By the Bay: May 15, 2020

May 15, 2020

A state delegation visits Bristol Bay to meet with health teams and city and tribal leaders. We lay out what the Dillingham City's ordinances mean for people coming in to the community. And we talk to Camai Health Center in Naknek about what their plans are heading into the season. 

Nushagak bay. Wednesday, May 13, 2020.
Credit Isabelle Ross/KDLG


Listen to the full show here:

In an effort to address the concerns in coastal communities about outside workers and fishermen bringing COVID-19 to their regions, the state is working to support rural health organizations and communities, as people travel to those areas for the fishing season. 

The group visited three seafood processing plants and met with local health professionals, as well as city and tribal leaders, all while social distancing. The first stop was Dillingham, where the group met with a health team at Kanakanak hospital as well as city officials and community members. After touring Peter Pan Seafoods in Dillingham, the delegation flew to Egegik, where they went to the health clinic and toured Icicle Seafoods’ processing plant. The final stop was Naknek-King Salmon, where the group visited Silver Bay Seafoods. 

At the Bristol Bay Borough’s town hall with the delegation last night, Dillingham resident Kaleb Westfall asked what the city of Dillingham should provide in order for the state to start sending resources to the community. Dr. Anne Zink, the state’s chief medical officer, said they are working to tailor their assistance to each community. 

Gregg Marxmiller of Dillingham asked what the state’s evacuation plan was for active cases in the region, and what its policy is for people who have had the virus but are no longer contagious. Heidi Hedberg, with the Division of Public Health, said the state’s approach was focused on quarantine and testing. 

If a person tests positive, they will be monitored. If they require additional care, they will be medevaced out. Dr. Zink said that they would be following the same protocols as medevacing people out for other health emergencies. 

Testing in villages is also a concern. Dennis Andrew, Sr., of New Stuyahok, asked when the state would be able to provide thorough testing in smaller communities around the region. Dr. Bob Onders, chief medical officer with ANTHC, said that BBAHC is working to equip villages with testing capabilities, and that training is available on ANTHC’s community health aide website, adding that to conserve PPE, it might be beneficial for the patient to administer the test themselves under the supervision of a health aide. 

There was also a question about financial aid to small businesses around the region -- especially since state and local mandates are discouraging people from doing a lot of things they would normally do in the summer. Ben Stevens, the governor’s chief of staff, said the federal CARES Act has allowed the state to set up programs to help businesses. He said that depending on how big the business is, it can use what’s called a paycheck protection act or disaster assistance funds. 

Dr. Alex Eastman, the chief medical officer of operations for the Department of Homeland Security, stressed the federal government’s commitment to operating the fishery safely. 

Dr. Zink said at a news conference Monday the state is collaborating with federal agencies to secure additional testing for areas like Bristol Bay, where thousands of fishermen and processing workers travel to participate in the sockeye fishery — that includes providing several additional testing machines.

“We are in the process of shipping those out to many of our rural locations right now to make sure that communities have that testing capacity there in location,” she said at a news conference Monday night.

Zink said the state is sending a cepheid machine to Cordova, where the red salmon fishery is set to open this week. 

In Bristol Bay, the City of Dillingham, as well as several tribes have asked the state to consider closing the fishery, citing the influx of outside workers and fishermen. In April, Governor Mike Dunleavy released a series of guidelines for commercial fishermen and the state remains committed to keeping the fishery open.

Zink is one of several senior medical officials traveling to communities around the state this week, including the Bristol Bay region, where they plan to meet with community members, and visit seafood plants in three different locations – Dillingham, Naknek-King Salmon, and Egegik. 

Dr. Alex Eastman, senior medical operations officer with the Department of Homeland Security, was also part of the group. He said Monday that the department would be ready to respond to any requests by the state for assistance during the upcoming fishing season.

The Department of Public Safety said last week that nearly 20% of the Alaska Wildlife Trooper force would be based in Bristol Bay this summer. In addition to responding to service and search and rescue operations, wildlife troopers are charged with educating fishing crews on how to follow the state's health and safety laws. 

DHSS Commissioner Adam Crum said during Monday's news conference that the increase in trooper presence is standard for the fishing season. 

"Prior conversations we've had discussions about bringing in folks and other outside agencies to help with the locals in just managing the influx of individuals as they travel in, educate them on the quarantine principals that may be in specific regions, and also just to make sure that they're doing everything they have agreed to in Health Mandate 17," he said.  

That additional enforcement would be separate from the state troopers currently set to come to the region this summer. Still, according to the Department of Public Safety, troopers will "monitor and encourage all fishery participants to comply with all State of Alaska issued Health Mandates related to the COVID-19 Pandemic."

Dillingham City Council passed several ordinances at a council meeting last Friday. The council worked late into the night, voting over more than four hours of discussion. 

Three of the ordinances they passed are COVID-19 related.

One extends the mandatory 14-day quarantine in Dillingham to June 29. It applies to outside workers coming in for the fishing season, and to anyone coming into Dillingham who hasn’t quarantined outside of the city prior to their arrival.

That means people don’t necessarily have to quarantine inside city limits, as long as that person quarantined in a supervised and approved location, like a fishing vessel, connex or encampment. 

If they have taken two COVID-19 tests outside of Dillingham 10 days apart that are negative,  they don't have to quarantine in the community. 

For people who do quarantine here, starting May 22, testing is required in order to come out of quarantine in Dillingham. People quarantining in Dillingham are required to take a test on day 13 of quarantine, and then quarantine for an additional day. 

Until that goes into effect, there’s an option to shorten quarantine by taking two tests. The first test can be taken outside of Dillingham, and the second must be taken at least three days after arrival. The tests must be at least 10 days apart, and a negative result will officially end the quarantine for that person.

If it’s positive, they have to isolate for another 14 days and monitor for symptoms. 

The city says that acceptable quarantine locations include fishing vessels, connexs, an employer supervised location or a city designated site like a Dillingham approved residence.

The only people allowed to enter are those quarantining in those locations, and they can only leave for work or to receive medical care.

The city is mandating that masks are required for city facilities. Private businesses may turn people away if they do not wear a mask.

And masks can be a variety of materials! Cloth, silk, linen, surgical, N-95, towels, T-shirts, you name it. Whatever the mask is, it needs to be secured around the nose and mouth. If people do not comply, fines could be issued. 

Dillingham is moving forward with the single-use plastic bag ban, which was first introduced last fall. Stores and restaurants will  be prohibited from storing plastic bags. That means any bag made from plastic that is not compostable, like a grocery bag. The ordinance will not be in effect until New Years Eve. The city also passed and adopted a “Remote Sellers Sales Tax.” 

“Basically, you have these corporations like a Walmart or Amazon they’re selling online, we all order some of the stuff online but there’s no sales tax there that helps the city," said City Manager Tod Larson, speaking in February about the ordinance. "Bottom line with this is, we put a resolution in and the Alaska municipal league is running a commission. They will collect the sales tax for the city of Dillingham and remit it. That will kind of replace some of our declining revenues in that area.”

Finally the city passed an ordinance that mandates hygiene standards for public facilities as the economy slowly begins to reopen.

The ordinance restricts anyone who hasn’t quarantined in or outside of city limits, showing symptoms of COVID-19 or has not received a negative test within 72 hours of arrival from entering public buildings.

The Camai Health Center in Naknek is ramping up its testing capacity. It’s currently testing residents and seasonal workers. It has conducted around 400 tests so far, and Mary Swain, the clinic’s executive director, says they are expecting to administer a total of 800 tests by the end of next week. Swain said they are working with the state to ensure that state labs can handle additional testing for seasonal workers.

“That mandate is in draft form right now. We’re testing the process for the state to see how it’ll work long term and once the bigger crowds come to town,” she said. 

Camai is opening an additional testing center in the first week of June. That will allow for walk up testing and drive through testing. The clinic is currently testing people by administering nasal swabs. They also have a rapid test, or “point of care”, machine and Swains says they expect another machine next week .

“However, testing supplies for all of those point of care machines are pretty limited, not only in the state but throughout the nation," she said. "And so several of those tests we will hold off a supply of so that we can test symptomatic people and not asymptomatic people. And that way if we do happen to get an outbreak or anything out here, we can do contact testing as well as, if they need to do a large group and need to know right now, that we’ll be able to handle that.”

Swain said they are preparing for the state to require all processors to get tested at least three times during the season. For the clinic, that would mean administering 30,000 tests. Swain says the state has committed to providing those testing kits to the clinic for them to comply with any additional testing requirements. Camai has a regular staff of 12, and Swain said they are working on a plan for how the clinic will handle the additional work.

“That is the biggest question," she said. "We’ve hired a team specifically for testing, and at this point it’s a four-person team. What we’re doing right now -- we’re using our existing staff and doing it in a controlled environment, controlling the groups that we can do so that we can make sure that we get everything sent out in a timely manner and it’s not delayed.”

Beginning June 1, there will be staff dedicated solely to running the testing center, which will be located near the clinic, along with a 20-foot container fitted out as a basic emergency room. If an outbreak occurs in a processing plant, Swain says that the state will contact Samaritans Purse, an evangelical aid organization, which will provide the borough with a 25-bed field hospital and the necessary staff within 48 hours. 

And I talked to Mary Swain for more details on how Camai Clinic is working with the state to test out testing capacity -- to see how the state labs will handle the increase in testing.