Alaska Department of Health and Social Service Weekly COVID-19 and Influenza Update
January 9 – January 15, 2022

Key Findings

• COVID-19 cases are rising very rapidly across most of Alaska, the great majority of which are likely due to the Omicron variant.
• Appreciable levels of influenza transmission began occurring in mid-December and have continued since then.
• Other respiratory viruses are circulating in addition to SARS-CoV-2 and influenza virus.

COVID-19

COVID-19 Case Trends

• High levels of COVID-19 transmission are occurring throughout much of Alaska and the pandemic is on a rapid upward trajectory in Alaska. Hospitalizations are increasing as well.
• 15,145 cases were reported in Alaskans the week of January 9–January 15. This is a 97.4% increase from the number of cases reported the week before. This increase in cases is the largest week-over-week increase recorded in Alaska in terms of the absolute number of cases and is also among the largest in terms of the proportional increase.  
• The number of reported COVID-19 cases last week was substantially higher in all 5 of the most populous boroughs compared to the previous week.
• The intensity of COVID-19 transmission varies between communities outside the largest boroughs, but many boroughs and census areas have seen recent and large increases in COVID-19 cases, and some have reached levels of weekly case counts not previously seen in the pandemic.
• Community transmission of the Omicron variant has been confirmed in multiple regions across Alaska. Laboratory evidence indicates that the Omicron variant has become the dominant SARS-CoV-2 variant in Alaska and is driving the sharp acceleration of the pandemic in Alaska. Visit Alaska’s SARS-CoV-2 Genomics Dashboard to learn more.  
• To learn more about COVID-19 cases, hospitalizations, and deaths due to COVID-19 in Alaska, visit the Cases Dashboard or the monthly report. The cases dashboard includes demographic information on cases and the monthly report includes demographic information on hospitalizations and deaths.

COVID-19 cases among Alaska residents by week of onset date.

Borough/Census Area	Alert Level December 27	Alert Level January 3	Alert Level January 10	Alert Level January 19
Count	Rate	Count	Rate	Count	Rate	Count	Rate
Anchorage Municipality	393	136.0	2,180	754.4	4,709	1,629.6	8,330	2,882.7
Fairbanks North Star Borough	125	128.7	224	230.5	753	775.0	1,559	1,604.6
Juneau City and Borough	73	229.8	259	815.2	531	1,671.2	742	2,335.3
Kenai Peninsula Borough	78	132.4	100	169.7	266	451.4	726	1,231.9
Matanuska-Susitna Region	107	99.7	439	409.1	391	364.4	1,305	1,216.2
Nome Census Area	19	194.5*	25	255.9	165	1,689.0	279	2,856.0
North Slope Borough	6	61.4*	35	358.2	76	777.8	103	1,054.1
Northwest Arctic Borough	15	197.8*	44	580.2	86	1,134.1	191	2,518.8
Chugach Census Area	2	**	9	133.3*	33	488.8	59	873.9
Copper River Census Area	6	222.3*	7	259.4*	13	481.7*	28	1,037.4
Denali Borough	1	**	4	**	1	**	12	664.5*
Southeast Fairbanks Census Area	7	100.9*	18	259.5*	21	302.7	47	677.5
Yukon-Koyukuk Census Area	1	**	23	456.0	76	1,506.7	29	574.9
Haines Borough	0	**	32	1,269.8	38	1,507.9	36	1,428.6
Petersburg Borough	6	188.1*	5	**	6	188.1*	15	470.4*
Sitka City and Borough	29	340.3	72	844.8	160	1,877.3	154	1,806.9
Skagway Municipality	1	**	2	**	1	**	2	**
Wrangell City and Borough	1	**	2	**	27	1,134.9	55	2,311.9
Yakutat plus Hoonah-Angoon	9	339.9*	6	226.6*	19	717.5*	34	1,284.0
Ketchikan Gateway Borough	52	380.2	50	365.6	72	526.4	217	1,586.6
Prince of Wales-Hyder Census Area	7	114.9*	5	**	97	1,592.8	82	1,346.5
Bethel Census Area	18	100.7*	40	223.9	120	671.6	307	1,718.2
Kusilvak Census Area	35	432.7	17	210.2*	97	1,199.3	207	2,559.3
Aleutians East Borough	1	**	2	**	10	341.9*	27	923.1
Aleutians West Census Area	4	**	12	216.5*	72	1,298.7	204	3,679.7
Dillingham Census Area	7	146.7*	14	293.3*	26	544.7	64	1,340.9
Kodiak Island Borough	13	103.1*	57	452.0	341	2,704.0	444	3,520.7
Bristol Bay plus Lake and Peninsula	4	**	6	247.9*	17	702.5*	34	1,405.0
Statewide	1,020	139.9	3,689	506.1	8,225	1,128.4	15,305	2,099.7

Alert levels by borough and census area are based on the number of reported cases over the past 7 days per 100,000 residents.
*Rates based on <20 observations are statistically unreliable and should be used with caution.
**Rates based on <6 observations are not reported.

COVID-19 and Hospital Capacity

• Hospital capacity is currently very limited because of staff being out with COVID-19 and because of high numbers of patients.
• The Crisis Care Committee remains active seeking input from, and providing guidance to, health care providers, including allocating, augmenting, or moving constrained resources during this surge to maximize the health of all Alaskans.
• As of January 19, 2022 there were 100 persons with COVID-19 in Alaska hospitals, accounting for 10.3% of all hospitalized persons. Visit the Hospital Dashboard for more data.

Total Confirmed COVID Beds Occupied

COVID-19 and Vaccination

• 68.6% of Alaska residents aged ≥5 years have received at least one dose of a COVID-19 vaccine. Among those who completed the primary vaccine series, 45.2% of Alaska residents ≥18 years have received their booster. Learn more about COVID-19 vaccination coverage in Alaska on the Vaccine Dashboard.
• Vaccines help protect against infection and against severe disease, especially when a person is up to date on vaccinations. Unvaccinated Alaskans are more than 10 times more likely to be hospitalized due to COVID-19 than Alaskans who have completed the primary series of COVID-19 vaccination and are more than 12 times more likely to die from COVID-19. See the monthly report to learn more.
• Among Alaska residents aged ≥5 years from January 16, 2021–January 15, 2022, 40,937 cases were documented in persons who had completed the primary series and were considered fully vaccinated. Among those vaccine-breakthrough cases, 386 hospitalizations and 133 deaths due to COVID-19 have been recorded. During that time, 76,460 cases have been documented in unvaccinated Alaskans aged ≥5 years, leading to 1,677 hospitalizations and 546 deaths. All data are preliminary and subject to change.
• During the Omicron wave, cases in vaccinated persons have become more frequent, but Alaskans who are up-to-date on their COVID-19 vaccines (i.e., completed the primary series and received a booster dose, if eligible) still have lower rates of becoming a case than those who are unvaccinated or are not up-to-date.

In order to more easily identify changes over time, the definition of “up-to-date” as of January 8, 2022 was applied to data from all time points.

Influenza (“Flu”)

• Reported influenza cases began increasing in Alaska in mid-December. The number of reported cases from the week of January 9–January 15 was similar to the number the prior week.
• Right now, most influenza in Alaska is caused by influenza A.
• 23% of Alaskans aged ≥10 years have been vaccinated against seasonal influenza. It is not too late to get vaccinated against influenza.
• Last week, far more cases of influenza were reported from Anchorage than any other region. Learn more in the weekly Alaska Influenza Snapshot.

Positive influenza lab reports in Alaska by week of specimen collection for the 2017-2018 influenza season through present. The current season through January 15, 2022 is shown in red.

Emergency Department Visits with COVID-like or Influenza-like Illness

• Syndromic surveillance consists of analyzing data on symptoms and diagnoses among patients visiting emergency departments in Alaska. The main goal is to identify trends. Unlike case-based surveillance, syndromic surveillance does not depend on laboratory testing.
• Influenza-like illness (ILI) is defined as having a fever and at least one other symptom, such cough or sore throat. Patients with a diagnosis of influenza are also included, regardless of symptoms.
• COVID-like illness (CLI) encompasses a broader array of respiratory and other symptoms than influenza-like illness. This category also includes any patient with a diagnosis of COVID-19, regardless of symptoms.
• Patients with a diagnosis of COVID-19 are excluded from the ILI category and, likewise, patients with a diagnosis of influenza are excluded from the CLI category. But a patient without a diagnosis for either could be included in both the CLI and ILI categories. CLI and ILI may be caused by respiratory viruses other than SARS-CoV-2 and influenza virus.
• As the Delta variant wave waned in Alaska in late October and November 2021, the percentage of emergency department patients with CLI declined. However, it has increased over the past few weeks since mid-December and is now at a level similar to that seen at the peak of the Delta wave.
• ILI levels have been low for most of the past year but increased substantially in December. This increase corresponds to an increasing number of reported laboratory-confirmed influenza cases.

Take action to protect yourself and your family

• Get vaccinated and stay up to date: COVID-19 vaccines are available for everyone aged 5 and older. Booster shots are available for everyone aged 12 and older if enough time has passed since the initial vaccine series. Getting vaccinated and boosted will help protect you, your family, and your community against COVID-19. Learn more about COVID-19 vaccines. You can visit vaccines.gov or text your zip code to GETVAX (438829) in English, or VACUNA (822862) for Spanish.
• Wear a mask indoors in public: Wearing a well-fitting mask when in indoor public spaces, regardless of vaccination status, is an important step to take to slow the spread of COVID-19. Most Alaskans live in an area with substantial or high community transmission where this action is needed to protect your health and the health of others. Some masks such as surgical, KN95, or N95 masks provide higher filtration and therefore better protection than cloth face coverings, but only if the mask fits your face well and is worn consistently.
• Practice physical distancing: When possible, avoid crowds and keep your distance from others while in public settings – particularly when indoors.
• Get tested: Seek testing if you have any symptoms or have been exposed to an infected person. If you do test positive, isolate right away and notify your contacts. Ask your contacts to get tested at the appropriate time and, if they are not up to date on COVID vaccination, to quarantine. Learn more about COVID-19 testing.
• Know your treatment options: If you test positive and you’re at increased risk for severe COVID, ask a health care provider about monoclonal antibody treatment or oral antivirals. These treatments reduce the risk of hospitalization. This treatment works best when given soon after symptoms start. Learn more about COVID-19 treatments.

Information and Resources

• The State of Alaska COVID-19 vaccines update page
• The State of Alaska COVID-19 information page provides more information about the virus and how individuals and businesses can protect themselves and others from transmission. 
• DHSS COVID-19 Communication Toolkit provides PSAs, flyers, and social media graphics.
  • Learn more about the importance of physical activity, highlighted by our Play Every Day and our Healthy You 2022 campaigns: Play Every Day.
• Subscribe to the DHSS Insights blog for behind-the-scenes news about Alaska’s COVID-19 response and other efforts to protect the health and well-being of Alaskans.
• DHSS offers free presentations upon request to groups about COVID-19, the vaccines, COVID-19 prevention, or other health topics upon request. Learn more or request a presentation on our Speaker’s Bureau web page.
• For the most up-to-date case information, see the Alaska Coronavirus Response Hub dashboard: data.coronavirus.alaska.gov. All dashboard data are updated Mondays, Wednesdays, and Fridays (except holidays). 
• For DHSS media inquiries, please contact clinton.bennett@alaska.gov

ECHO sessions

ECHO sessions create virtual learning communities by connecting Alaska’s health experts with specific audiences on specific topics. These sessions are produced and facilitated by UAA’s Center for Human Development Alaska ECHO project in partnership with the State of Alaska, Department of Health & Social Services.

Below is a selection of upcoming ECHO sessions. The full schedule of ECHO sessions and access to COVID-19 ECHO videos and slideshows are available for download anytime on the DHSS ECHO web page.

School Health ECHO
Monday, 3-4 p.m. (Register)
The School Health ECHO is a virtual learning network intended for professionals in the education setting (administrators, school-based nurses, etc.) to interface with a team of medical and education experts in Alaska.

Vaccine ECHO for Providers
Tuesday, 2-3 p.m. (Register)
The Vaccine ECHO for providers provides planning and operation updates to vaccine providers across Alaska, while answering any questions you may have.

Public Science ECHO
Wednesday, noon-1 p.m. (Register)
The Alaska Public Health Science ECHO is a virtual learning network intended for the general public to interface with our Public Health Leadership Team to explore the science of the COVID-19 virus, other public health topics, and current best practices. Or view via concurrent livestream to Facebook: https://www.facebook.com/akechoprograms

Healthcare Specific Situational Awareness ECHO
Thursday, noon-1 p.m. (Register)
The Healthcare Specific Situational ECHO is a virtual learning network intended for healthcare professionals to interface with our Public Health Leadership Team to explore current best practices and the most recent information related to Public Health.

Key Findings

• COVID-19 cases are rising very rapidly across most of Alaska, the great majority of which are likely due to the Omicron variant.
• Appreciable levels of influenza transmission began occurring in mid-December and have continued since then.
• Other respiratory viruses are circulating in addition to SARS-CoV-2 and influenza virus.

COVID-19

COVID-19 Case Trends

• High levels of COVID-19 transmission are occurring throughout much of Alaska and the pandemic is on a rapid upward trajectory in Alaska. Hospitalizations are increasing as well.
• 7,654 cases were reported in Alaskans the week of January 2–January 8. This is a 115% increase from the number of cases reported the week before. While differences in testing and reporting due to the holidays make quantifying the rate of increase more challenging, this increase in cases is the largest week-over-week increase recorded in Alaska in terms of the absolute number of cases and is also among the largest in terms of the proportional increase.
• The number of new COVID-19 cases has continued to increase rapidly in the most populous boroughs, with weekly case counts in the Municipality of Anchorage and the City and Borough of Juneau reaching record levels. Cases were up sharply in both the Kenai Peninsula Borough and the Fairbanks North Star Borough. Reported cases last week in the Matanuska-Susitna Borough were similar to levels reported the previous week, but this likely reflects a large reduction in testing availability related to severe weather.
• The intensity of COVID-19 transmission varies between communities outside the largest boroughs, but many boroughs and census areas have seen recent and large increases in COVID-19 cases and in some instances have reached levels of weekly case counts not previously seen in the pandemic.
• Community transmission of the Omicron variant has been confirmed in Anchorage and is likely widespread in Alaska. Laboratory evidence indicates that the Omicron variant has become the dominant SARS-CoV-2 variant in Alaska and is driving the sharp acceleration of the pandemic in Alaska. Visit Alaska’s SARS-CoV-2 Genomics Dashboard to learn more.  
• To learn more about COVID-19 cases, hospitalizations, and deaths due to COVID-19 in Alaska, visit the Cases Dashboard or the monthly report. The cases dashboard includes demographic information on cases and the monthly report includes demographic information on hospitalizations and deaths.

COVID-19 cases among Alaska residents by week of onset date.

Borough/Census Area	Alert Level December 20	Alert Level December 27	Alert Level January 3	Alert Level January 10
Count	Rate	Count	Rate	Count	Rate	Count	Rate
Anchorage Municipality	435	150.5	393	136.0	2,180	754.4	4,709	1,629.6
Fairbanks North Star Borough	123	126.6	125	128.7	224	230.5	753	775.0
Juneau City and Borough	55	173.1	73	229.8	259	815.2	531	1,671.2
Kenai Peninsula Borough	72	122.2	78	132.4	100	169.7	266	451.4
Matanuska-Susitna Region	181	168.7	107	99.7	439	409.1	391	364.4
Nome Census Area	45	460.6	19	194.5*	25	255.9	165	1,689.0
North Slope Borough	4	**	6	61.4*	35	358.2	76	777.8
Northwest Arctic Borough	17	224.2*	15	197.8*	44	580.2	86	1,134.1
Chugach Census Area	10	148.1*	2	**	9	133.3*	33	488.8
Copper River Census Area	3	**	6	222.3*	7	259.4*	13	481.7*
Denali Borough	0	**	1	**	4	**	1	**
Southeast Fairbanks Census Area	2	**	7	100.9*	18	259.5*	21	302.7
Yukon-Koyukuk Census Area	17	337.0*	1	**	23	456.0	76	1,506.7
Haines Borough	4	**	0	**	32	1,269.8	38	1,507.9
Petersburg Borough	6	188.1*	6	188.1*	5	**	6	188.1*
Sitka City and Borough	23	269.9	29	340.3	72	844.8	160	1,877.3
Skagway Municipality	1	**	1	**	2	**	1	**
Wrangell City and Borough	0	**	1	**	2	**	27	1,134.9
Yakutat plus Hoonah-Angoon	3	**	9	339.9*	6	226.6*	19	717.5*
Ketchikan Gateway Borough	52	380.2	52	380.2	50	365.6	72	526.4
Prince of Wales-Hyder Census Area	7	114.9*	7	114.9*	5	**	97	1,592.8
Bethel Census Area	31	173.5	18	100.7*	40	223.9	120	671.6
Kusilvak Census Area	52	642.9	35	432.7	17	210.2*	97	1,199.3
Aleutians East Borough	0	**	1	**	2	**	10	341.9*
Aleutians West Census Area	0	**	4	**	12	216.5*	72	1,298.7
Dillingham Census Area	5	**	7	146.7*	14	293.3*	26	544.7
Kodiak Island Borough	8	63.4*	13	103.1*	57	452.0	341	2,704.0
Bristol Bay plus Lake and Peninsula	3	**	4	**	6	247.9*	17	702.5*
Statewide	1,160	159.1	1,020	139.9	3,689	506.1	8,225	1,128.4

Alert levels by borough and census area are based on the number of reported cases over the past 7 days per 100,000 residents.
*Rates based on <20 observations are statistically unreliable and should be used with caution.
**Rates based on <6 observations are not reported.

COVID-19 and Hospital Capacity

• Hospital capacity is currently very limited because of staff being out with COVID-19 and because of high numbers of patients.
• The Crisis Care Committee remains active seeking input from, and providing guidance to, health care providers, including allocating, augmenting, or moving constrained resources during this surge to maximize the health of all Alaskans.
• As of January 10, 2022 there were 79 persons with COVID-19 in Alaska hospitals, accounting for 7.7% of all hospitalized persons. Visit the Hospital Dashboard for more data.

Total Confirmed COVID Beds Occupied

COVID-19 and Vaccination

• 68.2% of Alaska residents aged ≥5 years have received at least one dose of a COVID-19 vaccine. Among those who completed the primary vaccine series, 43.8% of Alaska residents ≥18 years have received their booster. Learn more about COVID-19 vaccination coverage in Alaska on the Vaccine Dashboard.
• Vaccines help protect against infection and against severe disease, especially when a person is up to date on vaccinations. Unvaccinated Alaskans are more than 10 times more likely to be hospitalized due to COVID-19 than Alaskans who have completed the primary series of COVID-19 vaccination and are more than 12 times more likely to die from COVID-19. See the monthly report to learn more.
• Among Alaska residents aged ≥5 years from January 16, 2021–January 8, 2022, 31,951 cases were documented in persons who had completed the primary series and were considered fully vaccinated. Among those vaccine-breakthrough cases, 352 hospitalizations and 112 deaths due to COVID-19 have been recorded. During that time, 69,267 cases have been documented in unvaccinated Alaskans aged ≥5 years, leading to 1,639 hospitalizations and 504 deaths. All data are preliminary and subject to change.
• During the Omicron wave, cases in vaccinated persons have become more frequent, but Alaskans who are up-to-date on their COVID-19 vaccines (i.e., completed the primary series and received a booster dose, if eligible) still have lower rates of becoming a case than those who are unvaccinated or are not up-to-date.

In order to more easily identify changes over time, the definition of “up-to-date” as of January 8, 2022 was applied to data from all time points.

Influenza (“Flu”)

• Reported influenza cases began increasing in Alaska in mid-December. The number of reported cases from the week of January 2–January 8 was similar to the number the prior week.
• Right now, most influenza in Alaska is caused by influenza A.
• 22% of Alaskans aged ≥10 years have been vaccinated against seasonal influenza. It is not too late to get vaccinated against influenza.

Last week, far more cases of influenza were reported from Anchorage than any other region. Learn more in the weekly Alaska Influenza Snapshot

Positive influenza lab reports in Alaska by week of specimen collection for the 2017-2018 influenza season through present. The current season through January 8, 2022 is shown in red.

Emergency Department Visits with COVID-like or Influenza-like Illness

• Syndromic surveillance consists of analyzing data on symptoms and diagnoses among patients visiting emergency departments in Alaska. The main goal is to identify trends. Unlike case-based surveillance, syndromic surveillance does not depend on laboratory testing.
• Influenza-like illness (ILI) is defined as having a fever and at least one other symptom, such cough or sore throat. Patients with a diagnosis of influenza are also included, regardless of symptoms.
• COVID-like illness (CLI) encompasses a broader array of respiratory and other symptoms than influenza-like illness. This category also includes any patient with a diagnosis of COVID-19, regardless of symptoms.
• Patients with a diagnosis of COVID-19 are excluded from the ILI category and, likewise, patients with a diagnosis of influenza are excluded from the CLI category. But a patient without a diagnosis for either could be included in both the CLI and ILI categories. CLI and ILI may be caused by respiratory viruses other than SARS-CoV-2 and influenza virus.
• As the Delta variant wave waned in Alaska in late October and November 2021, the percentage of emergency department patients with CLI declined. However, in the past two weeks it has rapidly increased.
• ILI levels have been low for most of the past year but increased substantially in December. This increase corresponds to an increasing number of reported laboratory-confirmed influenza cases.

Take action to protect yourself and your family

• Get vaccinated and stay up to date: COVID-19 vaccines are available for everyone aged 5 and older. Booster shots are available for everyone aged 12 and older if enough time has passed since the initial vaccine series. Getting vaccinated and boosted will help protect you, your family, and your community against COVID-19. Learn more about COVID-19 vaccines. You can visit vaccines.gov or text your zip code to GETVAX (438829) in English, or VACUNA (822862) for Spanish.
• Wear a mask indoors in public: Wearing a well-fitting mask when in indoor public spaces, regardless of vaccination status, is an important step to take to slow the spread of COVID-19. Most Alaskans live in an area with substantial or high community transmission where this action is needed to protect your health and the health of others. Some masks such as surgical, KN95, or N95 masks provide higher filtration and therefore better protection than cloth face coverings, but only if the mask fits your face well and is worn consistently.
• Practice physical distancing: When possible, avoid crowds and keep your distance from others while in public settings – particularly when indoors.
• Get tested: Seek testing if you have any symptoms or have been exposed to an infected person. If you do test positive, isolate right away and notify your contacts. Ask your contacts to get tested at the appropriate time and, if they are not up to date on COVID vaccination, to quarantine. Learn more about COVID-19 testing.

Know your treatment options: If you test positive and you’re at increased risk for severe COVID, ask a health care provider about monoclonal antibody treatment or oral antivirals. These treatments reduce the risk of hospitalization. This treatment works best when given soon after symptoms start. Learn more about COVID-19 treatments.

Information and Resources

• The State of Alaska COVID-19 vaccines update page
• The State of Alaska COVID-19 information page provides more information about the virus and how individuals and businesses can protect themselves and others from transmission. 
• DHSS COVID-19 Communication Toolkit provides PSAs, flyers, and social media graphics.
• Subscribe to the DHSS Insights blog for behind-the-scenes news about Alaska’s COVID-19 response and other efforts to protect the health and well-being of Alaskans.
• DHSS offers free presentations upon request to groups about COVID-19, the vaccines, COVID-19 prevention, or other health topics upon request. Learn more or request a presentation on our Speaker’s Bureau web page.
• For the most up-to-date case information, see the Alaska Coronavirus Response Hub dashboard: data.coronavirus.alaska.gov. All dashboard data are updated Mondays, Wednesdays, and Fridays (except holidays). 

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

ECHO Sessions

Session information and recordings of previous ECHO sessions
subscribe to ECHO calendar updates | email: echo@alaskachd.org | website: akecho.org

ECHO sessions create virtual learning communities by connecting Alaska’s health experts with specific audiences on specific topics. These sessions are produced and facilitated by UAA’s Center for Human Development Alaska ECHO project in partnership with the State of Alaska, Department of Health & Social Services.

Below is a selection of upcoming ECHO sessions. The full schedule of ECHO sessions and access to COVID-19 ECHO videos and slideshows are available for download anytime on the DHSS ECHO web page.

School Health ECHO
Monday, 3-4 p.m. (Register)
The School Health ECHO is a virtual learning network intended for professionals in the education setting (administrators, school-based nurses, etc.) to interface with a team of medical and education experts in Alaska.

Vaccine ECHO for Providers
Tuesday, 2-3 p.m. (Register)
The Vaccine ECHO for providers provides planning and operation updates to vaccine providers across Alaska, while answering any questions you may have.

Public Science ECHO
Wednesday, noon-1 p.m. (Register)
The Alaska Public Health Science ECHO is a virtual learning network intended for the general public to interface with our Public Health Leadership Team to explore the science of the COVID-19 virus, other public health topics, and current best practices. Or view via concurrent livestream to Facebook: https://www.facebook.com/akechoprograms

Healthcare Specific Situational Awareness ECHO
Thursday, noon-1 p.m. (Register)
The Healthcare Specific Situational ECHO is a virtual learning network intended for healthcare professionals to interface with our Public Health Leadership Team to explore current best practices and the most recent information related to Public Health.Special Pop-Up Session: Alaska Medical Provider ECHO
Tuesday, Jan. 18, 7-8 p.m. (Register)
This special pop-up session of the Alaska Medical Provider ECHO features updates on COVID-19, including the Omicron variant and new Federal guidelines.

SITKA, January 12, 2022 – Dr. Bruhl, Southeast Alaska Regional Health Consortium (SEARHC) Chief Medical Officer and Incident Commander reported the current surge with the Omicrom variant was rolling through the entire State of Alaska. He said the State of Alaska was lagging a few weeks behind the lower 48. He reported virtually all the variants that were being tested around the State was the Omicrom variant. He noted it was much more transmissible but less virulent. People were not as sick in general although, those that were still susceptible were and can get very and even deathly sick. He stated COVID-19 continued to be a real threat to human health especially with those that had chronic medical problems and people over the age of 65. He said the community needed to protect them and continue to do so with being aware of wearing masks around others, maintaining social distance, and washing hands. He stated that they were seeing cases of the flu which was another good reason for mitigations.

With regards to added activities that the hospital was undertaking, to reflect increased level of caution, Dr. Bruhl stated they had restricted the use of the cafeteria to whom was in or directly related to the hospital and they were not allowing congregation there. He said that staff was using N95 masks for all direct patient to patient contact noting that the ambulatory environments were using surgical masks. He said that because the hospital was where the most vulnerable were taken care of in general, they were insisting on N95 use for all patient to patient contacts in that environment. He said the CDC announcement two weeks ago changed the guidance for employers to allow staff who have contracted COVID-19 to return to employment after five days if they were asymptomatic and if all was resolved after the five days and it was safe to return to work, the requirement to wear a mask for a minimum of five days. He noted that most surgical masks would be fine. He emphasized the important of personal hygiene such as washing hands, not touching nose and eyes, wearing a mask, maintaining social distance, and to not go to work if you were sick. He stated that those were the basic measures as a community that would help the most.

Planning Section Chief Rob Janik reported Fire Hall protocols in place for a long time now of all patient contact with an N95 mask with eye protection or a Powered Air Purifying Respirator (PAPR). He noted the importance that the PAPR does not filter the exiting air. He stated they were OK with supplies and were doing testing of staff members if exposed or symptomatic. He said that there was an EMT training program this weekend with a lot of mitigation in place. 

Public Health Nurse Denise Ewing urged those to help slow the spread of COVID-19 by staying home if you were sick. She noted if you had tested positive at a testing site or with a personal at home test to isolate yourself and notify your close contacts. She informed that close contacts were those you have been with 2 days prior to symptoms or go to by your test date if you did not have symptoms. She said to wash hands, wear masks, get vaccinated and take care of your overall mental and physical health.

Ewing told of the three masks that were suggested by the CDC as superior during Omicron: N95, double straps worn by medical professionals, which would say NOSH on them and to be careful of knock offs; KN95, ear loop straps, sewn to a point; and KF95, ear loop straps with flat panel in front. She suggested considering to upgrading to a higher filtration mask. She noted that surgical masks, cloth masks, gaiters/buffs were not as effective unless doubled up and to make sure it was sealed around the face with no gaps. She stated if glasses fog up, the mask was not sealed well enough.

She told that the SEARHC COVID-19 testing was at Mountainside Urgent Care Monday through Friday 12:00 until 3:00 p.m., and Saturday 12:00 to 2:00 p.m. She stated to call the COVID hotline or Urgent Care for testing outside of those hours.

She said that Bionex or QuickVue at home tests were in high demand and noted shortages with none currently available from Public Health or Harry Race Pharmacy, but they were continuing to work on getting them in stock.

She relayed new CDC Guidelines: For Persons Who are Exposed to Someone with COVID-19. If you were asymptomatic and • have been boosted or • completed the primary series of Pfizer or Moderna vaccine within the last 6 months or • completed the primary series of J&J vaccine within the last two months then • wear a mask around others for 10 days • test on day 5 if you develop symptoms get tested and stay home. If you were asymptomatic and • completed the primary series of Pfizer or Moderna vaccine over 6 months ago and are not boosted or • completed the primary series of J&J over two months ago and were not boosted or • are unvaccinated then • self-quarantine for five days; after that, continue to wear a mask around others for five additional days • if unable to quarantine, wear a mask for 10 days • test on day five if you develop symptoms get tested and stay home.

Ewing reported that Influenza was in Sitka, Public Health was seeing an uptick in Influenza, and recommended getting a flu shot for anyone 6 months and older. She noted that vaccines were not everything but were an extremely helpful tool to keep from getting heavily impacted and or hospitalized.

She stated the CDC recommended everyone 12 years or older should get a COVID-19 vaccine booster and noted the following:

• For people who received a Moderna or Pfizer vaccine initially, a booster was recommended five months after their primary series.
• A booster was recommended two months after an initial Johnson & Johnson COVID-19 vaccine.
• mRNA vaccines were preferred vaccines.
• When you had completed the primary series of two shots (unless you were immune compromised then that was three) and you get a booster, you were considered up to date and fully vaccinated right after the dose, you did not have to wait the typical two weeks for full immunity.

Ewing relayed that the Alaska Department of Health and Social Services, both the Division of Public Health and Section of Epidemiology were working on the next phase of pandemic response with case investigation and contact tracing.  As of February 28, 2022, broad-based contact investigation and tracing would begin infrastructure transitions to an approach that supported high risk settings (congregate settings) with a streamlined team. She said the team would focus on supporting and coaching mitigation strategies including quarantine, isolation, testing, and workplace infection prevention. She said the streamlined team of contact tracers would support congregate settings such as fisheries, mining, homeless shelters, and assisted living settings with mitigation strategies including quarantine, isolation, testing, and workplace infection prevention. Which meant the State of Alaska would be transitioning away from broad-based tracing of all positive cases. She noted with the high Omicron transmission rates, it was no longer feasible to keep contact tracing successfully and accurately in the current iteration. As such they were focusing on a more targeted approach to those persons that would be most affected and to those we could most impact. With the availability of vaccines, reduced isolation and quarantine requirements, and expansive dissemination of information to the public on the need to isolate and seek testing when sick, wear a mask in public spaces, and quarantine after exposure, contact tracing of all positive cases did not provide the benefit in reduction of cases seen early in the pandemic before these resources were as widely available. They were focusing efforts on persons who were most affected by COVID-19 to make the greatest impact on the vulnerable populations within the State. She said early on in an epidemic, case investigation and contact tracing were needed to stop transmission and prevent a large outbreak from occurring. She relayed if efforts to contain the epidemic were unsuccessful and widespread transmission occurred in the community, then stricter community mitigation measures (such as stay-at-home orders, business closures, etc.) should be implemented. It was critical that case investigation and contact tracing activities be adequately resourced and widely accepted in any community where they were implemented. She said when there was no longer capacity to investigate a majority of new COVID-19 cases, case investigation, and contact tracing may not be the most effective approach noting at that point, suspending or scaling down contact tracing activities and reimplementing strict mitigation measures (such as stay-at-home orders, business closures, and school closures) until transmission begins to decline would be a strategy. She said with the high transmissibility and rapidly increasing case counts with the Omicron variant, capacity to investigate the majority of cases had been exceeded. The incubation period for Omicron was estimated to be two to four days, which reduced the ability of contact tracing to effectively investigate cases and notify contacts of the need to quarantine before the contacts became ill and further spread COVID-19 within the community.

Ewing stated that Public Health was available to answer questions or to help navigate COVID-19 Monday through Friday 8:00 a.m. to 4:30 p.m. and by calling 907.747.3255.

Thor Christianson, Logistics reported the ability to get most medical supplies.

Travis Miller, Sitka Tribe of Alaska (STA) reported testing of staff when requested and every two weeks with in-house testing which was reported through the state website. He relayed that most staff were working from home this week.

Public Information Officers Melissa Henshaw and Jessica Ieremia reported very few calls or emails and told of social media posts surrounding symptoms, quarantining, and isolation.

Incident Commander Craig Warren reported that both school districts were incredibly busy trying to keep in person learning and that Mt. Edgecumbe High School was finding it challenging to get students back to Sitka. He noted the trend and asked for help with the whole community. He urged citizens to not go to work sick with the flu or with COVID-19. He said it would be transmitted to co-workers and customers. He reminded of mitigations, washing hands, social distancing, and masking. He said only eight students would attend the EMT class in person in a large room with N95 masks on the entire time. He reminded citizens that we were not out of the woods yet with this and that we needed to double down on it. All mitigation measures talked about for almost two years would help us all out, help out the hospital, loved ones, friends, and emergency responders. He thanked those that were doing their part and those that sat on Unified Command.

Due to the High Alert Level in Sitka, Sitka Unified Command recommends continued mitigation: face coverings were strongly encouraged for individuals regardless of vaccination status, maintaining physical distance of 6 feet along with following CDC guidelines CDC Guidelines.

We urge citizens to remain diligent and practice proper hygiene measures, such as washing your hands often, avoiding close contact with others. In addition, get tested but stay home if you feel ill, wear a face covering when around others, and clean and disinfect objects and surfaces on a regular basis.

COVID-19 symptoms are similar to the flu – fever, aching, cough, sore throat, shortness of breath, and sometimes decreased sense of taste and smell. If you are concerned you might have contracted the coronavirus contact the COVID hotline at 966.8799. Outside of normal clinic hours, patients can contact the SEARHC 24/7 Nurse Advice Line at 1.800.613.0560 to be triaged by a registered nurse. 

The Sitka Emergency Unified Command continues to urge citizens to enroll for a vaccination online with Harry Race Pharmacy at Harry Race Pharmacy and with SEARHC at https://covid19.searhc.org/. According to the Center for Disease Control and Prevention (CDC), COVID-19 vaccines have demonstrated to be safe and effective. COVID-19 vaccines reduce the risk of people spreading the virus. Being vaccinated is the best way to protect our community.

The Emergency Operations Center encourages residents to prepare for any local emergency by ensuring each family member has a 14- day emergency supply kit, including any necessary medications.

For information on the local pandemic response, visit https://cityofsitka.org or https://covid19.searhc.org.

# # #

Alaska Department of Health & Social Services Weekly Case Update
December 26 — January 1, 2022

HIGH Statewide transmission Rt1.64	HIGH Statewide alert status 506.1	LIMITED Hospital capacity	HIGH Test positivity 12.78%	67.8% of Alaskans aged 5+ are vaccinated
Red- Rt >1.2 Orange- Rt 1-1.2 Yellow- Rt <1	7-day case rate per 100,000 population. Red-  ≥100 Orange- 50-99.99 Yellow- 10-49.99 Blue- 0-9.99	Multiple facilities continue to have a high number of inpatients, which results in delays in admitting patients from emergency departments as well as other operational challenges.	Red->5% Orange- 2-5% Yellow- <2%	This includes people with at least one dose. Estimated AK population 5 and older of 680,580 from the AK Department of Labor & Workforce Development.

Case Trends

• Alaska currently has the forty-fourth highest number of cases in the last seven days per 100,000 population among the 50 states.
• Hospital capacity was strained during the Delta variant wave of COVID-19 and continues to be limited as the Omicron variant spreads rapidly. In some hospitals, it may become difficult to care for everyone who needs care, even for non-COVID health concerns. Some care may need to be delayed, there may be long wait times, and hospital beds may not be available.
  • Hospitalizations are continuing to occur in younger Alaskans, with the median age of persons hospitalized due to COVID-19 in 2021 and 2022 being about 5 years younger than in 2020.
  • Among those hospitalized due to COVID-19 and with specimen collection dates from January 16, 2021 through January 1, 2022, unvaccinated and partially vaccinated patients had a median age 14 years younger than fully vaccinated patients.

• High levels of COVID-19 transmission are occurring throughout much of Alaska and the pandemic is on a rapid upward trajectory in Alaska. Dozens of Alaskans are hospitalized with COVID-19 each week.
• 3,576 cases were reported in Alaskans the week of December 26–January 1. This is a 232% increase from the number of cases reported the week before. While differences in testing and reporting due to the holidays make quantifying the rate of increase more challenging, this increase in cases is the largest week-over-week increase recorded in Alaska in terms of the absolute number of cases and is also among the largest in terms of the proportional increase.
• The number of new COVID-19 cases has rapidly increased in the Municipality of Anchorage, Matanuska-Susitna Borough, and the City and Borough of Juneau. There was also an increase in cases in the Fairbanks North Star Borough. There is not a clear upwards or downwards trajectory in the Kenai Peninsula Borough.
• The intensity of COVID-19 transmission varies substantially between communities outside the largest boroughs, but many boroughs and census areas have seen recent and large increases in COVID-19 cases.
• Community transmission of the Omicron variant has been confirmed in Anchorage. Preliminary laboratory evidence suggests that the Omicron variant is rapidly becoming the dominant SARS-CoV-2 variant in Alaska and is driving the sharp acceleration of the pandemic in Alaska. 

COVID-19 Guidance

Take action now to help slow the spread of COVID-19 and preserve health care capacity.

• Please get vaccinated if you haven’t already and get a booster dose if you are eligible (see below for more information). Currently available COVID vaccines will help protect you, your family, and your community against COVID-19.
• Wearing a mask when in indoor public spaces regardless of vaccination status is an important step to take to slow the spread of COVID-19. Most Alaskans live in an area with substantial or high community transmission where this action is needed to protect your health and the health of others.
• Continue to avoid crowds and practice social distancing – particularly when indoors.
• Seek testing if you have any symptoms or have been exposed to an infected person. If you do test positive, isolate right away, and notify your contacts. Ask them to get tested and to quarantine. People who are up to date on their COVID vaccination do not need to quarantine. Learn more about who needs to quarantine here.
• If you test positive and you’re at increased risk for severe COVID, consider obtaining monoclonal antibody treatment or oral antivirals. These have been shown to be effective treatments for reducing the risk of hospitalization. These treatments work best when given early.
• Persons at high risk include but are not limited to persons who are elderly, immunocompromised, obese, pregnant, or have certain chronic underlying medical conditions.

Borough/Census Area Alert Level Trends

• Alert levels are based on the case counts over the past 7 days as well as the daily number of reported cases over the past 7 days per 100,000 population.
• Alert levels have been changed to more closely mirror CDC’s community transmission indicator and are calculated by borough and census area, rather than by region.

Borough/Census Area	Alert Level December 13	Alert Level December 20	Alert Level December 27	Alert Level January 3
Count	Rate	Count	Rate	Count	Rate	Count	Rate
Anchorage Municipality	466	161.3	435	150.5	393	136.0	2,180	754.4
Fairbanks North Star Borough	91	93.7	123	126.6	125	128.7	224	230.5
Juneau City and Borough	63	198.3	55	173.1	73	229.8	259	815.2
Kenai Peninsula Borough	74	125.6	72	122.2	78	132.4	100	169.7
Matanuska-Susitna Region	217	202.2	181	168.7	107	99.7	439	409.1
Nome Census Area	58	593.7	45	460.6	19	194.5*	25	255.9
North Slope Borough	8	81.9*	4	**	6	61.4*	35	358.2
Northwest Arctic Borough	35	461.6	17	224.2*	15	197.8*	44	580.2
Chugach Census Area	1	**	10	148.1*	2	**	9	133.3*
Copper River Census Area	7	259.4*	3	**	6	222.3*	7	259.4*
Denali Borough	0	**	0	**	1	**	4	**
Southeast Fairbanks Census Area	8	115.3*	2	**	7	100.9*	18	259.5*
Yukon-Koyukuk Census Area	3	**	17	337.0*	1	**	23	456.0
Haines Borough	0	**	4	**	0	**	32	1,269.8
Petersburg Borough	3	**	6	188.1*	6	188.1*	5	**
Sitka City and Borough	26	305.1	23	269.9	29	340.3	72	844.8
Skagway Municipality	1	**	1	**	1	**	2	**
Wrangell City and Borough	1	**	0	**	1	**	2	**
Yakutat plus Hoonah-Angoon	1	**	3	**	9	339.9*	6	226.6*
Ketchikan Gateway Borough	67	489.9	52	380.2	52	380.2	50	365.6
Prince of Wales-Hyder Census Area	13	213.5*	7	114.9*	7	114.9*	5	**
Bethel Census Area	40	223.9	31	173.5	18	100.7*	40	223.9
Kusilvak Census Area	55	680.0	52	642.9	35	432.7	17	210.2*
Aleutians East Borough	1	**	0	**	1	**	2	**
Aleutians West Census Area	2	**	0	**	4	**	12	216.5*
Dillingham Census Area	13	272.4*	5	**	7	146.7*	14	293.3*
Kodiak Island Borough	19	150.7*	8	63.4*	13	103.1*	57	452.0
Bristol Bay plus Lake and Peninsula	5	**	3	**	4	**	6	247.9*
Statewide	1,278	175.3	1,160	159.1	1,020	139.9	3,689	506.1

*Rates based on <20 observations are statistically unreliable and should be used with caution.
**Rates based on <6 observations are not reported.

Vaccination Status

• Anyone aged ≥5 years in Alaska is now eligible to receive a COVID-19 vaccine.
• If you have received an initial dose of the Pfizer or Moderna COVID-19 vaccine, be sure to get your second dose too.
• Everyone ≥12 years old who received the primary series of Pfizer COVID-19 vaccine ≥5 months ago or the Moderna COVID-19 vaccine ≥6 months ago should receive a booster dose.
• Everyone who received the Janssen COVID-19 vaccine ≥2 months ago should receive a booster dose, preferably of an mRNA vaccine.
• Learn more about who should get a booster dose and to find COVID-19 vaccines near you at covidvax.alaska.gov.
• CDC recommends that people with moderately to severely compromised immune systems receive an additional dose of mRNA COVID-19 vaccine at least 28 days after a second dose of an mRNA vaccine.
• Vaccinated persons with immunocompromising conditions should discuss with their health care providers the need for additional personal protective measures.
• To schedule your vaccine appointment visit covidvax.alaska.gov or call 907-646-3322.
• To find clinics in your area you can visit vaccines.gov or text your zip code to GETVAX (438829) in English, or VACUNA (822862) for Spanish.
• The Alaska vaccine dashboard is available online for the most up-to-date data.

Borough/Census Area Vaccination Coverage

This is the percent of Alaskans aged ≥5 years who received one or more doses of vaccine.

Borough/Census Area	January 3
Aleutians East Borough	96%
Aleutians West Census Area	74%
Anchorage Municipality	76%
Bethel Census Area	81%
Bristol Bay plus Lake and Peninsula	77%
Denali Borough	75%
Dillingham Census Area	65%
Fairbanks North Star Borough	67%
Haines Borough	73%
Juneau City and Borough	84%
Kenai Peninsula Borough	53%
Ketchikan Gateway Borough	71%
Kodiak Island Borough	73%
Kusilvak Census Area	80%
Matanuska-Susitna Borough	46%
Nome Census Area	82%
North Slope Borough	42%
Northwest Arctic Borough	67%
Petersburg Borough	68%
Prince of Wales-Hyder Census Area	69%
Sitka City and Borough	83%
Skagway Municipality	82%
Southeast Fairbanks Census Area	39%
Valdez-Cordova Census Area	65%
Wrangell City and Borough	65%
Yakutat plus Hoonah-Angoon	80%
Yukon-Koyukuk Census Area	83%
Statewide	67.8%

New Hospitalizations and Deaths

• Cumulative hospitalizations increased by 21 to 3,269. Hospitalization reports often lag when a case was initially reported.
• 5.7% of hospitalized patients in Alaska had COVID-19 as of January 3, 2022.
• On January 1st there were 52 persons with COVID-19 in AK hospitals, which is a 5.5% decrease relative to the week before when there were 55 persons hospitalized.
• The cumulative number of COVID-19 deaths among Alaska residents increased by 2 to 947. It is common to take some time for a death to be reported and verified, and deaths that occurred during December 26–January 1 may be reported in the future after death certificates are reviewed.

Total Confirmed COVID Beds Occupied

Variant Tracking

• The most recent Genomic Surveillance data can be found on the “COVID-19 Variants” tab of the Cases Dashboard.

Variants of Concern

Cases Identified

Change from Previous Report

First Identified in Alaska

Variants of Concern	Cases Identified	Change from Previous Report	First Identified in Alaska
Delta (B.1.617.2-like)	6,251	+12	30 May 2021
Omicron (B.1.1.529-like)	7	+1	29 November 2021
Variants Being Monitored	Cases Identified	Change from Previous Report	First Identified in Alaska
Alpha (B.1.1.7)	466	0	20 December 2020
Beta (B.1.351)	7	0	20 March 2021
Epsilon (B.1.427/429)	144	0	24 December 2020
Eta (B.1.525)	1	0	16 March 2021
Gamma (P.1/P.1.1/P.1.2)	77	0	8 February 2021
Iota (B.1.526)	24	0	4 February 2021
Mu (B.1.621)	161	0	6 May 2021
Zeta (P.2)	4	0	27 January 2021

Vaccine Breakthrough Cases

• Vaccine breakthrough (VB) infections of COVID-19 are those detected in a person who is at least 2 weeks beyond their second dose of a 2-dose series or the only dose of a 1-dose series.
• Alaska residents who are fully vaccinated are much less likely to be hospitalized due to COVID-19 than those who are not fully vaccinated. (Age-standardized per capita rates of COVID-19 hospitalizations by vaccination status are updated monthly.)

• The following updated VB data are among Alaska residents aged ≥5 years with a specimen collection date from January 16–January 1, 2022.

• From January 16, 2021–January 1, 2022, 112 deaths, 349 hospitalizations, and 27,832 cases with a VB infection were reported among Alaska residents aged ≥5 years. These counts are provisional and subject to change as data are compiled and reviewed. In that same time frame, a total of 98,217 cases, 2,061 hospitalizations, and 634 deaths were reported.
• 73% of all cases, 83% of all hospitalizations, and 82% of deaths among Alaska residents aged ≥5 years from January 16, 2021–January 1, 2022 were in people who were not fully vaccinated. 
• More detailed information about hospitalizations, deaths, repeat and vaccine breakthrough infections among Alaska residents can also be found in the monthly report, which includes data through November.
• Age-standardized per capita rates of COVID-19 cases by vaccination status are updated weekly. Some COVID-19 cases with specimen collection in the immediate past week (indicated by the grey box) may have not yet been reported or counted.

• The following table shows by region the number of vaccine breakthrough cases and the number of cases among persons who are not fully vaccinated.

	Cases (December 26–January 1)
Region	Vaccine breakthrough (All ages)	Not fully vaccinated (All ages)
Anchorage Municipality	1079	1014
Fairbanks North Star Borough	85	117
Juneau City and Borough	145	90
Kenai Peninsula Borough	38	46
Matanuska-Susitna Borough	163	262
Northwest Region	62	42
Other Interior Region	31	31
Other Southeast Region – Northern	70	53
Other Southeast Region – Southern	36	24
Southwest Region	68	48
Y-K Delta Region	35	31

• A variety of factors may affect the proportion of vaccine breakthrough cases by region. In communities with higher vaccination coverage, a larger proportion of cases is expected to occur among fully vaccinated persons. Other potential factors include the extent of prior infection in a region and differences in testing practices between regions.

COVID-19 Communication Resources

• DHSS Insights Blog: Taking care of yourself is worth it
• Revised webpages:
  • If you are sick or exposed to COVID-19
• New video PSAs to share:
  • Home Test
  • Home Test Social Media
  • COVID-19 Vaccines for Ages 5+
  • Pediatric Vaccine
  • Pediatric Vaccine: Dr. Adam Grove
  • Why Not Get Vaccinated?
  • Layer up, Alaska! 
• Pediatric COVID-19 Vaccine Flyer: 5 Reasons to Vaccinate for Ages 5+
• Over-the-Counter Testing Flyer: At-home COVID-19 tests
• Request support from DHSS
  • DHSS offers free presentations upon request to groups about COVID-19, the vaccines, COVID-19 prevention, or other health topics upon request. Learn more or request a presentation on our Speaker’s Bureau web page. 
  • DHSS offers support for one-time or reoccurring COVID-19 vaccination events. Submit your request for support and provide information about the event by filling out this form.
• Can’t tune into a live ECHO videoconference but don’t want to miss out on the latest updates? The full schedule of ECHO sessions and access to COVID-19 ECHO videos and slideshows are available for download anytime on the DHSS ECHO web page.

Statewide Percentage of Daily Tests with Positive Results
(Seven day rolling average)

Cases by Week of Onset and Age

Note: Quality assurance efforts are ongoing to attribute cases to the correct date on the onset date epi curve. Some recent cases will be reattributed to different weeks.

Cases by Week of Onset and Race

Note: Quality assurance efforts are ongoing to attribute cases to the correct date on the onset date epi curve. Some recent cases will be reattributed to different weeks. Race abbreviations include AI/AN (American Indian or Alaska Native), Asian/NHOPI (Asian, Native Hawaiian or Other Pacific Islander), and UI/Unknown (Under investigation or unknown).

Additional informational resources:

• The State of Alaska COVID-19 vaccine status update page
• The State of Alaska COVID-19 information page provides 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: data.coronavirus.alaska.gov. All dashboard data are updated Mondays, Wednesdays, and Fridays (except holidays). 
• For DHSS media inquiries, please contact clinton.bennett@alaska.gov

Additional ECHO session details:

These ECHO sessions are produced and facilitated by
UAA’s Center for Human Development Alaska ECHO project
in partnership with the State of Alaska, Department of Health & Social Services

Regular Series

Alaska Medical Provider ECHO (formerly COVID-19 for AK Healthcare Providers)
Monthly on the 1st Tuesday of the month from 7-8 pm
This ECHO aims to increase knowledge and share best practices among medical providers across Alaska as well as to increase access to information for those living in rural areas of the state.

School Health ECHO
Every Monday from 3:00-4:00 p.m Register
The School Health ECHO is a virtual learning network intended for professionals in the education setting (administrators, school-based nurses, etc.) to interface with a team of medical and education experts in Alaska.

Vaccine ECHO for Providers
Weekly on Tuesday from 2-3 p.m. Register
The Vaccine ECHO for providers provides planning and operation updates to vaccine providers across Alaska, while answering any questions you may have.

Palliative Care ECHO
Monthly on the first Tuesday from 12-1 p.m.
This monthly ECHO is for all Alaskan healthcare disciplines supporting patients with serious illness, and aims to provide support and up-to-date information regarding Palliative Care during this period of COVID-19.

Public Science ECHO
Weekly on Wednesday from 12-1 p.m. register via Zoom
The Alaska Public Health Science ECHO is a virtual learning network intended for the general public to interface with our Public Health Leadership Team to explore the science of the COVID-19 virus, other public health topics, and current best practices. Or view via concurrent livestream to Facebook: https://www.facebook.com/akechoprograms

Local Government Public Health ECHO
Monthly on the third Wednesday from 3-4 p.m. Register
The Local Government Public Health Analysis ECHO is a virtual learning environment intended for local Alaska government leaders to interact with the State Public Health Leadership team and focuses on pandemic mitigation tools available, and how to use them.

Long Term Care Facilities ECHO 
Second Wednesday of the month from 4-5 p.m. Register 
Please join other staff and administrators of Alaska’s assisted living homes and residential care facilities to gather, learn, share, and grow. COVID has disrupted the fabric of our daily life and we can always learn from each other as we adjust to the new normal.

Healthcare Specific Situational Awareness ECHO
Weekly on Thursday from 12-1 p.m.  Register
The Healthcare Specific Situational ECHO is a virtual learning network intended for healthcare professionals to interface with our Public Health Leadership Team to explore current best practices and the most recent information related to Public Health.

Perinatal ECHO
Monthly on 3rd Thursday from 6-7 p.m. Register
The Alaska Perinatal ECHO is a virtual learning network intended for medical providers caring for pregnant patients and their newborns.

EMS ECHO
Monthly on the 1st and 3rd Wednesday 1-2 p.m Register
The EMS ECHO is a virtual learning network intended for Emergency Medical Services and related personnel in Alaska to amplify best practices. Sessions are topic-driven and typically include a guest presenter or a brief lecture with an interactive case or process discussion.

Co-Occurring Behavioral Health, Opioid and Stimulant Use Disorders ECHO
1st & 3rd Wednesdays from 12:00pm-1:00pm, November 3, 2021 – April 20, 2022
The Co-Occurring Behavioral Health (COBH), Opioid and Stimulant Use Disorders ECHO facilitates a virtual network for behavioral health providers to learn best practice care through real-time access to experienced subject matter experts and their peers. Each session includes a brief lecture, de-identified case presentation for participants to receive feedback on complex cases, and open discussion facilitated by an interdisciplinary team.

Data Waivers ECHO New ECHO!
2nd Wednesdays from 12:00pm-1:00pm, November 10, 2021 – September 14, 2022
The Data Waivers ECHO facilitates a virtual network for clinical providers to learn and implement best practices for offering buprenorphine and other medically assisted treatment (MAT) services under a data waiver. Each session includes a brief lecture, de-identified case presentation for participants to receive feedback on complex cases, and open discussion facilitated by an interdisciplinary team.

Alaska Department of Health & Social Services Weekly Case Update
December 19 — December 25, 2021

Low Statewide transmission Rt0.87	HIGH Statewide alert status 139.9	LIMITED Hospital capacity	Intermediate Test positivity 4.89%	67.5% of Alaskans aged 5+ are vaccinated
Red- Rt >1.2 Orange- Rt 1-1.2 Yellow- Rt <1	7-day case rate per 100,000 population. Red-  ≥100 Orange- 50-99.99 Yellow- 10-49.99 Blue- 0-9.99	Multiple facilities continue to have a high number of inpatients, which results in delays in admitting patients from emergency departments as well as other operational challenges.	Red->5% Orange- 2-5% Yellow- <2%	This includes people with at least one dose. Estimated AK population 5 and older of 680,580 from the AK Department of Labor & Workforce Development.

Case Trends

• Alaska currently has the forty-fifth highest number of cases in the last seven days per 100,000 population among the 50 states.
• Hospital capacity has been strained during the Delta variant wave of COVID-19 such that in some hospitals, it may become difficult to care for everyone who needs care, even for non-COVID health concerns. Some care may need to be delayed, there may be long wait times, and hospital beds may not be available.  
  • Hospitalizations are continuing to occur in younger Alaskans, with the median age of persons hospitalized due to COVID-19 in 2021 being about 5 years younger than in 2020.
  • Among those hospitalized due to COVID-19 and with specimen collection dates from January 16, 2021 through December 25, 2021, unvaccinated and partially vaccinated patients had a median age 14 years younger than fully vaccinated patients.

• Substantial or high levels of COVID-19 transmission are occurring throughout much of Alaska and dozens of Alaskans are hospitalized with COVID-19 each week.
• 1,076 cases were reported in Alaskans the week of December 19–December 25. This is a 0.75% increase from the number of cases reported the week before. Larger numbers of cases have been reported since December 25, indicating an upwards trajectory.
• The number of new COVID-19 cases has increased in the Anchorage Municipality, Matanuska-Susitna Borough, Fairbanks North Star Borough, and the City and Borough of Juneau. All four have also experienced recent increases in percent positivity, which suggests that this pattern reflects increased incidence of COVID-19 and is not an artifact of testing. There is not a clear upwards or downwards trajectory in the Kenai Peninsula Borough.
• The intensity of COVID-19 transmission varies substantially between communities outside the largest boroughs. COVID-19 cases are regularly reported from nearly all boroughs and census areas and some communities are experiencing widespread transmission.
• Community transmission of the Omicron variant has been identified in Anchorage. The proportion of SARS-CoV-2 infections in Alaska currently due to the Omicron variant is unclear, but preliminary laboratory evidence suggests that the number of cases due to the Omicron variant is rapidly increasing in Alaska and contributing to the overall rise in cases.

COVID-19 Guidance

Take action now to help slow the spread of COVID-19 and preserve health care capacity.

• Please get vaccinated if you haven’t already and get a booster dose if you are eligible (see below for more information). Currently available COVID vaccines will help protect you, your family, and your community against COVID-19.
• Wearing a mask when in indoor public spaces regardless of vaccination status is an important step to take to slow the spread of COVID-19. Most Alaskans live in an area with substantial or high community transmission where this action is needed to protect your health and the health of others.
• Continue to avoid crowds and practice social distancing – particularly when indoors.
• Seek testing if you have any symptoms or have been exposed to an infected person. If you do test positive, isolate right away, and notify your contacts. Ask them to get tested and to quarantine. The CDC recommends people should quarantine if they are unvaccinated, more than six months out from their second mRNA dose (and not yet boosted), or more than 2 months out from their Janssen vaccine (and not yet boosted).
• If you test positive and you’re at increased risk for severe COVID, consider obtaining monoclonal antibody treatment or oral antivirals. These have been shown to be effective treatments for reducing the risk of hospitalization. These treatments work best when given early.
• Persons at high risk include but are not limited to persons who are elderly, immunocompromised, obese, pregnant, or have certain chronic underlying medical conditions.

Borough/Census Area Alert Level Trends

• Alert levels are based on the case counts over the past 7 days as well as the daily number of reported cases over the past 7 days per 100,000 population.

Alert levels have been changed to more closely mirror CDC’s community transmission indicator and are calculated by borough and census area, rather than by region.

Borough/Census Area	Alert Level December 6	Alert Level December 13	Alert Level December 20	Alert Level December 27
Count	Rate	Count	Rate	Count	Rate	Count	Rate
Anchorage Municipality	579	200.4	466	161.3	435	150.5	393	136.0
Fairbanks North Star Borough	144	148.2	91	93.7	123	126.6	125	128.7
Juneau City and Borough	59	185.7	63	198.3	55	173.1	73	229.8
Kenai Peninsula Borough	117	198.5	74	125.6	72	122.2	78	132.4
Matanuska-Susitna Region	286	266.5	217	202.2	181	168.7	107	99.7
Nome Census Area	65	665.4	58	593.7	45	460.6	19	194.5*
North Slope Borough	12	122.8*	8	81.9*	4	**	6	61.4*
Northwest Arctic Borough	74	975.9	35	461.6	17	224.2*	15	197.8*
Chugach Census Area	4	**	1	**	10	148.1*	2	**
Copper River Census Area	17	629.9*	7	259.4*	3	**	6	222.3*
Denali Borough	3	**	0	**	0	**	1	**
Southeast Fairbanks Census Area	4	**	8	115.3*	2	**	7	100.9*
Yukon-Koyukuk Census Area	1	**	3	**	17	337.0*	1	**
Haines Borough	3	**	0	**	4	**	0	**
Petersburg Borough	13	407.7*	3	**	6	188.1*	6	188.1*
Sitka City and Borough	10	117.3*	26	305.1	23	269.9	29	340.3
Skagway Municipality	2	**	1	**	1	**	1	**
Wrangell City and Borough	4	**	1	**	0	**	1	**
Yakutat plus Hoonah-Angoon	1	**	1	**	3	**	9	339.9*
Ketchikan Gateway Borough	104	760.4	67	489.9	52	380.2	52	380.2
Prince of Wales-Hyder Census Area	23	377.7	13	213.5*	7	114.9*	7	114.9*
Bethel Census Area	79	442.1	40	223.9	31	173.5	18	100.7*
Kusilvak Census Area	64	791.3	55	680.0	52	642.9	35	432.7
Aleutians East Borough	0	**	1	**	0	**	1	**
Aleutians West Census Area	1	**	2	**	0	**	4	**
Dillingham Census Area	23	481.9	13	272.4*	5	**	7	146.7*
Kodiak Island Borough	13	103.1*	19	150.7*	8	63.4*	13	103.1*
Bristol Bay plus Lake and Peninsula	10	413.2*	5	**	3	**	4	**
Statewide	1,715	235.3	1,278	175.3	1,160	159.1	1,020	139.9

*Rates based on <20 observations are statistically unreliable and should be used with caution.
**Rates based on <6 observations are not reported.

Vaccination Status

• Anyone aged ≥5 years in Alaska is now eligible to receive a COVID-19 vaccine.
• If you have received an initial dose of the Pfizer or Moderna COVID-19 vaccine, be sure to get your second dose too.
• Everyone ≥18 years old who received the primary series of an mRNA (Pfizer or Moderna) COVID-19 vaccine ≥6 months ago should receive a booster dose.
• For people who received the Janssen COVID-19 vaccine, a boosterdose (either the Janssen vaccine again or an mRNA vaccine) is recommended for anyone aged ≥18 years who was vaccinated ≥2 months ago.
• Adolescents aged 16 and 17 who received the primary series of the Pfizer vaccine ≥6 months ago may receive a booster dose of the Pfizer vaccine.
• Learn more about who should get a booster dose and to find COVID-19 vaccines near you at covidvax.alaska.gov.
• CDC recommends that people with moderately to severely compromised immune systems receive an additional dose of mRNA COVID-19 vaccine at least 28 days after a second dose of an mRNA vaccine.
• Vaccinated persons with immunocompromising conditions should discuss with their health care providers the need for additional personal protective measures.
• To schedule your vaccine appointment visit covidvax.alaska.gov or call 907-646-3322.
• To find clinics in your area you can visit vaccines.gov or text your zip code to GETVAX (438829) in English, or VACUNA (822862) for Spanish.
• The Alaska vaccine dashboard is available online for the most up-to-date data.

Borough/Census Area Vaccination Coverage
This is the percent of Alaskans aged ≥5 years who received one or more doses of vaccine.

Borough/Census Area	December 27
Aleutians East Borough	95%
Aleutians West Census Area	74%
Anchorage Municipality	75%
Bethel Census Area	80%
Bristol Bay plus Lake and Peninsula	77%
Denali Borough	75%
Dillingham Census Area	65%
Fairbanks North Star Borough	67%
Haines Borough	72%
Juneau City and Borough	84%
Kenai Peninsula Borough	53%
Ketchikan Gateway Borough	71%
Kodiak Island Borough	73%
Kusilvak Census Area	80%
Matanuska-Susitna Borough	45%
Nome Census Area	82%
North Slope Borough	42%
Northwest Arctic Borough	67%
Petersburg Borough	68%
Prince of Wales-Hyder Census Area	69%
Sitka City and Borough	82%
Skagway Municipality	82%
Southeast Fairbanks Census Area	39%
Valdez-Cordova Census Area	65%
Wrangell City and Borough	65%
Yakutat plus Hoonah-Angoon	80%
Yukon-Koyukuk Census Area	83%
Statewide	67.5%

New Hospitalizations and Deaths

• Cumulative hospitalizations increased by 44 to 3,248. Hospitalization reports often lag when a case was initially reported.
• 6.7% of hospitalized patients in Alaska had COVID-19 as of December 27, 2021.
• On December 25th there were 55 persons with COVID-19 in AK hospitals, which is a 15.4% decrease relative to the week before when there were 65 persons hospitalized.
• The cumulative number of COVID-19 deaths among Alaska residents increased by 30 to 945. It is common to take some time for a death to be reported and verified, and deaths that occurred during December 19–December 25 may be reported in the future after death certificates are reviewed.

Total Confirmed COVID Beds Occupied

Variant Tracking

The most recent Genomic Surveillance data can be found on the “COVID-19 Variants” tab of the Cases Dashboard.

Variants of Concern	Cases Identified	Change from Previous Report	First Identified in Alaska
Delta (B.1.617.2-like)	6,239	+42	30 May 2021
Omicron (B.1.1.529-like)	6	+5	29 November 2021
Variants Being Monitored	Cases Identified	Change from Previous Report	First Identified in Alaska
Alpha (B.1.1.7)	466	0	20 December 2020
Beta (B.1.351)	7	0	20 March 2021
Epsilon (B.1.427/429)	144	0	24 December 2020
Eta (B.1.525)	1	0	16 March 2021
Gamma (P.1/P.1.1/P.1.2)	77	0	8 February 2021
Iota (B.1.526)	24	0	4 February 2021
Mu (B.1.621)	161	0	6 May 2021
Zeta (P.2)	4	0	27 January 2021

Vaccine Breakthrough Cases

• Vaccine breakthrough (VB) infections of COVID-19 are those detected in a person who is at least 2 weeks beyond their second dose of a 2-dose series or the only dose of a 1-dose series.
• Alaska residents who are fully vaccinated are much less likely to be hospitalized due to COVID-19 than those who are not fully vaccinated. (Age-standardized per capita rates of COVID-19 hospitalizations by vaccination status are updated monthly.)

• The following updated VB data are among Alaska residents aged ≥5 years with a specimen collection date from January 16–December 25, 2021.

• From January 16–December 25, 2021, 112 deaths, 344 hospitalizations, and 25,954 cases with a VB infection were reported among Alaska residents aged ≥5 years. These counts are provisional and subject to change as data are compiled and reviewed. In that same time frame, a total of 94,696 cases, 2,037 hospitalizations, and 634 deaths were reported.
• 73% of all cases, 83% of all hospitalizations, and 82% of deaths among Alaska residents aged ≥5 years from January 16–December 25, 2021 were in people who were not fully vaccinated. 
• More detailed information about hospitalizations, deaths, repeat and vaccine breakthrough infections among Alaska residents can also be found in the monthly report, which includes data through October.
• Age-standardized per capita rates of COVID-19 cases by vaccination status are updated weekly. Some COVID-19 cases with specimen collection in the immediate past week (indicated by the grey box) may have not yet been reported or counted.

• The following table shows by region the number of vaccine breakthrough cases and the number of cases among persons who are not fully vaccinated.

	Cases (December 19–December 25)
Region	Vaccine breakthrough (All ages)	Not fully vaccinated (All ages)
Anchorage Municipality	256	279
Fairbanks North Star Borough	84	82
Juneau City and Borough	36	44
Kenai Peninsula Borough	27	53
Matanuska-Susitna Borough	51	101
Northwest Region	23	14
Other Interior Region	10	5
Other Southeast Region – Northern	16	28
Other Southeast Region – Southern	26	28
Southwest Region	17	9
Y-K Delta Region	31	16

**To protect privacy, data are excluded from rows in which any value is <5.

A variety of factors may affect the proportion of vaccine breakthrough cases by region. In communities with higher vaccination coverage, a larger proportion of cases is expected to occur among fully vaccinated persons. Other potential factors include the extent of prior infection in a region and differences in testing practices between regions.

COVID-19 Communication Resources

• DHSS Insights Blog: Celebrate the Holidays Safely
• Revised webpages:
  • COVID-19 Vaccine Information for all Alaskans 
  • COVID-19 treatments for hospitalized patient
  • COVID-19 Outpatient Treatment
  • Guidance for COVID-19 Testing in Alaska
• New video PSAs to share:
  • 16+ Booster Dose
  • Bring Back the Light
  • Pediatric Vaccine
  • Holiday Vaccine
  • Home Test
  • Home Test Social Media
  • Pediatric Vaccine: Dr. Adam Grove
  • Boosters for anyone 18+
  • COVID-19 Vaccines for Ages 5+
  • Holiday Flu
  • Why Not Get Vaccinated?
  • Layer up, Alaska! 
• Pediatric COVID-19 Vaccine Flyer: 5 Reasons to Vaccinate for Ages 5+
• Over-the-Counter Testing Flyer: At-home COVID-19 tests
• Request support from DHSS
  • DHSS offers free presentations upon request to groups about COVID-19, the vaccines, COVID-19 prevention, or other health topics upon request. Learn more or request a presentation on our Speaker’s Bureau web page. 
  • DHSS offers support for one-time or reoccurring COVID-19 vaccination events. Submit your request for support and provide information about the event by filling out this form.
• Can’t tune into a live ECHO videoconference but don’t want to miss out on the latest updates? The full schedule of ECHO sessions and access to COVID-19 ECHO videos and slideshows are available for download anytime on the DHSS ECHO web page.

Statewide Percentage of Daily Tests with Positive Results
(Seven day rolling average)

Cases by Week of Onset and Age

Note: Quality assurance efforts are ongoing to attribute cases to the correct date on the onset date epi curve. Some recent cases will be reattributed to different weeks.

Note: Quality assurance efforts are ongoing to attribute cases to the correct date on the onset date epi curve. Some recent cases will be reattributed to different weeks. Race abbreviations include AI/AN (American Indian or Alaska Native), Asian/NHOPI (Asian, Native Hawaiian or Other Pacific Islander), and UI/Unknown (Under investigation or unknown).

Additional informational resources:

• The State of Alaska COVID-19 vaccine status update page
• The State of Alaska COVID-19 information page provides 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: data.coronavirus.alaska.gov. All dashboard data are updated Mondays, Wednesdays, and Fridays (except holidays). 
• For DHSS media inquiries, please contact clinton.bennett@alaska.gov

Additional ECHO session details:

Updated December 30, 2021 These ECHO sessions are produced and facilitated by UAA’s Center for Human Development Alaska ECHO project in partnership with the State of Alaska, Department of Health & Social Services Important Note: Most Division of Public Health ECHO series will be taking a break from December 20-December 31 for the winter holidays. Please check individual ECHO registration pages for additional information on holiday scheduling.

SITKA, December 29, 2021 – Incident Commander Craig Warren reported Unified Command was meeting every four weeks. He noted that Sitka had been in the high alert level since the end of November and was trending up quickly much like other places in the US. He stated it was most likely the Omicron variant but that had not been confirmed. He said Omicron was more transmittable, but that people were not getting quite as sick. He cautioned with the numbers going up though, there could be higher hospitalizations. He reminded the public to stay home if they were sick. He asked for vigilance as to not spread COVID. He stated the CDC had updated guidance of five days of quarantine rather than the ten days for those asymptomatic. He relayed there would be an update from Cruise Lines International Association (CLIA) tomorrow noting that the CDC may give recommendations rather than mandates for cruise travel. He reminded if you were sick, do not go to school or work and to wash your hands, mask up around others, and to get out and enjoy the fresh air.

Warren relayed for Dr. Bruhl, Southeast Alaska Regional Health Consortium (SEARHC) Chief Medical Officer and Incident Commander of two COVID-19 positive patients at the hospital. The next vaccine clinic would be January 4 at Mountainside Urgent Care, 209 Moller Avenue from 9:00 a.m. to 5:00 p.m. with Pfizer for ages 5 to 11 from 3:00 p.m. to 5:00 p.m. A link to schedule an appointment would be advertised soon. For questions, call the COVID hotline at 907.966.8799.

Public Health Nurse Denise Ewing reported having the tools to fight Omicron by getting vaccinated and boosted, continue to mask, and test if you felt symptoms, had been around someone with COVID, or when travelling. SEARHC had testing at Mountainside Clinic, home test kits were available, two per family from Public Health (540 had been given out since Monday) and tests were available at Harry Race. She said that 800 test kits had been given to organizations. She relayed that there were 27 positive COVID cases today and 39 yesterday stating it was likely the Omicron variant but there were no results from sequencing yet. She relayed from the CDC that data was still out but there was a current increase of Omicron cases likely to lead to a national surge in the coming weeks.

Ewing reminded of the CDC guidance changes for people with COVID-19 if boosted or had completed the primary series of Pfizer or Moderna vaccine within the last six months or completed the primary of Johnson & Johnson vaccine within the last two months to wear a mask around others for 10 days, test on day five if possible and to stay home if symptoms develop. She stated for those that had COVID-19 and had completed the primary series of the Pfizer or Moderna vaccine that had been over six months and you were not boosted, or you completed the primary series of the Johnson & Johnson vaccine over two months ago and were not boosted or not vaccinated to stay home for five days and continue to wear a mask around others for five additional days. She said if unable to quarantine, to wear a mask around others for ten days and test on day five if possible and if symptoms develop, stay home. The changes can be found by visiting https://www.cdc.gov/.

Trish White, Harry Race Pharmacist reported a full clinic on Friday with mostly booster doses, a few second doses, and about a dozen children. To get on the waitlist, visit http://www.sitkapharmacies.com. She stated the dates and times were listed on the website which also included the flu vaccine. She thanked Public Health for the test kits and was grateful to have a supply.

Thor Christianson, Logistics reported able to get most medical supplies although there were delays with anything that was manufactured in China.

Travis Miller, Sitka Tribe of Alaska (STA) reported continued office closure to the public and testing of staff every two weeks.

Public Information Officer Melissa Henshaw reported very few calls or emails. She told of social media posts with regards to the high alert level and the mask mandate, travel mitigation guidance, international travel requirements along with recommendations for quarantine and isolation.

Due to the High Alert Level in Sitka, Sitka Unified Command recommends continued mitigation: face coverings were strongly encouraged for individuals regardless of vaccination status, maintaining physical distance of 6 feet along with following CDC guidelines CDC Guidelines.

We urge citizens to remain diligent and practice proper hygiene measures, such as washing your hands often, avoiding close contact with others. In addition, get tested but stay home if you feel ill, wear a face covering when around others, and clean and disinfect objects and surfaces on a regular basis.

COVID-19 symptoms are similar to the flu – fever, aching, cough, sore throat, shortness of breath, and sometimes decreased sense of taste and smell. If you are concerned you might have contracted the coronavirus contact the COVID hotline at 966.8799. Outside of normal clinic hours, patients can contact the SEARHC 24/7 Nurse Advice Line at 1.800.613.0560 to be triaged by a registered nurse. 

The Sitka Emergency Unified Command continues to urge citizens to enroll for a vaccination online with Harry Race Pharmacy at Harry Race Pharmacy and with SEARHC at https://covid19.searhc.org/. According to the Center for Disease Control and Prevention (CDC), COVID-19 vaccines have demonstrated to be safe and effective. COVID-19 vaccines reduce the risk of people spreading the virus. Being vaccinated is the best way to protect our community.

The Emergency Operations Center encourages residents to prepare for any local emergency by ensuring each family member has a 14- day emergency supply kit, including any necessary medications.

For information on the local pandemic response, visit https://cityofsitka.org or https://covid19.searhc.org.

# # #

Alaska Department of Health & Social Services Weekly Case Update
December 12 — December 18, 2021

Low Statewide transmission Rt0.84	HIGH Statewide alert status 159.1	LIMITED Hospital capacity	Intermediate Test positivity 3.38%	67.2% of Alaskans aged 5+ are vaccinated
Red- Rt >1.2 Orange- Rt 1-1.2 Yellow- Rt <1	7-day case rate per 100,000 population. Red-  ≥100 Orange- 50-99.99 Yellow- 10-49.99 Blue- 0-9.99	Multiple facilities continue to have a high number of inpatients, which results in delays in admitting patients from emergency departments as well as other operational challenges.	Red->5% Orange- 2-5% Yellow- <2%	This includes people with at least one dose. Estimated AK population 5 and older of 680,580 from the AK Department of Labor & Workforce Development.

Case Trends

• Alaska currently has the forty-fifth highest number of cases in the last seven days per 100,000 population among the 50 states.
• Hospital capacity has been strained during the Delta variant wave of COVID-19 such that in some hospitals, it may become difficult to care for everyone who needs care, even for non-COVID health concerns. Some care may need to be delayed, there may be long wait times, and hospital beds may not be available.  
  • Hospitalizations are continuing to occur in younger Alaskans, with the median age of persons hospitalized due to COVID-19 in 2021 being about 5 years younger than in 2020.
  • Among those hospitalized due to COVID-19 and with specimen collection dates from January 16, 2021 through December 18, 2021, unvaccinated and partially vaccinated patients had a median age 14 years younger than fully vaccinated patients.

• Substantial or high levels of COVID-19 transmission are occurring throughout much of Alaska.
• 1,068 cases were reported in Alaskans the week of December 12–December 18. This is a 24.4% decrease from the number of cases reported the week before and indicates a downward trajectory. The course of the COVID-19 pandemic is difficult to predict, and the pattern of declining cases may not be sustained in future weeks.  
• In the Anchorage Municipality and Matanuska-Susitna Borough, the number of new COVID-19 cases appears to be continuing to decline. There is not a clear upwards or downwards trajectory in the Fairbanks North Star Borough, the Kenai Peninsula Borough or the City and Borough of Juneau.  
• Regardless of the trajectories, high levels of community transmission are widespread, and dozens of Alaskans are hospitalized with COVID each week.
• The intensity of COVID-19 transmission varies substantially between communities outside the largest boroughs. COVID-19 cases are regularly reported from nearly all boroughs and census areas and some communities are experiencing widespread transmission.

COVID-19 Guidance

Take action now to help slow the spread of COVID-19 and preserve health care capacity.

• Please get vaccinated if you haven’t already and get a booster dose if you are eligible (see below for more information). Currently available COVID vaccines will help protect you, your family, and your community against COVID-19.
• Wearing a mask when in indoor public spaces regardless of vaccination status is an important step to take to slow the spread of COVID-19. Most Alaskans live in an area with substantial or high community transmission where this action is needed to protect your health and the health of others.
• Continue to avoid crowds and practice social distancing – particularly when indoors.
• Seek testing if you have any symptoms or have been exposed to an infected person. If you do test positive, isolate right away, and notify your contacts. Ask them to get tested and, if they are unvaccinated, to quarantine.
• If you test positive and you’re at increased risk for severe COVID, obtain monoclonal antibody treatment. This has been shown to be an effective treatment for reducing the risk of hospitalization. This treatment works best when given early.
• Persons at high risk include but are not limited to persons who are elderly, immunocompromised, obese, pregnant, or have certain chronic underlying medical conditions.

Borough/Census Area Alert Level Trends

• Alert levels are based on the case counts over the past 7 days as well as the daily number of reported cases over the past 7 days per 100,000 population.
• Alert levels have been changed to more closely mirror CDC’s community transmission indicator and are calculated by borough and census area, rather than by region.

Borough/Census Area	Alert Level November 29	Alert Level December 6	Alert Level December 13	Alert Level December 20
Count	Rate	Count	Rate	Count	Rate	Count	Rate
Anchorage Municipality	652	225.6	579	200.4	466	161.3	435	150.5
Fairbanks North Star Borough	211	217.2	144	148.2	91	93.7	123	126.6
Juneau City and Borough	60	188.8	59	185.7	63	198.3	55	173.1
Kenai Peninsula Borough	99	168.0	117	198.5	74	125.6	72	122.2
Matanuska-Susitna Region	340	316.9	286	266.5	217	202.2	181	168.7
Nome Census Area	80	818.9	65	665.4	58	593.7	45	460.6
North Slope Borough	35	358.2	12	122.8*	8	81.9*	4	**
Northwest Arctic Borough	70	923.1	74	975.9	35	461.6	17	224.2*
Chugach Census Area	10	148.1*	4	**	1	**	10	148.1*
Copper River Census Area	22	815.1	17	629.9*	7	259.4*	3	**
Denali Borough	0	**	3	**	0	**	0	**
Southeast Fairbanks Census Area	19	273.9*	4	**	8	115.3*	2	**
Yukon-Koyukuk Census Area	8	158.6*	1	**	3	**	17	337.0*
Haines Borough	1	**	3	**	0	**	4	**
Petersburg Borough	38	1,191.6	13	407.7*	3	**	6	188.1*
Sitka City and Borough	8	93.9*	10	117.3*	26	305.1	23	269.9
Skagway Municipality	0	**	2	**	1	**	1	**
Wrangell City and Borough	10	420.3*	4	**	1	**	0	**
Yakutat plus Hoonah-Angoon	3	**	1	**	1	**	3	**
Ketchikan Gateway Borough	91	665.4	104	760.4	67	489.9	52	380.2
Prince of Wales-Hyder Census Area	3	**	23	377.7	13	213.5*	7	114.9*
Bethel Census Area	129	722.0	79	442.1	40	223.9	31	173.5
Kusilvak Census Area	41	506.9	64	791.3	55	680.0	52	642.9
Aleutians East Borough	2	**	0	**	1	**	0	**
Aleutians West Census Area	4	**	1	**	2	**	0	**
Dillingham Census Area	9	188.6*	23	481.9	13	272.4*	5	**
Kodiak Island Borough	9	71.4*	13	103.1*	19	150.7*	8	63.4*
Bristol Bay plus Lake and Peninsula	4	**	10	413.2*	5	**	3	**
Statewide	1,958	268.6	1,715	235.3	1,278	175.3	1,160	159.1

*Rates based on <20 observations are statistically unreliable and should be used with caution.
**Rates based on <6 observations are not reported.

Vaccination Status

• Anyone aged ≥5 years in Alaska is now eligible to receive a COVID-19 vaccine.
• If you have received an initial dose of the Pfizer or Moderna COVID-19 vaccine, be sure to get your second dose too.
• Everyone ≥18 years old who received the primary series of an mRNA (Pfizer or Moderna) COVID-19 vaccine ≥6 months ago should receive a booster dose.
• For people who received the Janssen COVID-19 vaccine, a boosterdose (either the Janssen vaccine again or an mRNA vaccine) is recommended for anyone aged ≥18 years who was vaccinated ≥2 months ago.
• Adolescents aged 16 and 17 who received the primary series of the Pfizer vaccine ≥6 months ago may receive a booster dose of the Pfizer vaccine.
• Learn more about who should get a booster dose and to find COVID-19 vaccines near you at covidvax.alaska.gov.
• CDC recommends that people with moderately to severely compromised immune systems receive an additional dose of mRNA COVID-19 vaccine at least 28 days after a second dose of an mRNA vaccine.
• Vaccinated persons with immunocompromising conditions should discuss with their health care providers the need for additional personal protective measures.
• To schedule your vaccine appointment visit covidvax.alaska.gov or call 907-646-3322.
• To find clinics in your area you can visit vaccines.gov or text your zip code to GETVAX (438829) in English, or VACUNA (822862) for Spanish.
• The Alaska vaccine dashboard is available online for the most up-to-date data.

Borough/Census Area Vaccination Coverage

This is the percent of Alaskans aged ≥5 years who received one or more doses of vaccine.

Borough/Census Area	December 20
Aleutians East Borough	95%
Aleutians West Census Area	74%
Anchorage Municipality	75%
Bethel Census Area	80%
Bristol Bay plus Lake and Peninsula	77%
Denali Borough	75%
Dillingham Census Area	65%
Fairbanks North Star Borough	66%
Haines Borough	72%
Juneau City and Borough	83%
Kenai Peninsula Borough	52%
Ketchikan Gateway Borough	70%
Kodiak Island Borough	72%
Kusilvak Census Area	80%
Matanuska-Susitna Borough	45%
Nome Census Area	82%
North Slope Borough	42%
Northwest Arctic Borough	67%
Petersburg Borough	68%
Prince of Wales-Hyder Census Area	69%
Sitka City and Borough	82%
Skagway Municipality	82%
Southeast Fairbanks Census Area	39%
Valdez-Cordova Census Area	65%
Wrangell City and Borough	65%
Yakutat plus Hoonah-Angoon	79%
Yukon-Koyukuk Census Area	83%
Statewide	67.2%

New Hospitalizations and Deaths

• Cumulative hospitalizations increased by 56 to 3,204. Hospitalization reports often lag when a case was initially reported.
• 6.7% of hospitalized patients in Alaska had COVID-19 as of December 20, 2021.
• On December 18th there were 65 persons with COVID-19 in AK hospitals, which is a 1.5% decrease relative to the week before when there were 66 persons hospitalized.
• The cumulative number of COVID-19 deaths among Alaska residents increased by 58 to 915. It is common to take some time for a death to be reported and verified, and deaths that occurred during December 12–December 18 may be reported in the future after death certificates are reviewed.

Total Confirmed COVID Beds Occupied

Variant Tracking

The most recent Genomic Surveillance data can be found on the “COVID-19 Variants” tab of the Cases Dashboard.

Variants of Concern	Cases Identified	Change from Previous Report	First Identified in Alaska
Delta (B.1.617.2-like)	6,197	+248	30 May 2021
Omicron (B.1.1.529-like)	1	0	29 November 2021
Variants Being Monitored	Cases Identified	Change from Previous Report	First Identified in Alaska
Alpha (B.1.1.7)	466	+5	20 December 2020
Beta (B.1.351)	7	0	20 March 2021
Epsilon (B.1.427/429)	144	+5	24 December 2020
Eta (B.1.525)	1	0	16 March 2021
Gamma (P.1/P.1.1/P.1.2)	77	+1	8 February 2021
Iota (B.1.526)	24	0	4 February 2021
Mu (B.1.621)	161	0	6 May 2021
Zeta (P.2)	4	0	27 January 2021

Vaccine Breakthrough Cases

• Vaccine breakthrough (VB) infections of COVID-19 are those detected in a person who is at least 2 weeks beyond their second dose of a 2-dose series or the only dose of a 1-dose series.
• Alaska residents who are fully vaccinated are much less likely to be hospitalized due to COVID-19 than those who are not fully vaccinated. (Age-standardized per capita rates of COVID-19 hospitalizations by vaccination status are updated monthly.)

• The following updated VB data are among Alaska residents aged ≥5 years with a specimen collection date from January 16–December 18, 2021.

• From January 16–December 18, 2021, 112 deaths, 340 hospitalizations, and 25,328 cases with a VB infection were reported among Alaska residents aged ≥5 years. These counts are provisional and subject to change as data are compiled and reviewed. In that same time frame, a total of 93,437 cases, 2,023 hospitalizations, and 631 deaths were reported.
• 73% of all cases, 83% of all hospitalizations, and 82% of deaths among Alaska residents aged ≥5 years from January 16–December 18, 2021 were in people who were not fully vaccinated. 
• More detailed information about hospitalizations, deaths, repeat and vaccine breakthrough infections among Alaska residents can also be found in the monthly report, which includes data through October.
• Age-standardized per capita rates of COVID-19 cases by vaccination status are updated weekly. Some COVID-19 cases with specimen collection in the immediate past week (indicated by the grey box) may have not yet been reported or counted.

• The following table shows by region the number of vaccine breakthrough cases and the number of cases among persons who are not fully vaccinated.

	Cases (December 12–December 18)
Region	Vaccine breakthrough (All ages)	Not fully vaccinated (All ages)
Anchorage Municipality	157	222
Fairbanks North Star Borough	30	66
Juneau City and Borough	28	20
Kenai Peninsula Borough	15	59
Matanuska-Susitna Borough	49	108
Northwest Region	28	40
Other Interior Region	8	19
Other Southeast Region – Northern	18	21
Other Southeast Region – Southern	20	36
Southwest Region	**	**
Y-K Delta Region	27	42

**To protect privacy, data are excluded from rows in which any value is <5.

• A variety of factors may affect the proportion of vaccine breakthrough cases by region. In communities with higher vaccination coverage, a larger proportion of cases is expected to occur among fully vaccinated persons. Other potential factors include the extent of prior infection in a region and differences in testing practices between regions.

COVID-19 Communication Resources

• DHSS Insights Blog: Celebrate the Holidays Safely
• Revised webpages:
  • COVID-19 Vaccine Information for all Alaskans 
  • COVID-19 treatments for hospitalized patient
  • COVID-19 Outpatient Treatment
• New video PSAs to share:
  • 16+ Booster Dose
  • Bring Back the Light
  • Pediatric Vaccine
  • Holiday Vaccine
  • Home Test
  • Home Test Social Media
  • Pediatric Vaccine: Dr. Adam Grove
  • Boosters for anyone 18+
  • COVID-19 Vaccines for Ages 5+
  • Holiday Flu
  • Why Not Get Vaccinated?
  • Layer up, Alaska! 
• Pediatric COVID-19 Vaccine Flyer: 5 Reasons to Vaccinate for Ages 5+
• Over-the-Counter Testing Flyer: At-home COVID-19 tests
• Request support from DHSS
  • DHSS offers free presentations upon request to groups about COVID-19, the vaccines, COVID-19 prevention, or other health topics upon request. Learn more or request a presentation on our Speaker’s Bureau web page.  
  • DHSS offers support for one-time or reoccurring COVID-19 vaccination events. Submit your request for support and provide information about the event by filling out this form .
• Can’t tune into a live ECHO videoconference but don’t want to miss out on the latest updates? The full schedule of ECHO sessions and access to COVID-19 ECHO videos and slideshows are available for download anytime on the DHSS ECHO web page.

Statewide Percentage of Daily Tests with Positive Results
(Seven day rolling average)

Cases by Week of Onset and Age

Note: Quality assurance efforts are ongoing to attribute cases to the correct date on the onset date epi curve. Some recent cases will be reattributed to different weeks.

Cases by Week of Onset and Race

Note: Quality assurance efforts are ongoing to attribute cases to the correct date on the onset date epi curve. Some recent cases will be reattributed to different weeks. Race abbreviations include AI/AN (American Indian or Alaska Native), Asian/NHOPI (Asian, Native Hawaiian or Other Pacific Islander), and UI/Unknown (Under investigation or unknown).

Additional informational resources:

• The State of Alaska COVID-19 vaccine status update page
• The State of Alaska COVID-19 information page provides 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: data.coronavirus.alaska.gov. All dashboard data are updated Mondays, Wednesdays, and Fridays (except holidays). 
• For DHSS media inquiries, please contact clinton.bennett@alaska.gov

Additional ECHO session details:

Updated December 23, 2021

These ECHO sessions are produced and facilitated by
UAA’s Center for Human Development Alaska ECHO project
in partnership with the State of Alaska, Department of Health & Social Services

Important Note: Most Division of Public Health ECHO series will be taking a break from December 20-December 31 for the winter holidays. Please check individual ECHO registration pages for additional information on holiday scheduling.

Alaska Department of Health & Social Services Weekly Case Update
December 5 — December 11, 2021

Low Statewide transmission Rt0.85	HIGH Statewide alert status 175.3	LIMITED Hospital capacity	Intermediate Test positivity 3.57%	66.8% of Alaskans aged 5+ are vaccinated
Red- Rt >1.2 Orange- Rt 1-1.2 Yellow- Rt <1	7-day case rate per 100,000 population. Red-  ≥100 Orange- 50-99.99 Yellow- 10-49.99 Blue- 0-9.99	Multiple facilities continue to have a high number of inpatients, which results in delays in admitting patients from emergency departments as well as other operational challenges.	Red->5% Orange- 2-5% Yellow- <2%	This includes people with at least one dose. Estimated AK population 5 and older of 680,580 from the AK Department of Labor & Workforce Development.

Case Trends

• Alaska currently has the thirty-third highest number of cases in the last seven days per 100,000 population among the 50 states.
• Hospital capacity has been strained during the Delta variant wave of COVID-19 such that in some hospitals, it may become difficult to care for everyone who needs care, even for non-COVID health concerns. Some care may need to be delayed, there may be long wait times, and hospital beds may not be available.  
  • Hospitalizations are continuing to occur in younger Alaskans, with the median age of persons hospitalized due to COVID-19 in 2021 being about 5 years younger than in 2020.
  • Among those hospitalized due to COVID-19 and with specimen collection dates from January 16, 2021 through December 11, 2021, unvaccinated and partially vaccinated patients had a median age 14 years younger than fully vaccinated patients.

• Substantial or high levels of COVID-19 transmission are occurring throughout much of Alaska.
• 1,413 cases were reported in Alaskans the week of December 5–December 11. This is a 13.0% decrease from the number of cases reported the week before and indicates a downward trajectory. The course of the COVID-19 pandemic is difficult to predict, and the pattern of declining cases may not be sustained in future weeks.  
• In the three largest boroughs (Anchorage Municipality, Matanuska-Susitna Borough, and Fairbanks North Star Borough) the number of new COVID-19 cases appears to be continuing to decline. There is not a clear upwards or downwards trajectory in the Kenai Peninsula Borough or the City and Borough of Juneau.
• Regardless of the trajectories, high levels of community transmission are widespread, and dozens of Alaskans are hospitalized with COVID each week.
• The intensity of COVID-19 transmission varies substantially between communities outside the largest boroughs. COVID-19 cases are regularly reported from nearly all boroughs and census areas and some communities are experiencing widespread transmission.

COVID-19 Guidance

Take action now to help slow the spread of COVID-19 and preserve health care capacity.

• Please get vaccinated if you haven’t already and get a booster dose if you are eligible (see below for more information). Currently available COVID vaccines will help protect you, your family, and your community against COVID-19.
• Wearing a mask when in indoor public spaces regardless of vaccination status is an important step to take to slow the spread of COVID-19. Most Alaskans live in an area with substantial or high community transmission where this action is needed to protect your health and the health of others.
• Continue to avoid crowds and practice social distancing – particularly when indoors.
• Seek testing if you have any symptoms or have been exposed to an infected person. If you do test positive, isolate right away, and notify your contacts. Ask them to get tested and, if they are unvaccinated, to quarantine.
• If you test positive and you’re at increased risk for severe COVID, obtain monoclonal antibody treatment. This has been shown to be an effective treatment for reducing the risk of hospitalization. This treatment works best when given early.
• Persons at high risk include but are not limited to persons who are elderly, immunocompromised, obese, pregnant, or have certain chronic underlying medical conditions.

Borough/Census Area Alert Level Trends

• Alert levels are based on the case counts over the past 7 days as well as the daily number of reported cases over the past 7 days per 100,000 population.
• Alert levels have been changed to more closely mirror CDC’s community transmission indicator and are calculated by borough and census area, rather than by region.

Borough/Census Area	Alert Level November 22	Alert Level November 29	Alert Level December 6	Alert Level December 13
Count	Rate	Count	Rate	Count	Rate	Count	Rate
Anchorage Municipality	793	274.4	652	225.6	579	200.4	466	161.3
Fairbanks North Star Borough	289	297.5	211	217.2	144	148.2	91	93.7
Juneau City and Borough	49	154.2	60	188.8	59	185.7	63	198.3
Kenai Peninsula Borough	158	268.1	99	168.0	117	198.5	74	125.6
Matanuska-Susitna Region	407	379.3	340	316.9	286	266.5	217	202.2
Nome Census Area	112	1,146.5	80	818.9	65	665.4	58	593.7
North Slope Borough	54	552.7	35	358.2	12	122.8*	8	81.9*
Northwest Arctic Borough	103	1,358.3	70	923.1	74	975.9	35	461.6
Chugach Census Area	24	355.5	10	148.1*	4	**	1	**
Copper River Census Area	25	926.3	22	815.1	17	629.9*	7	259.4*
Denali Borough	7	387.6*	0	**	3	**	0	**
Southeast Fairbanks Census Area	9	129.7*	19	273.9*	4	**	8	115.3*
Yukon-Koyukuk Census Area	13	257.7*	8	158.6*	1	**	3	**
Haines Borough	1	**	1	**	3	**	0	**
Petersburg Borough	76	2,383.2	38	1,191.6	13	407.7*	3	**
Sitka City and Borough	10	117.3*	8	93.9*	10	117.3*	26	305.1
Skagway Municipality	0	**	0	**	2	**	1	**
Wrangell City and Borough	21	882.7	10	420.3*	4	**	1	**
Yakutat plus Hoonah-Angoon	9	339.9*	3	**	1	**	1	**
Ketchikan Gateway Borough	91	665.4	91	665.4	104	760.4	67	489.9
Prince of Wales-Hyder Census Area	24	394.1	3	**	23	377.7	13	213.5*
Bethel Census Area	204	1,141.7	129	722.0	79	442.1	40	223.9
Kusilvak Census Area	37	457.5	41	506.9	64	791.3	55	680.0
Aleutians East Borough	2	**	2	**	0	**	1	**
Aleutians West Census Area	2	**	4	**	1	**	2	**
Dillingham Census Area	13	272.4*	9	188.6*	23	481.9	13	272.4*
Kodiak Island Borough	16	126.9*	9	71.4*	13	103.1*	19	150.7*
Bristol Bay plus Lake and Peninsula	10	413.2*	4	**	10	413.2*	5	**
Statewide	2,559	351.1	1,958	268.6	1,715	235.3	1,278	175.3

*Rates based on <20 observations are statistically unreliable and should be used with caution.
**Rates based on <6 observations are not reported.

Vaccination Status

• Anyone aged ≥5 years in Alaska is now eligible to receive a COVID-19 vaccine.
• If you have received an initial dose of the Pfizer or Moderna COVID-19 vaccine, be sure to get your second dose too.
• Everyone ≥18 years old who received the primary series of an mRNA (Pfizer or Moderna) COVID-19 vaccine ≥6 months ago should receive a booster dose.
• For people who received the Janssen COVID-19 vaccine, a boosterdose (either the Janssen vaccine again or an mRNA vaccine) is recommended for anyone aged ≥18 years who was vaccinated ≥2 months ago.
• Adolescents aged 16 and 17 who received the primary series of the Pfizer vaccine ≥6 months ago may receive a booster dose of the Pfizer vaccine.
• Learn more about who should get a booster dose and to find COVID-19 vaccines near you at covidvax.alaska.gov.
• CDC recommends that people with moderately to severely compromised immune systems receive an additional dose of mRNA COVID-19 vaccine at least 28 days after a second dose of an mRNA vaccine.
• Vaccinated persons with immunocompromising conditions should discuss with their health care providers the need for additional personal protective measures.
• To schedule your vaccine appointment visit covidvax.alaska.gov or call 907-646-3322.
• To find clinics in your area you can visit vaccines.gov or text your zip code to GETVAX (438829) in English, or VACUNA (822862) for Spanish.
• The Alaska vaccine dashboard is available online for the most up-to-date data.

Borough/Census Area Vaccination Coverage

This is the percent of Alaskans aged ≥5 years who received one or more doses of vaccine.

Borough/Census Area	December 13
Aleutians East Borough	95%
Aleutians West Census Area	74%
Anchorage Municipality	74%
Bethel Census Area	80%
Bristol Bay plus Lake and Peninsula	76%
Denali Borough	75%
Dillingham Census Area	63%
Fairbanks North Star Borough	66%
Haines Borough	72%
Juneau City and Borough	83%
Kenai Peninsula Borough	52%
Ketchikan Gateway Borough	70%
Kodiak Island Borough	72%
Kusilvak Census Area	80%
Matanuska-Susitna Borough	45%
Nome Census Area	81%
North Slope Borough	42%
Northwest Arctic Borough	66%
Petersburg Borough	68%
Prince of Wales-Hyder Census Area	69%
Sitka City and Borough	82%
Skagway Municipality	81%
Southeast Fairbanks Census Area	39%
Valdez-Cordova Census Area	65%
Wrangell City and Borough	65%
Yakutat plus Hoonah-Angoon	79%
Yukon-Koyukuk Census Area	82%
Statewide	66.8%

Note: Vaccination coverage estimates by borough and census area now include data on vaccines administered by the DoD and VA, which led to an increase in reported vaccination coverage for certain boroughs and census areas.  

New Hospitalizations and Deaths

• Cumulative hospitalizations increased by 31 to 3,148. Hospitalization reports often lag when a case was initially reported.
• 6.4% of hospitalized patients in Alaska had COVID-19 as of December 13, 2021.
• On December 11th there were 66 persons with COVID-19 in AK hospitals, which is a 12% decrease relative to the week before when there were 75 persons hospitalized.
• The cumulative number of COVID-19 deaths among Alaska residents increased by 4 to 857. It is common to take some time for a death to be reported and verified, and deaths that occurred during December 5–December 11 may be reported in the future after death certificates are reviewed.

Total Confirmed COVID Beds Occupied

Variant Tracking

The most recent Genomic Surveillance data can be found on the “COVID-19 Variants” tab of the Cases Dashboard.

Variants of Concern	Cases Identified	Change from Previous Report	First Identified in Alaska
Delta (B.1.617.2-like)	5,949	+257	30 May 2021
Omicron (B.1.1.529-like)	1	+1	29 November 2021
Variants Being Monitored	Cases Identified	Change from Previous Report	First Identified in Alaska
Alpha (B.1.1.7)	461	-2	20 December 2020
Beta (B.1.351)	7	0	20 March 2021
Epsilon (B.1.427/429)	139	0	24 December 2020
Eta (B.1.525)	1	0	16 March 2021
Gamma (P.1/P.1.1/P.1.2)	76	0	8 February 2021
Iota (B.1.526)	24	0	4 February 2021
Mu (B.1.621)	161	0	6 May 2021
Zeta (P.2)	4	0	27 January 2021

Vaccine Breakthrough Cases

• Vaccine breakthrough (VB) infections of COVID-19 are those detected in a person who is at least 2 weeks beyond their second dose of a 2-dose series or the only dose of a 1-dose series.
• Alaska residents who are fully vaccinated are much less likely to be hospitalized due to COVID-19 than those who are not fully vaccinated. (Age-standardized per capita rates of COVID-19 hospitalizations by vaccination status are updated monthly.)

• The following updated VB data are among Alaska residents aged ≥5 years with a specimen collection date from January 16–December 11, 2021.

• From January 16–December 11, 2021, 100 deaths, 317 hospitalizations, and 24,841 cases with a VB infection were reported among Alaska residents aged ≥5 years. These counts are provisional and subject to change as data are compiled and reviewed. In that same time frame, a total of 92,352 cases, 1,936 hospitalizations, and 546 deaths were reported.
• 73% of all cases, 84% of all hospitalizations, and 82% of deaths among Alaska residents aged ≥5 years from January 16–December 11, 2021 were in people who were not fully vaccinated. 
• More detailed information about hospitalizations, deaths, repeat and vaccine breakthrough infections among Alaska residents can also be found in the monthly report, which includes data through October.
• Age-standardized per capita rates of COVID-19 cases by vaccination status are updated weekly. Some COVID-19 cases with specimen collection in the immediate past week (indicated by the grey box) may have not yet been reported or counted.

• The following table shows by region the number of vaccine breakthrough cases and the number of cases among persons who are not fully vaccinated.

	Cases (December 5–December 11)
Region	Vaccine breakthrough (All ages)	Not fully vaccinated (All ages)
Anchorage Municipality	144	264
Fairbanks North Star Borough	25	52
Juneau City and Borough	28	29
Kenai Peninsula Borough	20	49
Matanuska-Susitna Borough	57	125
Northwest Region	35	58
Other Interior Region	**	**
Other Southeast Region – Northern	13	15
Other Southeast Region – Southern	28	50
Southwest Region	10	20
Y-K Delta Region	45	48

**To protect privacy, data are excluded from rows in which any value is <5.

• A variety of factors may affect the proportion of vaccine breakthrough cases by region. In communities with higher vaccination coverage, a larger proportion of cases is expected to occur among fully vaccinated persons. Other potential factors include the extent of prior infection in a region and differences in testing practices between regions.

COVID-19 Communication Resources

• DHSS Insights Blog: Celebrate the Holidays Safely
• Revised webpages:
  • COVID-19 treatments for hospitalized patient
  • COVID-19 Outpatient Treatment
• Not recently revised but helpful downloads: Social media toolkit and downloads to share
• New video PSAs to share:
  • Bring Back the Light
  • 1-year COVID-19 Vaccine Anniversary
  • Pediatric Vaccine
  • Holiday Vaccine
  • Home Test
  • Home Test Social Media
  • Pediatric Vaccine: Dr. Adam Grove
  • Boosters for anyone 18+
  • COVID-19 Vaccines for Ages 5+
  • Pediatric Vaccine Clinic at TVC Day 1
  • Pediatric Vaccine Clinic at TVC Day 2
  • Holiday Flu
  • Why Not Get Vaccinated?
  • Layer up, Alaska! 
• Pediatric COVID-19 Vaccine Flyer: 5 Reasons to Vaccinate for Ages 5+
• Over-the-Counter Testing Flyer: At-home COVID-19 tests
• Request support from DHSS
  • DHSS offers free presentations upon request to groups about COVID-19, the vaccines, COVID-19 prevention, or other health topics upon request. Learn more or request a presentation on our Speaker’s Bureau web page.  
  • DHSS offers support for one-time or reoccurring COVID-19 vaccination events. Submit your request for support and provide information about the event by filling out this form .
• Can’t tune into a live ECHO videoconference but don’t want to miss out on the latest updates? The full schedule of ECHO sessions and access to COVID-19 ECHO videos and slideshows are available for download anytime on the DHSS ECHO web page .

Statewide Percentage of Daily Tests with Positive Results
(Seven day rolling average)

Cases by Week of Onset and Age

Note: Quality assurance efforts are ongoing to attribute cases to the correct date on the onset date epi curve. Some recent cases will be reattributed to different weeks.

Cases by Week of Onset and Race

Note: Quality assurance efforts are ongoing to attribute cases to the correct date on the onset date epi curve. Some recent cases will be reattributed to different weeks. Race abbreviations include AI/AN (American Indian or Alaska Native), Asian/NHOPI (Asian, Native Hawaiian or Other Pacific Islander), and UI/Unknown (Under investigation or unknown).

Additional informational resources:

• The State of Alaska COVID-19 vaccine status update page
• The State of Alaska COVID-19 information page provides 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: data.coronavirus.alaska.gov. All dashboard data are updated Mondays, Wednesdays, and Fridays (except holidays). 
• For DHSS media inquiries, please contact clinton.bennett@alaska.gov

Additional ECHO session details:

Updated December 16, 2021

These ECHO sessions are produced and facilitated by
UAA’s Center for Human Development Alaska ECHO project
in partnership with the State of Alaska, Department of Health & Social Services

Important Note: Most Division of Public Health ECHO series will be taking a break from December 20-December 31 for the winter holidays. Please check individual ECHO registration pages for additional information on holiday scheduling.

Regular Series

Alaska Medical Provider ECHO (formerly COVID-19 for AK Healthcare Providers)
Monthly on the 1st Tuesday of the month from 7-8 pm
This ECHO aims to increase knowledge and share best practices among medical providers across Alaska as well as to increase access to information for those living in rural areas of the state.

School Health ECHO
Every Monday from 3:00-4:00 p.m Register
The School Health ECHO is a virtual learning network intended for professionals in the education setting (administrators, school-based nurses, etc.) to interface with a team of medical and education experts in Alaska.

Vaccine ECHO for Providers
Weekly on Tuesday from 2-3 p.m. Register
The Vaccine ECHO for providers provides planning and operation updates to vaccine providers across Alaska, while answering any questions you may have.

Palliative Care ECHO
Monthly on the first Tuesday from 12-1 p.m.
This monthly ECHO is for all Alaskan healthcare disciplines supporting patients with serious illness, and aims to provide support and up-to-date information regarding Palliative Care during this period of COVID-19.

Public Science ECHO
Weekly on Wednesday from 12-1 p.m. register via Zoom
The Alaska Public Health Science ECHO is a virtual learning network intended for the general public to interface with our Public Health Leadership Team to explore the science of the COVID-19 virus, other public health topics, and current best practices. Or view via concurrent livestream to Facebook: https://www.facebook.com/akechoprograms

Local Government Public Health ECHO
Monthly on the third Wednesday from 3-4 p.m. Register
The Local Government Public Health Analysis ECHO is a virtual learning environment intended for local Alaska government leaders to interact with the State Public Health Leadership team and focuses on pandemic mitigation tools available, and how to use them.

Long Term Care Facilities ECHO 
Second Wednesday of the month from 4-5 p.m. Register 
Please join other staff and administrators of Alaska’s assisted living homes and residential care facilities to gather, learn, share, and grow. COVID has disrupted the fabric of our daily life and we can always learn from each other as we adjust to the new normal.

Healthcare Specific Situational Awareness ECHO
Weekly on Thursday from 12-1 p.m.  Register
The Healthcare Specific Situational ECHO is a virtual learning network intended for healthcare professionals to interface with our Public Health Leadership Team to explore current best practices and the most recent information related to Public Health.

Perinatal ECHO
Monthly on 3rd Thursday from 6-7 p.m. Register
The Alaska Perinatal ECHO is a virtual learning network intended for medical providers caring for pregnant patients and their newborns.EMS ECHO
Monthly on the 1st and 3rd Wednesday 1-2 p.m Register
The EMS ECHO is a virtual learning network intended for Emergency Medical Services and related personnel in Alaska to amplify best practices. Sessions are topic-driven and typically include a guest presenter or a brief lecture with an interactive case or process discussion.

Co-Occurring Behavioral Health, Opioid and Stimulant Use Disorders ECHO
1st & 3rd Wednesdays from 12:00pm-1:00pm, November 3, 2021 – April 20, 2022
The Co-Occurring Behavioral Health (COBH), Opioid and Stimulant Use Disorders ECHO facilitates a virtual network for behavioral health providers to learn best practice care through real-time access to experienced subject matter experts and their peers. Each session includes a brief lecture, de-identified case presentation for participants to receive feedback on complex cases, and open discussion facilitated by an interdisciplinary team.Data Waivers ECHO New ECHO!
2nd Wednesdays from 12:00pm-1:00pm, November 10, 2021 – September 14, 2022
The Data Waivers ECHO facilitates a virtual network for clinical providers to learn and implement best practices for offering buprenorphine and other medically assisted treatment (MAT) services under a data waiver. Each session includes a brief lecture, de-identified case presentation for participants to receive feedback on complex cases, and open discussion facilitated by an interdisciplinary team.

Session information and recordings of previous ECHO sessions
subscribe to ECHO calendar updates | email: echo@alaskachd.org | website: akecho.org

Alaska Department of Health & Social Services Weekly Case Update
November 28 — December 4, 2021

Intermediate Statewide transmission Rt0.84	HIGH Statewide alert status 235.3	LIMITED Hospital capacity	HIGH Test positivity 4.84%	62% of Alaskans aged 5+ are vaccinated
Red- Rt >1.2 Orange- Rt 1-1.2 Yellow- Rt <1	7-day case rate per 100,000 population. Red-  ≥100 Orange- 50-99.99 Yellow- 10-49.99 Blue- 0-9.99	Multiple facilities continue to have a high number of inpatients, which results in delays in admitting patients from emergency departments as well as other operational challenges.	Red->5% Orange- 2-5% Yellow- <2%	This includes people with at least one dose. Estimated AK population 5 and older of 680,580 from the AK Department of Labor & Workforce Development.

Case Trends

• Alaska currently has the thirtieth highest number of cases in the last seven days per 100,000 population among the 50 states.
• Hospital capacity has been strained during the Delta variant wave of COVID-19 such that in some hospitals, it may become difficult to care for everyone who needs care, even for non-COVID health concerns. Some care may need to be delayed, there may be long wait times, and hospital beds may not be available.  
  • Hospitalizations are continuing to occur in younger Alaskans, with the median age of persons hospitalized due to COVID-19 in 2021 being about 5 years younger than in 2020.
  • Among those hospitalized due to COVID-19 and with specimen collection dates from January 16, 2021 through December 4, 2021, unvaccinated and partially vaccinated patients had a median age 14 years younger than fully vaccinated patients.

• High levels of COVID-19 transmission are occurring throughout much of Alaska.
• 1,624 cases were reported in Alaskans the week of November 28–December 4. This is an 18.9% decrease from the number of cases reported the week before and indicates a downward trajectory. The course of the COVID-19 pandemic is difficult to predict, and the pattern of declining cases may not be sustained in future weeks.  
• In the five largest boroughs (Anchorage Municipality, Matanuska-Susitna Borough, Fairbanks North Star Borough, Kenai Peninsula Borough, and the City and Borough of Juneau), the number of new COVID-19 cases the week of November 28–December 4 was generally similar to the number the prior week. It is unclear if a downward trajectory is continuing. Making comparisons between weeks is difficult because the volume of testing was affected by the Thanksgiving holiday.  
• Regardless of the trajectories, high levels of community transmission are widespread, and dozens of Alaskans are hospitalized with COVID each week.
• The intensity of COVID-19 transmission varies substantially between communities outside the largest boroughs. COVID-19 cases are regularly reported from nearly all boroughs and census areas and some communities are experiencing extremely widespread transmission.

COVID-19 Guidance

Take action now to help slow the spread of COVID-19 and preserve health care capacity.

• Please get vaccinated if you haven’t already and get a booster dose if you are eligible (see below for more information). Currently available COVID vaccines will help protect you, your family, and your community against COVID-19.
• Wearing a mask when in indoor public spaces regardless of vaccination status is an important step to take to slow the spread of COVID-19. Most Alaskans live in an area with substantial or high community transmission where this action is needed to protect your health and the health of others.
• Continue to avoid crowds and practice social distancing – particularly when indoors.
• Seek testing if you have any symptoms or have been exposed to an infected person. If you do test positive, isolate right away, and notify your contacts. Ask them to get tested and, if they are unvaccinated, to quarantine.
• If you test positive and you’re at increased risk for severe COVID, obtain monoclonal antibody treatment. This has been shown to be an effective treatment for reducing the risk of hospitalization. This treatment works best when given early.
• Persons at high risk include but are not limited to persons who are elderly, immunocompromised, obese, pregnant, or have certain chronic underlying medical conditions.

Borough/Census Area Alert Level Trends

• Alert levels are based on the case counts over the past 7 days as well as the daily number of reported cases over the past 7 days per 100,000 population.
• Alert levels have been changed to more closely mirror CDC’s community transmission indicator and are calculated by borough and census area, rather than by region.

Borough/Census Area	Alert Level November 15	Alert Level November 22	Alert Level November 29	Alert Level December 6
Count	Rate	Count	Rate	Count	Rate	Count	Rate
Anchorage Municipality	904	312.8	793	274.4	652	225.6	579	200.4
Fairbanks North Star Borough	294	302.6	289	297.5	211	217.2	144	148.2
Juneau City and Borough	31	97.6	49	154.2	60	188.8	59	185.7
Kenai Peninsula Borough	155	263.0	158	268.1	99	168.0	117	198.5
Matanuska-Susitna Region	537	500.4	407	379.3	340	316.9	286	266.5
Nome Census Area	170	1,740.2	112	1,146.5	80	818.9	65	665.4
North Slope Borough	31	317.3	54	552.7	35	358.2	12	122.8*
Northwest Arctic Borough	118	1,556.1	103	1,358.3	70	923.1	74	975.9
Chugach Census Area	17	251.8*	24	355.5	10	148.1*	4	**
Copper River Census Area	23	852.2	25	926.3	22	815.1	17	629.9*
Denali Borough	4	**	7	387.6*	0	**	3	**
Southeast Fairbanks Census Area	30	432.5	9	129.7*	19	273.9*	4	**
Yukon-Koyukuk Census Area	18	356.9*	13	257.7*	8	158.6*	1	**
Haines Borough	2	**	1	**	1	**	3	**
Petersburg Borough	43	1,348.4	76	2,383.2	38	1,191.6	13	407.7*
Sitka City and Borough	6	70.4*	10	117.3*	8	93.9*	10	117.3*
Skagway Municipality	0	**	0	**	0	**	2	**
Wrangell City and Borough	28	1,177.0	21	882.7	10	420.3*	4	**
Yakutat plus Hoonah-Angoon	2	**	9	339.9*	3	**	1	**
Ketchikan Gateway Borough	89	650.7	91	665.4	91	665.4	104	760.4
Prince of Wales-Hyder Census Area	32	525.5	24	394.1	3	**	23	377.7
Bethel Census Area	188	1,052.2	204	1,141.7	129	722.0	79	442.1
Kusilvak Census Area	32	395.6	37	457.5	41	506.9	64	791.3
Aleutians East Borough	2	**	2	**	2	**	0	**
Aleutians West Census Area	0	**	2	**	4	**	1	**
Dillingham Census Area	14	293.3*	13	272.4*	9	188.6*	23	481.9
Kodiak Island Borough	35	277.5	16	126.9*	9	71.4*	13	103.1*
Bristol Bay plus Lake and Peninsula	13	537.2*	10	413.2*	4	**	10	413.2*
Statewide	2,818	386.6	2,559	351.1	1,958	268.6	1,715	235.3

Alaska Department of Health & Social Services Weekly Case Update
November 28 — December 4, 2021

Intermediate Statewide transmission Rt0.84	HIGH Statewide alert status 235.3	LIMITED Hospital capacity	HIGH Test positivity 4.84%	62% of Alaskans aged 5+ are vaccinated
Red- Rt >1.2 Orange- Rt 1-1.2 Yellow- Rt <1	7-day case rate per 100,000 population. Red-  ≥100 Orange- 50-99.99 Yellow- 10-49.99 Blue- 0-9.99	Multiple facilities continue to have a high number of inpatients, which results in delays in admitting patients from emergency departments as well as other operational challenges.	Red->5% Orange- 2-5% Yellow- <2%	This includes people with at least one dose. Estimated AK population 5 and older of 680,580 from the AK Department of Labor & Workforce Development.

Case Trends

• Alaska currently has the thirtieth highest number of cases in the last seven days per 100,000 population among the 50 states.
• Hospital capacity has been strained during the Delta variant wave of COVID-19 such that in some hospitals, it may become difficult to care for everyone who needs care, even for non-COVID health concerns. Some care may need to be delayed, there may be long wait times, and hospital beds may not be available.  
  • Hospitalizations are continuing to occur in younger Alaskans, with the median age of persons hospitalized due to COVID-19 in 2021 being about 5 years younger than in 2020.
  • Among those hospitalized due to COVID-19 and with specimen collection dates from January 16, 2021 through December 4, 2021, unvaccinated and partially vaccinated patients had a median age 14 years younger than fully vaccinated patients.

• High levels of COVID-19 transmission are occurring throughout much of Alaska.
• 1,624 cases were reported in Alaskans the week of November 28–December 4. This is an 18.9% decrease from the number of cases reported the week before and indicates a downward trajectory. The course of the COVID-19 pandemic is difficult to predict, and the pattern of declining cases may not be sustained in future weeks.  
• In the five largest boroughs (Anchorage Municipality, Matanuska-Susitna Borough, Fairbanks North Star Borough, Kenai Peninsula Borough, and the City and Borough of Juneau), the number of new COVID-19 cases the week of November 28–December 4 was generally similar to the number the prior week. It is unclear if a downward trajectory is continuing. Making comparisons between weeks is difficult because the volume of testing was affected by the Thanksgiving holiday.  
• Regardless of the trajectories, high levels of community transmission are widespread, and dozens of Alaskans are hospitalized with COVID each week.
• The intensity of COVID-19 transmission varies substantially between communities outside the largest boroughs. COVID-19 cases are regularly reported from nearly all boroughs and census areas and some communities are experiencing extremely widespread transmission.

COVID-19 Guidance

Take action now to help slow the spread of COVID-19 and preserve health care capacity.

• Please get vaccinated if you haven’t already and get a booster dose if you are eligible (see below for more information). Currently available COVID vaccines will help protect you, your family, and your community against COVID-19.
• Wearing a mask when in indoor public spaces regardless of vaccination status is an important step to take to slow the spread of COVID-19. Most Alaskans live in an area with substantial or high community transmission where this action is needed to protect your health and the health of others.
• Continue to avoid crowds and practice social distancing – particularly when indoors.
• Seek testing if you have any symptoms or have been exposed to an infected person. If you do test positive, isolate right away, and notify your contacts. Ask them to get tested and, if they are unvaccinated, to quarantine.
• If you test positive and you’re at increased risk for severe COVID, obtain monoclonal antibody treatment. This has been shown to be an effective treatment for reducing the risk of hospitalization. This treatment works best when given early.
• Persons at high risk include but are not limited to persons who are elderly, immunocompromised, obese, pregnant, or have certain chronic underlying medical conditions.

Borough/Census Area Alert Level Trends

• Alert levels are based on the case counts over the past 7 days as well as the daily number of reported cases over the past 7 days per 100,000 population.
• Alert levels have been changed to more closely mirror CDC’s community transmission indicator and are calculated by borough and census area, rather than by region.

Borough/Census Area	Alert Level November 15	Alert Level November 22	Alert Level November 29	Alert Level December 6
Count	Rate	Count	Rate	Count	Rate	Count	Rate
Anchorage Municipality	904	312.8	793	274.4	652	225.6	579	200.4
Fairbanks North Star Borough	294	302.6	289	297.5	211	217.2	144	148.2
Juneau City and Borough	31	97.6	49	154.2	60	188.8	59	185.7
Kenai Peninsula Borough	155	263.0	158	268.1	99	168.0	117	198.5
Matanuska-Susitna Region	537	500.4	407	379.3	340	316.9	286	266.5
Nome Census Area	170	1,740.2	112	1,146.5	80	818.9	65	665.4
North Slope Borough	31	317.3	54	552.7	35	358.2	12	122.8*
Northwest Arctic Borough	118	1,556.1	103	1,358.3	70	923.1	74	975.9
Chugach Census Area	17	251.8*	24	355.5	10	148.1*	4	**
Copper River Census Area	23	852.2	25	926.3	22	815.1	17	629.9*
Denali Borough	4	**	7	387.6*	0	**	3	**
Southeast Fairbanks Census Area	30	432.5	9	129.7*	19	273.9*	4	**
Yukon-Koyukuk Census Area	18	356.9*	13	257.7*	8	158.6*	1	**
Haines Borough	2	**	1	**	1	**	3	**
Petersburg Borough	43	1,348.4	76	2,383.2	38	1,191.6	13	407.7*
Sitka City and Borough	6	70.4*	10	117.3*	8	93.9*	10	117.3*
Skagway Municipality	0	**	0	**	0	**	2	**
Wrangell City and Borough	28	1,177.0	21	882.7	10	420.3*	4	**
Yakutat plus Hoonah-Angoon	2	**	9	339.9*	3	**	1	**
Ketchikan Gateway Borough	89	650.7	91	665.4	91	665.4	104	760.4
Prince of Wales-Hyder Census Area	32	525.5	24	394.1	3	**	23	377.7
Bethel Census Area	188	1,052.2	204	1,141.7	129	722.0	79	442.1
Kusilvak Census Area	32	395.6	37	457.5	41	506.9	64	791.3
Aleutians East Borough	2	**	2	**	2	**	0	**
Aleutians West Census Area	0	**	2	**	4	**	1	**
Dillingham Census Area	14	293.3*	13	272.4*	9	188.6*	23	481.9
Kodiak Island Borough	35	277.5	16	126.9*	9	71.4*	13	103.1*
Bristol Bay plus Lake and Peninsula	13	537.2*	10	413.2*	4	**	10	413.2*
Statewide	2,818	386.6	2,559	351.1	1,958	268.6	1,715	235.3

*Rates based on <20 observations are statistically unreliable and should be used with caution.
**Rates based on <6 observations are not reported.

Vaccination Status

• Anyone aged ≥5 years in Alaska is now eligible to receive a COVID-19 vaccine.
• If you have received an initial dose of the Pfizer or Moderna COVID-19 vaccine, be sure to get your second dose too.
• Everyone ≥18 years old who received the primary series of an mRNA (Pfizer or Moderna) COVID-19 vaccine ≥6 months ago should receive a booster dose.
• For people who received the Janssen COVID-19 vaccine, a booster dose (either the Janssen vaccine again or an mRNA vaccine) is recommended for anyone aged ≥18 years who was vaccinated ≥2 months ago.
• Adolescents aged 16 and 17 who received the primary series of the Pfizer vaccine ≥6 months ago may receive a booster dose of the Pfizer vaccine.
• Learn more about who should get a booster dose and to find COVID-19 vaccines near you at covidvax.alaska.gov.
• CDC recommends that people with moderately to severely compromised immune systems receive an additional dose of mRNA COVID-19 vaccine at least 28 days after a second dose of an mRNA vaccine.
• Vaccinated persons with immunocompromising conditions should discuss with their health care providers the need for additional personal protective measures.
• To schedule your vaccine appointment visit covidvax.alaska.gov or call 907-646-3322.
• To find clinics in your area you can visit vaccines.gov or text your zip code to GETVAX (438829) in English, or VACUNA (822862) for Spanish.
• The Alaska vaccine dashboard is available online for the most up-to-date data.

Borough/Census Area Vaccination Coverage

This is the percent of Alaskans aged ≥5 years who received one or more doses of vaccine.

Borough/Census Area	December 6
Aleutians East Borough	95%
Aleutians West Census Area	73%
Anchorage Municipality	67%
Bethel Census Area	79%
Bristol Bay plus Lake and Peninsula	76%
Denali Borough	75%
Dillingham Census Area	62%
Fairbanks North Star Borough	53%
Haines Borough	72%
Juneau City and Borough	82%
Kenai Peninsula Borough	51%
Ketchikan Gateway Borough	69%
Kodiak Island Borough	71%
Kusilvak Census Area	79%
Matanuska-Susitna Borough	44%
Nome Census Area	81%
North Slope Borough	41%
Northwest Arctic Borough	66%
Petersburg Borough	68%
Prince of Wales-Hyder Census Area	69%
Sitka City and Borough	81%
Skagway Municipality	79%
Southeast Fairbanks Census Area	38%
Valdez-Cordova Census Area	64%
Wrangell City and Borough	65%
Yakutat plus Hoonah-Angoon	79%
Yukon-Koyukuk Census Area	81%
Statewide	62%

New Hospitalizations and Deaths

• Cumulative hospitalizations increased by 64 to 3,117. Hospitalization reports often lag when a case was initially reported.
• 8.1% of hospitalized patients in Alaska had COVID-19 as of December 6, 2021.
• On December 4th there were 75 persons with COVID-19 in AK hospitals, which is a 6.3% decrease relative to the week before when there were 80 persons hospitalized.
• The cumulative number of COVID-19 deaths among Alaska residents increased by 5 to 853. It is common to take some time for a death to be reported and verified, and deaths that occurred during November 28–December 4 may be reported in the future after death certificates are reviewed.

Total Confirmed COVID Beds Occupied

Variant Tracking

• The most recent Genomic Surveillance data can be found on the “COVID-19 Variants” tab of the Cases Dashboard.

Variants of Concern	Cases Identified	Change from Previous Report	First Identified in Alaska
Delta (B.1.617.2-like)	5,692	+97	30 May 2021
Omicron (B.1.1.529-like)	0		Not identified
Variants Being Monitored	Cases Identified	Change from Previous Report	First Identified in Alaska
Alpha (B.1.1.7)	463	0	20 December 2020
Beta (B.1.351)	7	0	20 March 2021
Epsilon (B.1.427/429)	139	+1	24 December 2020
Eta (B.1.525)	1	0	16 March 2021
Gamma (P.1/P.1.1/P.1.2)	76	0	8 February 2021
Iota (B.1.526)	24	0	4 February 2021
Mu (B.1.621)	161	0	6 May 2021
Zeta (P.2)	4	0	27 January 2021

Vaccine Breakthrough Cases

• Vaccine breakthrough (VB) infections of COVID-19 are those detected in a person who is at least 2 weeks beyond their second dose of a 2-dose series or the only dose of a 1-dose series.
• Alaska residents who are fully vaccinated are much less likely to be hospitalized due to COVID-19 than those who are not fully vaccinated. (Age-standardized per capita rates of COVID-19 hospitalizations by vaccination status are updated monthly.)

• The following updated VB data are among Alaska residents aged ≥12 years with a specimen collection date from January 16–December 4, 2021. (Children ages 5 to 11 are not included because at this time they have not been eligible for vaccination long enough to become fully vaccinated.)

• From January 16–December 4, 2021, 100 deaths, 310 hospitalizations, and 24,352 cases with a VB infection were reported among Alaska residents aged ≥12 years. These counts are provisional and subject to change as data are compiled and reviewed. In that same time frame, a total of 79,650 cases, 1,906 hospitalizations, and 542 deaths were reported.
• 69% of all cases, 84% of all hospitalizations, and 82% of deaths among Alaska residents aged ≥12 years from January 16–December 4, 2021 were in people who were not fully vaccinated. 
• More detailed information about hospitalizations, deaths, repeat and vaccine breakthrough infections among Alaska residents can also be found in the monthly report, which includes data through October.
• Age-standardized per capita rates of COVID-19 cases by vaccination status are updated weekly. Some COVID-19 cases with specimen collection in the immediate past week (indicated by the grey box) may have not yet been reported or counted.

• The following table shows by region the number of vaccine breakthrough cases, the number of cases among persons aged ≥12 years who are not fully vaccinated, and the number of cases among children 11 years and younger who are not fully vaccinated. (Children 5 to 11 years old have not been eligible for vaccination long enough to be considered fully vaccinated).

	Cases (November 28–December 4)
Region	Vaccine breakthrough (≥12 years)	Not fully vaccinated (≥ 12 years old)	Not fully vaccinated (<12 years old)
Anchorage Municipality	200	248	120
Fairbanks North Star Borough	47	58	23
Juneau City and Borough	29	19	14
Kenai Peninsula Borough	23	67	13
Matanuska-Susitna Borough	68	192	37
Northwest Region	66	42	40
Other Interior Region	**	**	**
Other Southeast Region – Northern	**	**	**
Other Southeast Region – Southern	41	64	24
Southwest Region	22	22	12
Y-K Delta Region	65	20	50

**To protect privacy, data are excluded from rows in which any value is <5.

• A variety of factors may affect the proportion of vaccine breakthrough cases by region. In communities with higher vaccination coverage, a larger proportion of cases is expected to occur among fully vaccinated persons. Other potential factors include the extent of prior infection in a region and differences in testing practices between regions.

COVID-19 Communication Resources

• DHSS Insights Blog: Celebrate the Holidays Safely
• New video PSAs to share:
  • Pediatric Vaccine
  • Holiday Vaccine
  • Home Test
  • Home Test Social Media
  • Pediatric Vaccine: Dr. Adam Grove
  • Boosters for anyone 18+
  • COVID-19 Vaccines for Ages 5+
  • Pediatric Vaccine Clinic at TVC Day 1
  • Pediatric Vaccine Clinic at TVC Day 2
  • Holiday Flu
  • Why Not Get Vaccinated?
  • Layer up, Alaska! 
• Pediatric COVID-19 Vaccine Flyer: 5 Reasons to Vaccinate for Ages 5+
• COVID-19 Vaccine Booster Chart: Boosters are now authorized for all COVID-19 vaccines for anyone 18+ with mixed dosing allowed
• Over-the-Counter Testing Flyer: At-home COVID-19 tests
• Flyer for Schools regarding ordering Over-the-Counter Testing Kits: Over-the-Counter COVID-19 Antigen Tests for Schools
• Revised COVID-19 Webpages: Flu Toolkit
• Request support from DHSS
  • DHSS offers free presentations upon request to groups about COVID-19, the vaccines, COVID-19 prevention, or other health topics upon request. Learn more or request a presentation on our Speaker’s Bureau web page. 
  • DHSS offers support for one-time or reoccurring COVID-19 vaccination events. Submit your request for support and provide information about the event by filling out this form.
• Can’t tune into a live ECHO videoconference but don’t want to miss out on the latest updates? The full schedule of ECHO sessions and access to COVID-19 ECHO videos and slideshows are available for download anytime on the DHSS ECHO web page.

Statewide Percentage of Daily Tests with Positive Results
(Seven day rolling average)

Cases by Week of Onset and Age

Note: Quality assurance efforts are ongoing to attribute cases to the correct date on the onset date epi curve. Some recent cases will be reattributed to different weeks.

Cases by Week of Onset and Race

Note: Quality assurance efforts are ongoing to attribute cases to the correct date on the onset date epi curve. Some recent cases will be reattributed to different weeks. Race abbreviations include AI/AN (American Indian or Alaska Native), Asian/NHOPI (Asian, Native Hawaiian or Other Pacific Islander), and UI/Unknown (Under investigation or unknown).

Additional informational resources:

• The State of Alaska COVID-19 vaccine status update page
• The State of Alaska COVID-19 information page provides 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: data.coronavirus.alaska.gov. All dashboard data are updated Mondays, Wednesdays, and Fridays (except holidays). 
• For DHSS media inquiries, please contact clinton.bennett@alaska.gov

Additional ECHO session details:

Updated December 9, 2021

These ECHO sessions are produced and facilitated by
UAA’s Center for Human Development Alaska ECHO project
in partnership with the State of Alaska, Department of Health & Social Services

Session information and recordings of previous ECHO sessions
subscribe to ECHO calendar updates | email: echo@alaskachd.org | website: akecho.org

Important Note: Most Division of Public Health ECHO series will be taking a break from December 20-December 31 for the winter holidays. Please check individual ECHO registration pages for additional information on holiday scheduling.

Our Alaska Medical Providers ECHO is returning to a once-monthly schedule, on the 1st Tuesday of the month. The next session will take place Tuesday, December 7. Visit the series registration page for additional information.

Regular Series

Alaska Medical Provider ECHO (formerly COVID-19 for AK Healthcare Providers)
Monthly on the 1st Tuesday of the month from 7-8 pm
This ECHO aims to increase knowledge and share best practices among medical providers across Alaska as well as to increase access to information for those living in rural areas of the state.

School Health ECHO
Every Monday from 3:00-4:00 p.m Register
The School Health ECHO is a virtual learning network intended for professionals in the education setting (administrators, school-based nurses, etc.) to interface with a team of medical and education experts in Alaska.

Vaccine ECHO for Providers
Weekly on Tuesday from 2-3 p.m. Register
The Vaccine ECHO for providers provides planning and operation updates to vaccine providers across Alaska, while answering any questions you may have.

Palliative Care ECHO
Monthly on the first Tuesday from 12-1 p.m.
This monthly ECHO is for all Alaskan healthcare disciplines supporting patients with serious illness, and aims to provide support and up-to-date information regarding Palliative Care during this period of COVID-19.

Public Science ECHO
Weekly on Wednesday from 12-1 p.m. register via Zoom
The Alaska Public Health Science ECHO is a virtual learning network intended for the general public to interface with our Public Health Leadership Team to explore the science of the COVID-19 virus, other public health topics, and current best practices. Or view via concurrent livestream to Facebook: https://www.facebook.com/akechoprograms

Local Government Public Health ECHO
Monthly on the third Wednesday from 3-4 p.m. Register
The Local Government Public Health Analysis ECHO is a virtual learning environment intended for local Alaska government leaders to interact with the State Public Health Leadership team and focuses on pandemic mitigation tools available, and how to use them.

Long Term Care Facilities ECHO 
Second Wednesday of the month from 4-5 p.m. Register 
Please join other staff and administrators of Alaska’s assisted living homes and residential care facilities to gather, learn, share, and grow. COVID has disrupted the fabric of our daily life and we can always learn from each other as we adjust to the new normal.

Healthcare Specific Situational Awareness ECHO
Weekly on Thursday from 12-1 p.m.  Register
The Healthcare Specific Situational ECHO is a virtual learning network intended for healthcare professionals to interface with our Public Health Leadership Team to explore current best practices and the most recent information related to Public Health.

Perinatal ECHO
Monthly on 3rd Thursday from 6-7 p.m. Register
The Alaska Perinatal ECHO is a virtual learning network intended for medical providers caring for pregnant patients and their newborns.

EMS ECHO
Monthly on the 1st and 3rd Wednesday 1-2 p.m Register
The EMS ECHO is a virtual learning network intended for Emergency Medical Services and related personnel in Alaska to amplify best practices. Sessions are topic-driven and typically include a guest presenter or a brief lecture with an interactive case or process discussion.

Co-Occurring Behavioral Health, Opioid and Stimulant Use Disorders ECHO
1st & 3rd Wednesdays from 12:00pm-1:00pm, November 3, 2021 – April 20, 2022
The Co-Occurring Behavioral Health (COBH), Opioid and Stimulant Use Disorders ECHO facilitates a virtual network for behavioral health providers to learn best practice care through real-time access to experienced subject matter experts and their peers. Each session includes a brief lecture, de-identified case presentation for participants to receive feedback on complex cases, and open discussion facilitated by an interdisciplinary team.

Data Waivers ECHO New ECHO!
2nd Wednesdays from 12:00pm-1:00pm, November 10, 2021 – September 14, 2022
The Data Waivers ECHO facilitates a virtual network for clinical providers to learn and implement best practices for offering buprenorphine and other medically assisted treatment (MAT) services under a data waiver. Each session includes a brief lecture, de-identified case presentation for participants to receive feedback on complex cases, and open discussion facilitated by an interdisciplinary team.

Sitka’s alert level remains in High which means ordinance 2021-32 is still activated that requires the use of face covering in certain indoor settings and providing a penalty.

The following mitigations are recommended:

• Masks/face coverings recommended when 6 feet of distance can’t be maintained from others

• 6 feet of distance should be maintained

• Large indoor gatherings are not recommended

• Restaurants/ Bars/ Lounges: Indoor capacity reduced to 50% – Encourage delivery/carryout/curbside or outside dining – All employees strongly encouraged to wear masks

• Travel recommendation: Testing strongly encouraged for all travelers – Limit travel when possible