As case counts spike across the state of Alaska, Wrangell’s EOC is reminding Wrangellites to remain vigilant, for the sake of the community, and for Wrangell to be able to remain economically open — wear a mask, maintain six feet of distance, and make sure your bubbles are remaining small.
Below is a transcript of the special COVID-19 update with Wrangell’s media that took place on Tuesday, October 20, 2020, with Wrangell Mayor Steve Prysunka and Wrangell Medical Center Director Dr. Lynn Prysunka, Wrangell Sentinel reporter Caleb Vierkant, and KSTK reporter Sage Smiley. The text has been lightly edited for clarity and flow.
MAYOR STEVE PRYSUNKA: I met with the emergency operation center on Monday, we meet twice a week right now. And then we meet every two weeks with SEARHC in sort of a joint unified command, where we speak with the hospital and the clinic and staff from the hospital — testers, people that do the testing at the airport. So we go over the bigger picture at that point. But in Monday’s meeting, a lot of red flags came up regarding where we’re heading in the state. And, and states that we border with, our supply states like Washington, and Oregon, and so on. We’ve been really concerned about this [current COVID situation]. We decided to reach out to the media again, and have another discussion about mitigation and about some of the concerns we’re having. And then I asked Lynn, who’s our medical director for the hospital to sit in as well and maybe be able to address some questions if you guys have any, regarding COVID specific medical questions. But that’s why we asked to speak with you guys today.
CALEB VIERKANT (WRANGELL SENTINEL): Let’s start with the first question I had; what determines if a COVID-19 case can be sent home just to quarantine and wait it out? Or if they have to be hospitalized or airlifted out of town? And if they are airlifted out of town, who does the cost go to?
DR. LYNN PRYSUNKA: (2:02) Okay, let me answer that as best I can, Caleb. It’s not a simple question in terms of who needs to be hospitalized and who doesn’t need to be hospitalized. It depends on a number of different things. The easy answer is it depends on your symptoms, your pre-existing conditions, and how much oxygen you do or do not require. So the only really hard and fast thing that I’ve seen that is quoted is the oxygen level. If your oxygen level in your blood system without any extra oxygen is 95% or greater, you’re considered okay. The reason it gets kind of gray is some people without COVID, because they’ve got lung disease, have a significantly lower oxygen level. So there’s a certain amount of clinical judgment that has to play into whether somebody should be hospitalized. If somebody is very short of breath, even if their oxygen level is okay, but they’re short of breath and they’re lightheaded, and dizzy, or they’ve got other symptoms like chest pain or diarrhea that’s uncontrolled, all these things play into it. There’s a number of things that need to be looked at in terms of [whether it’s] safe for somebody to go home, but most important, I think, is that we can identify who the people are, who are potentially sick with COVID, So that we can follow them. And we can help them make a decision of whether they’re getting sicker and need to get treatment or not. There isn’t a simple ‘You’ve got a mild case of COVID so you go home,’ it’s more of ‘Okay, at this point in time, we think that you have a mild-ish case of COVID. And we think that you are safe to stay at home for the time being, but we need to keep checking in daily and figure out, are you getting worse? Or are you getting better? Or are there medications that we have access to that can help reduce your risk of going on to a more severe infection?’
Now, the second part of your question is if we decide that you do need to be hospitalized and you agree to be hospitalized, what does that look like in Wrangell? Well, Wrangell Medical Center is part of the larger SEARHC consortium. And as a medical system, we’ve decided that we will put our resources in the larger hospital in Sitka, the Mt. Edgecumbe Medical Center, where they have doctors and practitioners in-house all the time, they’ve got enough providers there to always have somebody in house, they’ve got a respiratory therapist there, and they’ve got larger amounts of nursing staff. So we’ve put our resources into developing a larger COVID wing there. So if we have decided, for whatever reason, that you should be either admitted to the hospital there or transferred to Sitka so that you’re closer to a large hospital if you do need to be admitted, then, as it’s part of our system, SEARHC, we’ll arrange for the transportation for the patients to go from Wrangell to Sitka. The way they’re looking at this is very similar to how they’re looking at testing people for COVID-19 who have symptoms. If you don’t go to the free testing, but you come in because you have symptoms, they will do the test, and you will never get a bill. Now, SEARHC will bill your insurance to see if they’ll cover it. And if your insurance doesn’t cover it, SEARHC will cover the rest. So that’s how they’re dealing with the transfer of patients from any of the outlying facilities, including Wrangell to Sitka.
VIERKANT: So their insurance covers it. But if their insurance doesn’t cover it, then SEARHC covers it.
DR. PRYSUNKA: (6:21) Exactly. Their insurance will be billed, but if their insurance doesn’t cover it, the patient will not see a bill.
SAGE SMILEY (KSTK): Interesting, because I did see a bill. I wonder, is that a more recently instituted policy?
DR. PRYSUNKA: I guess my question would be, did you get a bill because you had a test because you were symptomatic? Because that’s not a recent policy, that’s a mistake.
MAYOR: We’re saving you money, see?
*Laughter*
SMILEY: Along a similar line, then, I have a follow up question. I’m wondering — and I know this might get into privacy stuff, but if you can — have any of the 20 cases Wrangell has had been sent out of the community for care?
DR. PRYSUNKA: (7:12) We have had some patients that needed to be hospitalized.
SMILEY: Okay, so then they went to Sitka or another hospital not in Wrangell.
DR. PRYSUNKA: (7:21) In the consortium, in general, the system has worked very well. So all over these communities when people get sick, if they’re sick enough to be admitted to the hospital, they’ve been sent to Sitka and admitted to the hospital if they’re just at really high risk. Some of these patients are sent to Sitka and then there is a boarding facility that they can live in so that they’re really close to the major center. So multiple areas in [the] SEARHC [area] have had patients and have needed to be transferred into the larger hub there and it’s worked very well.
SMILEY: Would you be able to say exactly how many from Wrangell have been sent, or does that…
DR. PRYSUNKA: I don’t think I could just because we’re into the range of — it’s a small town and so people… it’s not a very big jump to figure out who might have been sent and that does breach patient confidentiality.
SMILEY: That makes sense.
DR. PRYSUNKA: But the system works.
SMILEY: Good. We’re glad this system works.
VIERKANT: Let’s move on to a kind of medical topic. I recently — I’ve been seeing a lot of articles online talking about flu season coming up and Coronavirus. Also, I’ve heard that getting a flu shot can possibly help you kind of build up immunity and help avoid contracting Coronavirus. Is that true?
DR. PRYSUNKA: (8:48) Oh, I’d love to say it was true. I don’t think that we’ve got evidence of that, Caleb, but we also don’t know what might happen if you got COVID-19 and you got influenza at the same time, how severe that illness might be. The other problem is they present very similarly to begin with. And so if you can avoid getting one then you can avoid the concern and worry that your new symptoms might be influenza or might be the other thing. So there is no question that the absolute best advice is get your flu vaccine, they’re actually looking to see if they can get swabs that will test for both influenza and COVID at the same time. I don’t think they’ve got those yet. But that’s in the books.
VIERKANT (to SMILEY): And I guess it’s your turn now. Since we’re back and forth.
SMILEY: I guess my next big question is kind of a two part question. What are your biggest concerns going forward locally? And then just more broadly, in terms of the pandemic, the way that the community is reacting to it, the way that the state is reacting to it? Wintertime… which is a pretty broad, big question, but I know that the broader concerns are probably a bit different, just because we don’t currently have any active cases here in Wrangell. But basically, what are your biggest concerns locally, and then more broadly, going forward into the winter months?
MAYOR: (10:21) Well, we are really concerned, given what’s taking place in the state right now. We’ve had triple digit numbers for the last few weeks. And we’ve really kind of moved into the red zone with some regions definitely showing a lot of cases. Southeast is a bit unique and is kind of divided into the northern and the southern [parts, at the moment]. And in the northern with Juneau, of course, they’ve had a real outbreak with their homeless populations, and just in general. In the southern, we haven’t been quite hit the same way. Wrangell has enjoyed being COVID free for weeks, which is fantastic. And it just goes to show the great efforts that everybody’s putting forward. But we have people traveling into the community intrastate, and folks flying down from Juneau, to Seattle. Our folks get on the plane with them here in Wrangell, we spend the next hour and a half cooped up in a little cylinder. So with air travel, you can’t isolate yourself any longer. That’s where the mitigation really has to come in, and unfortunately, we’re seeing across the nation and definitely across Alaska, that people are exhausted with it and exhausted with masks and COVID and six feet and the whole thing. It’s really unfortunate because the timing is lining up and we’re getting a bit of a perfect storm coming. We have COVID exhaustion, and decreased use of masks and social distancing. We have the flu season coming up, we’re indoors more, especially in Alaska — we don’t have the same opportunities for being outside. And it’s really starting to concern us at the EOC that we have the potential for a major outbreak.
The concern for me as the mayor is, I don’t want the assembly to have to put mandates in place that says ‘You must,’ or ‘You will,’ I don’t want to do that. But we have to look at what’s going on at the time. And right now we’re not there. But if we can prevent getting there, that’s really what I’d like to do. So if we wind up having a real dustup of cases in the community, we have to take measures to protect everyone. But also at the same time, we have to take measures to protect our economic security. There’s the physical health, and there’s the economic security. And we have enjoyed the last five or six months of just being open, and pretty wide open. I don’t want to see that have to be curtailed at all. So, I’m encouraging everyone to continue doing the things that we do to prevent COVID. I know you’re tired of hearing this, but: wear masks, keep your bubble small, all the things that Dr. Zink keeps reminding us all about. That’s what we need to do.
Here in Wrangell, we have another concern, and that is that the travel mandates that have been put in by the state are going away. So testing is going to become less and less and the Emergency Operations Center recognizes the importance of testing, especially for people coming into the community. So we will be trying to set something up in the near future to extend our testing ability at the airport through January, February and March, just because we see this as a time where we just really don’t want to back off having that available. We’re looking at some options with SEARHC to partner to be able to do some more testing [at the airport during that time].
DR. PRYSUNKA: (14:12) I’d just like to say that we have the ability in this town to do what larger places can’t do. Isolation is our friend really. Isolation comes from being on an island, but it also comes from having enough testing available so that people can find out soon, whether they’re positive or not. And yes, it’s an incredible inconvenience to be isolated for 10 days or 14 days, depending on your situation. But if we can encourage everybody to get investigated if they’ve got symptoms, or if they’ve traveled or anything, so that we can isolate a small number of people, we can keep everybody else open. If you’re wearing your masks, it also limits the number of people who are also inconvenienced because it’s how many people you’ve been exposed to for 15 minutes without a mask on, within six feet. Everything you can do to reduce that risk is less of an inconvenience for everybody who has been around you. So we really do have a marvelous opportunity to manage this very well in our community, more so than than most places because we’ve got really good access to testing and we’ve got isolation on our side, we’re not on a road system, we’re not on those sort of things that that bring germs in.
SMILEY: Is SEARHC looking to expand free testing two more days of the week as the winter [proceeds]? Because I know that you talked about [how] we have it on Saturdays and Sundays right now and the mayor talked a bit about expanding that to the airport. So is that the kind of thing that will be extended longer term or or not longer term, but further into the week?
DR. PRYSUNKA: (16:08) I’m not sure that there’s plans to do that because that has a cost in terms of employee time and so forth. I think that it is a doable and a wonderful service. A doable thing the way that it is now. Basically, if you’ve got symptoms, you can get a test. If you feel that you are symptomatic and you need to be seen by a doctor, you can get a rapid test that day. If you are only slightly ill but want to get a test, you can still sign up and get a test or you can go to the free testing on the weekends. [That] test doesn’t get back right away. It takes three to four days. But it is significantly more accurate probably than the rapid test and all. You know, we get a handful of people, 40 to 60 people, who come through and get tested every week. That’s 40 to 60 people that we know don’t have the virus at that time. So the more people we can get to do that, the better off we are. But in general, no, I think that they’re going to stay with just having the free testing on weekends.
MAYOR: (17:27) But if you’re symptomatic, or you’re worried, you can go to the hospital or to the clinic and get a test.
DR. PRYSUNKA: What I would do is call. Call the COVID-19 hotline and get scheduled in for a test so that you’re not standing outside the hospital or the clinic in the cold waiting to see what they’re going to do with you. They will set up a time where you can go get that test done at the drive-thru testing place or walk-up testing place, depending on your current vehicle situation. But that doesn’t mean that if you are really ill, you can’t see a doctor. You can. You do have to go to the hospital, if you’re that ill and can’t wait the day to be seen. But if you have symptoms of COVID, they will do a rapid test, and they do show that the rapid test is much more reliable, if it’s picking up COVID-19 in a patient with symptoms. So there is that as well.
VIERKANT: So kind of In summary, while we haven’t had cases here in wrangell, for about a month now give or take, we really need to focus on still wearing our masks socially distancing, and remember to go get tested whenever we feel like there might be a chance, just as a precaution.
MAYOR: (18:49) Yeah, you summed it up nicely. I think [I might add] resist the temptation — and we all feel it — to slack off. Because it’s not as prevalent as it was, you know, when we first started out, I looked at the case counts the other day. Early on, we were all freaking out. And it was such low case numbers that you almost feel foolish now, here we are with thousands of cases and, and 200 a day being tested positive. And we’re actually responding less than we were when it was five cases a day, I remember when we would have 10 and and Lynn and I would be like ‘Ah, it’s busted loose.’ So it’s just important to keep this thing in perspective. And there’s hope on the other end of the line, we’re all hopeful there’ll be a vaccine, but it’s going to take some time. And the goal is to not get yourself sick. That’s the goal. And to not have to have things enforced upon us because people are just volunteering and doing the right thing. And the right thing is wear the mask and and limit your contact and if you’re elderly or you have other issues going on, really minimize your contact with others. I mean, it’s just not worth your worth it to wind up getting COVID.
DR. PRYSUNKA: (20:18) There’s just one last thing that I’d like to clarify, you said to go get tested, if you think there might be a chance. Just remember the free testing is for asymptomatic people, and it is a way to try and figure out if the virus is out there, because so many people are asymptomatic. So if you think that you’ve got the virus, you should call the COVID hotline and get scheduled for a test that way. If you’re just being a good citizen and want to get tested, please come up to the free testing.
SMILEY: Just one more question which is: is the EOC in Wrangell recommending any kind of specific activities as more preferable for the holiday season, or ways to still gather somewhat or mitigate but still be able to celebrate? Because I know that that is a big consideration for a lot of people that as things do get colder as we do get into the holiday season, that people are wanting to gather, are there ways or recommendations that the EOC is putting forward or are we directed to, for example, the CDC or their recommendations there? Where should people go to kind of figure out how to best balance the fact that we’re getting into the time of gathering, but also that it’s a really big time for people to be spreading the virus?
MAYOR: (21:56) You know, Dr. Zink spoke about this, and she was pretty clear that gatherings need to be stopped, and you need to keep your bubble super small. And as a matter of fact, basically was saying that if you are unsure where the people are, you know, if your bubble is extending out too far, you need to get it smaller. Unfortunately, that means [for] things like Thanksgiving, people need to be very cautious about how they proceed with Thanksgiving. I know, for our own family, we have asked our son and his girlfriend to stay down in Oregon this year, because the risks of them traveling [are just too high]. And the quarantine restrictions and so on, it’s just too, too high. So that’s not great for our family, but it is what we think is wise and what certainly the health officials are recommending. So, yeah, large gatherings are just not encouraged.
DR PRYSUNKA: (23:01) If your family is going to gather regardless, ways to reduce your risk is to make sure that you get tested and tested again a week later. And I think we get into trouble [because] we all think we’ve got a bubble, but our bubbles start to overlap. If you’ve got a bubble, [make sure] everybody in your bubble is in your bubble and not in three other bubbles. I think that will help remarkably, and remember, you just keep it in the back of your head, keep that six foot distance. And if it’s a casual ‘Just wanted to say hi from a distance,’ both wear masks and be on your way. But everything you can do to reduce that six feet 15 minute without masks situation, the better off we are. So if you’re trying to imagine what to do, if you find out you’re positive, the first question they’re gonna ask you is ‘Who have you been in contact with in the last 48 hours without a mask within six feet for greater than 15 minutes?’ And that should be less than the people on one hand. So if it’s more than that, then you’ve got to make your bubble significantly smaller.
