Alaska Department of Health and Social Services Weekly Case Analysis
November 1-7, 2020

Data previously included in this report can be found on the data hub. DHSS has also published summaries of COVID-19 deaths and hospitalizations and EPI Bulletin: Summary of COVID-19 Hospitalizations, respectively.

Brief status report

• Virus transmission across Alaska increased for the sixth week in a row.
• Hospitalizations for COVID-19 are rising and hospital capacity and staffing remain a concern.
• Positivity rates for arriving travelers getting tested at Alaska airports have nearly doubled over the last two weeks, illustrating an increased risk of travel.
• Testing is not keeping up with new cases.
• Alaskans should get tested immediately at the first sign of any symptoms. Testing is our best tool for understanding virus transmission and risk in our communities.
• Most Alaskans get COVID-19 from a friend, family member or coworker. Alaskans should avoid indoor gatherings with non-household members, avoid crowds, wear masks when around non-household members and stay six feet from anyone not in their household.

Cases by Week Reported and Age Group

Alaska emergency department visits rising for COVID-19 and COVID-19 like symptoms

As cases of COVID-19 are on the rise, so are people showing up in emergency departments but diagnosed with COVID-19 and COVID like symptoms.  Syndromic surveillance uses de-identified data from hospitals to look at trends in diseases.  The below graph is the data for both possible COVID cases (blue) and possible influenza cases (yellow) in Alaska. This graph is intended to help clinicians understand the frequency of certain symptom sets, the frequency of diagnosis of these two viruses, and the general state of viral respiratory illness in Alaska as ‘flu season’ continues with the new impact of COVID. These data suggest a few points- that there are a high frequency of people with COVID or COVID like illness (CLI) visiting emergency departments and that influenza is still infrequently seen in emergency departments. We will follow these trends as flu season develops.

Case trends and predictions

• For the sixth week in a row, more cases (3,061) were reported in Alaskans this week than any previous week, a 18% increase over last week.
• The statewide positivity rate is at a record high for the sixth week in a row. Increases in testing are not keeping up with increases in cases. 
• Cases are increasing in both urban and rural regions and increased in every region this week. For the first time, all regions of Alaska have high community transmission and are at a high alert level. The largest increase in cases was again in the Anchorage Municipality, which averaged 210 new cases a day this week, for a 14-day case rate of 72. The largest increase in case rate was in the Southern Southeast Region, which averaged 4.7 new cases a day this week, for a 14-day case rate of 23.7. Kenai Peninsula Borough also had a substantial increase in case rate, from 44.7 to 56.9.
• An updated model epidemic curve predicts Alaska’s cases will continue to accelerate over the next week and are expected to double again within the next 25 days or sooner, with a daily growth rate near 3%.

Travelers with COVID-19

The proportion of travelers testing positive at airport testing nearly doubled over the last two weeks. As airport tests are only free for Alaskan residents, this likely reflects substantially increased risk of travel over the last two weeks, which correlates with increased case rates across most of the United States.

New cases, hospitalizations and deaths

• The week of November 1-7 saw 3,061 new cases in Alaskans, for a total of 18,716 cumulative cases in Alaskans.
• Cumulative hospitalizations increased to 482 with 24 reported as occurring this week.
• Deaths among Alaska residents increased by 1 to 84 total, although the newly reported death occurred prior to the past week. It is common to take more than a week for a death to be reported.
• There were 29 nonresident cases identified this week, for a total of 1,113.

How COVID-19 spreads in Alaska

• Most new infections among Alaskans are from community spread, not from travel. Most Alaskans get the virus from someone they work, socialize, or go to school with.
• Many cases do not have a clear source, meaning that contact tracers have not been able to identify where the person got the virus. This means that there are cases in our communities that we do not know about.
• Many Alaskans who are diagnosed with COVID-19 report that they went to social gatherings, community events, church services and other social venues while they were contagious but before they knew they had the virus.

Regional case trends

*Insufficient data; low case rate

 Positivity rates

• The statewide test positivity rate went from 6.6% to 6.9% this week, which is the sixth week in a row that it is the highest it has ever been. 
• Currently, the national average is 7.7%. Since Alaska’s per-capita testing capacity is more robust than 90% of states, a positivity rate near the national average is concerning. Source: Johns Hopkins
• Test positivity can tell us if testing is adequate in an area. The goal is a positivity rate <2%. If the rate is over 5%, it means we are likely missing a lot of cases in that area.
• Test positivity is affected by the number of tests performed as well as the number of new cases in an area.

Health care capacity

• Hospitalizations hit record highs for the third week in a row and exceeded 100 Alaskans hospitalized at one time for the first time in the pandemic.
• Currently, 103 Alaskans with confirmed COVID-19 are hospitalized and 9 are requiring a mechanical ventilator.
• Hospital staffing can change quickly, particularly if a community has many health workers impacted by COVID-19.

Total Confirmed COVID Beds Occupied

COVID-19 and travel

• Travel is not currently thought to be a main factor in most new COVID-19 infections in Alaska, meaning that most Alaskans who get COVID-19 are getting it from social, work or family contacts rather than travel.
• Travel for gatherings remains risky and gets more risky as cases rise across the US. The risk is from being in close contact and enclosed spaces with others while traveling as well as gathering with friends and family members indoors who may have COVID-19 and not know it.
• Alaskans must follow Health Mandate 10.1 when returning from out-of-state travel.

What Alaskans should do

• Alaskans should avoid gatherings and crowds, wear masks when around any non-household member, keep six feet of distance from anyone not in their household and wash hands frequently to slow community transmission of COVID-19.
• Anyone with even one new symptom of COVID-19 (fever, chills, cough, shortness of breath, difficulty breathing, fatigue, muscle aches, body aches, headache, new loss of taste or smell, sore throat, congestion, runny nose, nausea, vomiting, or diarrhea), even if it is very mild, should get tested for COVID-19 right away and immediately isolate themselves from others by staying home, staying away from others, and not leaving their house except to seek testing or other medical care. Tests are most accurate in the first few days of symptoms, so testing as soon as possible after the first symptom starts is important, even if the symptom is very mild. Getting tested right away also helps contact tracers move as quickly as possible.
• Alaskans can help contact tracers work to slow the spread of COVID-19 by answering the phone promptly and providing accurate information.

Further information

• The Frequently Asked Questions webpage is often the quickest route to an answer regarding testing, travel, health mandates and other COVID-19 information.
• Please see the State of Alaska COVID-19 information 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.
• For DHSS media inquiries, please contact clinton.bennett@alaska.gov.