cases in Alaskans and 60 in nonresidents, for a total of 3,706 and 764 respectively. 10 additional Alaskans required hospitalization this week for COVID-19, for a total of 154 since the epidemic began. Two additional deaths were reported this week, for a total of 26. By convention, deaths are counted based on the residency of the patient rather than where they contracted the virus. 

 

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 halve about every 38 days based on the current case trend, a reversal in trend from last week, when they were predicted to double about every 21 days; however, this will depend on a continued effort among Alaskans to slow the spread of transmission through physical distancing, masks and limiting contacts. 

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

 

 

Communities affected this week 

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

·         Anchorage (272), Chugiak (5), and Eagle River (14), for a total of 291 new cases in the Anchorage Municipality. 

·         Fairbanks (29) and North Pole (6) for a total of 35 new cases in the Fairbanks North Star Borough

·         Wasilla (20), Palmer (10), Houston (1), Willow (4), Sutton-Alpine (1), Big Lake (1), and a smaller community (1) for a total of 39 new cases in the Matanuska-Susitna Borough

·         Seward (2), Soldotna (9), Homer (1), Fritz Creek (1), Sterling (4) and a smaller community (1) for a total of 18 new cases in the Kenai Peninsula Borough

·         Cordova (1), and 1 in a smaller community in Valdez-Cordova Census Area, for a total of 2

·         Yukon-Koyukuk Census Area (6)

·         Juneau (17)

·         Delta Junction (3)

·         Ketchikan (1)

·         Kotzebue (1) and 3 in a smaller community or communities in the Northwest Arctic Borough, for a total of 4

·         Sitka (3)

·         Utqiagvik (5)

·         Nome Census Area (2) 

·         Bristol Bay plus Lake and Peninsula (4)

·         Bethel Census Area (1)

·         Aleutians East Borough (1)

·         Metlakatla (1)

·         Wrangell (1)

·         Hooper Bay (1) and one in a smaller community for 2 total in Kusilvak Census Area 

 

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, Anchorage Municipality remains in the red, but has decreased its 7 day case rate from 28 to 14 in the last week. The Interior Region has worsened slightly to 9.2 from 7 last week, and the Northwest Region has improved to 6.3 from 8.8. Next, Fairbanks North Star Borough and Kenai Peninsula Borough had 4.6 and 5.9 respectively, both declined modestly since last week. Matanuska-Susitna Borough has improved to 5.8 from 8.6 last week. Juneau City and Borough worsened to 8.5 from 6.7. 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. 

 

 

 

7-day Case Rate Map (cases per 100,000 people)

Because of Alaska’s unique geography and smaller population, a 14 day case rate can also be useful. The alert level map below, designed to help long term facilities decide when it may be safer to allow visitors in their facilities, uses a 14 day case rate approach. By that approach, the Interior Region excluding Fairbanks is improved to the intermediate alert level, going from a case rate of 18 to a case rate of 7.9 in a week.  The Anchorage Municipality, which nearly doubled its rate in a week from 10.9 to 20.5, is now down to 18.5 a week later. Fairbanks itself has improved from 7.2 to 5. Kenai Peninsula Borough’s rate has improved slightly to 6.5 from 8 last week. Matanuska-Susitna Borough rose to 7.4 from 7.25 and Juneau City and Borough from 6.7 to 7.4, and with the Northwest Borough (7.6 from 7.3 last week) are in the intermediate (orange) alert level. Other regions had case rates <5, including the Northern and Southern Southeast Regions, which improved from 5.9 to 4.2 and 5.0 to 2.2 respectively in the past week. 

 

Alaska COVID-19 Alert Levels

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.

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. 

 

 

Age and gender distributions

The majority of COVID-19 cases have been found in adults aged 20-39. Gender distribution has been close to equal, with slightly fewer than half of cases in males and slightly over half in females. 

 

 

Distribution of cases compared to population distribution

Includes data from all cases reporting one or more races. 

Based on these data, American Indian and Alaska Native as well as Native Hawaiian and Pacific Islander populations are disproportionately affected. 

Race	Number of cases	Percent of cases (of those for whom a race is known)	Percent of Alaska population
American Indian and Alaska Native	503	24% (same as last week)	16%
Native Hawaiian and Pacific Islanders	155	7.4% (0.4% increase from last week)	1%
Black/African American	117	5.6% (0.6% increase from last week)	4%
Asian	103	5% (same as last week)	7%
Multiple	107	5%	8%
White	999	48% (4% fewer than last week)	65%
Other race	92	4%
Total for whom a race is known	2076
Under investigation	1507
Race unknown	192

 

Hospital capacity

Hospitals remain below capacity, with ventilators and ICU beds available, but use is rising. 154 Alaskans have required hospitalization for COVID-19. Bed occupancy due to COVID-19 rose in July, following a rise in cases, and has decreased slightly over the past week. Hospitals report all inpatient beds in this total, including those for infants and obstetrics. However, the ICU bed count includes only staffed adult and pediatric ICU beds, as NICU (neonatal ICU) beds can only be used for infants and would not be useful for teenage or adult patients with severe COVID-19. 

 

 

Risk of severe COVID-19 by race and ethnicity

CDC notes that older adults and people with underlying medical conditions are at increased risk for severe illness if they get COVID-19. In particular, CDC specifies cancer, chronic renal disease, COPD, immunocompromised state from a solid organ transplant, obesity (BMI 30 or higher), serious heart conditions such as heart failure, coronary artery disease and problems with the heart muscle, sickle cell disease and type 2 diabetes as carrying an increased risk of severe illness. 

Data was immediately available for the prevalence of several of these conditions among Alaskans. Because Alaska’s population is small and the data collected is even smaller, several of these estimates are considered statistically unstable, or not very reliable. However, they are presented here as an example of how different chronic diseases impact different populations of Alaskans, and they may be able to predict increased risk of severe COVID-19 among some populations.

 

Race or ethnicity	Cardiovascular disease	COPD	Diabetes	Obesity	Current smoker
Multiple races, non-Latino	3.3%*	2.4%*	7.2%	28.6%	12.9%
Hispanic or Latino	5.2%*	5%*	10%	23.1%	25.5%
White	4.2%	5%	8.3%	30.6%	15.9%
Native Hawaiian or Other Pacific Islander	No data available	No data available	6.6%*	55.4%	17.9%
Black or African American	8%*	6.1%*	17.2%	44.3%	20%
Asian	No data available	2.9%*	8.6%	18.7%	8.5%
Alaska Native	4.6%	7.4%	7.8%	36.3%	36.8%

 

*Statistically unstable: there is not enough data for this category to consider this a reliable estimate

 

Hospitalizations and deaths by race and ethnicity

Hospitalization percentages are influenced both by the number of people of that race hospitalized and the number of people of that race who have been found to have COVID-19. This means that a population that either has a high degree of severity of COVID-19 and/or a low rate of testing and many undiscovered cases may have a high percent hospitalized shown in state data. Conversely, a population that has many hospitalizations but has a disproportionately high testing rate may have a lower percent hospitalized relative to other groups, since they have fewer undetected cases.

 

Because Alaska has had 26 deaths related to COVID-19, it is very difficult to draw robust conclusions from these small numbers. Hospitalizations may be a better indicator of actual severity among different populations, since those draw from larger numbers. Other states have had far larger numbers of hospitalizations and deaths and can draw conclusions about trends with more confidence. It is too early to say with confidence whether disparities in severity among Alaskan populations will mirror those in other states. However, state and federal data reflects significant racial disparities in the impact of COVID-19 on minority communities, and Alaskan populations such as Alaskan Native People and Pacific Islanders are known to experience conditions that place them at higher risk for severe COVID-19 at increased rates.

 

 

Reporting of deaths due to 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. 

26 Alaskans are reported as having died from COVID-19. 

 

Recovered cases

221 Alaskans are presumed to have recovered (either they have been confirmed by public health as recovered or they have completed 10 days of isolation) from COVID-19 this week, for a total of 1153, or 31% of total cases. This is an increase of 2% from last week, meaning that more Alaskans are getting COVID-19 than are recovering from it but this trend is starting to slow down slightly. 

 

Nonresident cases

Of the 60 nonresident cases identified this week, 16 were in the Kodiak Island Borough, 11 were in the Kenai Peninsula Borough, 8 were in Juneau City and Borough, 7 were in the Anchorage Municipality, 4 were in Fairbanks North Star Borough, 3 were in the Bristol Bay plus Lake and Peninsula Census Area and 1 each was in the Valdez-Cordova Census Area, Ketchikan Gateway Borough, North Slope Borough, Sitka City and Borough, Yakutat plus Hoonah-Angoon and Dillingham Census Area. 5 nonresident cases did not yet have their location identified. 

32 nonresident cases were associated with the seafood industry, 5 with tourism or visiting purposes, 3 with the oil industry, 1 with mining, and 8 with other industries. 

 

Testing update

By Saturday evening, 37,253 tests had resulted this week in Alaska, for a total of 280,343 243,090. Test positivity rate for this week averaged 2.3%, improved from 2.6% last week, meaning around 23 in every 1000 tests performed came back positive. Not all positive tests represent distinct positive cases, since occasionally patients with COVID-19 are retested, but 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 31st through Thursday, August 6th. 

 

This week saw 25,588 travelers screened at airports entering Alaska, and 7,938 (31%) opted to be tested on entry. The other options available to them were a 14 day quarantine (selected by 3,533  passengers, 14%) or providing proof of another test performed within 72 hours of landing in Alaska, which 12,970 passengers did (51%). The remaining 1,147 (4%) 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. 55 new cases were discovered through airport arrival testing, for a test positivity rate of ~0.7%. 

 

Since testing began eight weeks ago, 174,384 travelers have been screened at Alaska airports. 76,924 (44%) tested prior to travel, 56,480 (32%) have tested in Alaska airports, and 22,144 (13%) selected a 14 day quarantine. There have been 328 positive tests through airport testing, for an overall test positivity rate of 0.6%.

 

Of the 60 cases in nonresidents this week, 5 were linked with tourism or visiting, including 2 in Juneau City and Borough, 2 in the Anchorage municipality and one in the Ketchikan Gateway Borough.  

 

Seafood industry

Of 60 nonresident cases total identified this week, 32 are in workers in the seafood industry, including 15 in the Kodiak Island Borough, 10 in the Kenai Peninsula Borough, 3 in the Juneau City and Borough, 3 in Bristol Bay plus Lake and Peninsula, and one in the Valdez-Cordova Census Area. All nonresidents with COVID-19 are quarantined and contact tracing is ongoing for these 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.