DHSS Alaska COVID-19 Weekly Case Update

This data summary covers COVID-19 in Alaska from Sunday, July 26th through Saturday, August 1st, 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 Alaska Coronavirus Response 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 have rapid increases in resident and nonresident new cases. 

·      The biggest increase this week was in Anchorage, which had 505 new cases, or 67% of this week’s increase.

·      Total cases in Alaska residents rose 30% this week with 755 new cases, the most Alaska has had in a single week. 

·       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.

·       There were more than four times as many people hospitalized from COVID-19 in July as there were in June or previous months.

·       Cases are expected to continue to rise, although several communities have adopted more restrictions.

·       The majority of new cases continue to be among younger adults, particularly Alaskans in their 20s and 30s.  

·       The share of cases by race distribution rose by 4% among Alaska Native People, 1% among African Americans, and 1% among Native Hawaiian and Pacific Islanders this week. Many cases continue to be under investigation, so race distribution data lags overall case counts.  

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

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

Correction

The Alaska State Hospital and Nursing Home association has clarified that the hospital bed counts provided to the State of Alaska Department of Health and Social Services and displayed on the Dashboard include adult and pediatric (child and teenager) staffed ICU beds but do not include NICU beds. NICU beds are used only for infants. Hospitals excluding NICU beds ensures that ICU bed counts reflect only beds that could be potentially used for adult or teenage patients who are severely or critically ill with COVID-19. Inpatient beds include all staffed inpatient beds. The total bed count includes surge capacity using all areas of the hospital. 

Larger Outbreaks

Defined as more than 5 people linked to a single location, workplace or event. This is a compilation of previously publicly reported outbreak events. This does not represent every instance of an outbreak or large outbreak in Alaska and is not comprehensive. Several of these outbreaks or clusters are still undergoing investigation and some data may be updated in the future as more information comes to light through ongoing efforts in contact tracing and testing.

LocationFirst case foundAssociated industry or setting# cases in outbreakHospitalizations  & deaths
OBI/Seward7/19Seafood 139 (of 252 workers total) 
Copper River Seafoods/Anchorage7/17Seafood76 (of 135 workers total) 
F/V American Triumph7/16Seafood85 (of 119 aboard)1 hospitalized
Alaska Glacier Seafoods plant/Juneau7/4Seafood62 (of 150 workers total) 
M/V Tustumena6/6Alaska Marine Highway101 hospitalized
Whittier Seafoods6/1Seafood11 
PTCC5/29Elder care595 hospitalizations, 2 deaths

New cases

A total of 755 new cases were identified in Alaskans and 126 new cases were identified in nonresidents, for a total of 3,280 and 704 respectively. A total of 19 Alaskans required hospitalization this week for COVID-19, for a total of 134 hospitalizations since the epidemic began. Four additional deaths were reported this week, for a total of 24 fatalities since the epidemic began. 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 double about every 21 days, worse than last week where cases were projected to double every 23 days. 

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

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Cumulative Cases by Death, Recovered, and Active Status

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Communities affected this week 

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

·        Anchorage (505), Chugiak (7), Eagle River (21), and Girdwood (1), for a total of 534 new cases in the Anchorage Municipality. Anchorage cases alone make up 67% of this week’s cases. 

·        Fairbanks (35), North Pole (3), and a smaller community (1), for a total of 39 new cases in the Fairbanks North Star Borough

·        Wasilla (39), Palmer (26), Houston (1), Willow (2), Sutton-Alpine (1), Big Lake (3), and a smaller community or communities (2) for a total of 74 new cases in the Matanuska-Susitna Borough

·        Kenai (9), Seward (4), Soldotna (9), and Homer (11) for a total of 33 new cases in the Kenai Peninsula Borough

·        Cordova (5), Valdez (3) and 2 in smaller communities or community in Valdez-Cordova Census Area, for a total of 10

·        Yukon-Koyukuk Census Area (4)

·        Juneau (14)

·        Ketchikan (2)

·        Kotzebue (4) and 13 in a smaller community or communities in the Northwest Arctic Borough, for a total of 17

·        Sitka (4)

·        Yakutat plus Hoonah Census Area (4)

·        Bethel (2) and one in a smaller community, for 3 in Bethel Census Area 

·        Unalaska (2)

·        Utqiaġvik (5) 

·        Craig (2) and 2 in a smaller community or communities for a total of 4 in the Prince of Wales-Hyder Census Area 

·        Wrangell (3)

·        Kodiak (1)

·        Kusilvak Census Area (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, Anchorage Municipality remains in the red, having doubled its case rate from 14 to 28 in the last week. The Interior Region has improved to 7 from 29 last week, and the Northwest Region has passed it, now at 8.85, also nearly doubled from 4.7 last week and now in the high orange zone. Next, Fairbanks North Star Borough and Kenai Peninsula Borough had 6.7 and 7.3 respectively, both declined modestly since last week. Matanuska-Susitna Borough has increased to 8.6 from 6.3 last week. Juneau City and Borough held steady at 6.7, while the southernmost Southeast Region improved from orange to yellow, with 4.3 from 5.7 last week. The northern Southeast Region is now in orange, at 7.7. 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 nursing home 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 has continued to have case rates in the high alert level, with a case rate of 18; now surpassed by the Anchorage Municipality, which nearly doubled its rate in a week from 10.9 to 20.5. Fairbanks itself has improved slightly within the high orange/intermediate, at 7.2. Kenai Peninsula Borough’s rate has improved slightly to 8 from 9.6 last week. Matanuska-Susitna Borough rose to 7.25 from 5.8 and Juneau City and Borough from 5.6 to 6.7, and were joined by the Northwest Borough and the Northern and Southern Southeast Regions in the intermediate (orange) alert level, with case rates of 7.3, 5.9 and 5.0 respectively. Other regions had case rates <5. 

Alaska COVID-19 Alert Levels

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More information on alert levels is available on this page

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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 masks when around any non-household members or in public, and responding promptly to being contacted. 

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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. 

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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. 

RaceNumber of casesPercent of cases (of those for whom a race is known)Percent of Alaska population
American Indian and Alaska Native40224% (4% increase from last week)16%
Native Hawaiian and Pacific Islanders1157% (1% increase from last week)1%
Black/African American875% (1% increase from last week)4%
Asian 875%7%
Multiple744%8%
White87452%65%
Other race503% 
Total for whom a race is known1689  
Under investigation1146  
Race unknown115  
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Hospital capacity

Hospitals remain below capacity, with ventilators and ICU beds available, but use is rising. 134 Alaskans have required hospitalization for COVID-19. 19 have been hospitalized in the last week and bed occupancy due to COVID-19 is rising. The increase in need for hospitalization has followed the rise in cases by a few weeks. 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. Hospitals report all inpatient beds in this total, including those for infants and obstetrics. However, the Alaska State Hospital and Nursing Home Association has now clarified that hospitals have been reporting and continue to report only staffed adult and pediatric ICU beds and do not include any NICU beds. NICU beds can only be used for infants and would not be useful for teenage or adult patients with severe COVID-19. DHSS regrets the error in previous weekly updates and wishes to thank ASHNHA for the clarification. 

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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 ethnicityCardiovascular diseaseCOPDDiabetes Obesity Current smoker
Multiple races, non-Latino3.3%*2.4%*7.2%28.6%12.9%
Hispanic or Latino5.2%*5%*10%23.1%25.5%
White4.2%5%8.3%30.6%15.9%
Native Hawaiian or Other Pacific IslanderNo data availableNo data available6.6%*55.4%17.9%
Black or African American8%*6.1%*17.2%44.3%20%
AsianNo data available2.9%*8.6%18.7%8.5%
Alaska Native4.6%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 24 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.

RaceNumber of casesPercent of cases who were or are hospitalizedPercent of cases who have died
Native Hawaiian and Pacific Islander13016.2%2.3% 
Asian9410.6% 2.1% 
American Indian and Alaska Native4248.3% 2.1% 
Black/African American974.1% 0%
Multiple races940% 0%
White9055.4% 1.2%  
Other676.0% 0%
Unknown1707.1% 0%
Not yet identified13600%0% 
All cases33414.0%0.7%

Reporting of deaths due to COVID-19

24 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. One death that had previously been counted as in an Alaskan was reclassified this week to be counted in another state’s totals after more information came to light. 

Recovered cases

117 Alaskans recovered from COVID-19 this week, for a total of 932, or 28% of total cases. This is a decrease of 7% from last week, meaning that more Alaskans are getting COVID-19 than are recovering from it and this trend is accelerating. 

Nonresident cases

Of the 126 nonresident cases identified this week, 48 were in the Kenai Peninsula Borough, 18 were in Juneau City and Borough, 12 were in the Anchorage Municipality, 8 were in the Matanuska-Susitna Borough, 4 were in the Kodiak Island Borough, 3 were in Fairbanks North Star Borough, 4 were in the Valdez-Cordova Census Area, 2 were in the Ketchikan Gateway Borough, 1 was in the Bristol Bay plus Lake and Peninsula Census Area and 1 was in the North Slope Borough. 25 nonresident cases did not yet have their location identified. 

64 nonresident cases were associated with the seafood industry, 8 with tourism or visiting purposes, 1 with the oil industry, 1 with mining, and 2 with other industries. 

Testing update

By Saturday evening, 38,024 tests had been resulted this week in Alaska, an increase of 38% over last week, for a total of 243,090. Test positivity rate for this week averaged 2.6%, up from 2.5% last week, meaning around 26 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. 

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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 masks, 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 24th through Thursday, July 30th. 

This week saw 24,622 travelers screened at airports entering Alaska, and 7,984 (32%) opted to be tested on entry. The other options available to them were a 14 day quarantine (selected by 2,978 passengers, 12%) or providing proof of another test performed within 72 hours of landing in Alaska, which 12,606 passengers did (51%). The remaining 1,054 (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. 34 new cases were discovered through airport arrival testing, for a test positivity rate of ~0.4%. 

Since testing began eight weeks ago, 148,796 travelers have been screened at Alaska airports. 63,954 (43%) tested prior to travel, 48,542 (33%) have tested in Alaska airports, and 18,611 (13%) selected a 14 day quarantine. There have been 273 positive tests through airport testing, for an overall test positivity rate of 0.6%.

Of the 126 cases in nonresidents this week, 8 were linked with tourism or visiting, including 2 in Juneau City and Borough, 2 in the Matanuska-Sustina Borough, 2 in the Kenai Peninsula, and one in the Ketchikan Gateway Borough. One had not yet had a location identified.

Seafood industry

Of 126 nonresident cases total identified this week, 64 are in workers in the seafood industry, including 43 in the Kenai Peninsula Borough, 11 in the Juneau City and Borough, 6 in Anchorage, 3 in the Valdez-Cordova Census Area and 1 in the Kodiak Island Borough. All nonresidents with COVID-19 are quarantined and contact tracing is ongoing for these cases. Most cases are associated with one of several major outbreaks in the seafood industry, including at seafood processing plants in Juneau, Seward and Anchorage.

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 data or the dashboard, email data.coronavirus@alaska.gov

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.

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