The COVID Brief: Thursday, May 14, 2020

May 15, 2020

Statue of Brother Asaiah Bates, by Leo Vait, at Cosmic Kitchen on Pioneer Avenue.
Credit KBBI

Jenny Carroll, Information Officer for the City of Homer, Nurse Lorne Carroll from the Homer Public Health Clinic, Derotha Ferraro of South Peninsula Hospital, and Homer Fire and EMS Chief Mark Kirko discuss the latest from the Homer Unified Command and answer listener questions every Thursday at 9 a.m. If you have questions for the panel, email them to kathleen@kbbi.org.

Representative Sarah Vance of Homer's letter to Dr. Anne Zink, Alaska Department of Health and Social Services, sent Friday, May 8 2020.
Credit Representative Sarah Vance

Transcripts

Part I

This is KBBI Homer AM 890 and this is your weekly Thursday COVID 19 brief. On the line right now from the City of Homer, Jenny Carroll, are you there?

 

Jenny Carroll, City of Homer:
Good morning, Kathleen. I'm here.

 

KBBI: Good morning. Also, Lorne Carroll from the Alaska Department of Public Health. Nurse Carroll, are you there?

 

Nurse Lorne Carroll, Alaska Department of Health and Social Services:
Good morning, you're loud and clear, Kathleen.

 

KBBI: Good morning and Chief Kirko.

 

Chief Kirko, City of Homer Volunteer Fire Department:

Good morning everybody.

 

KBBI: Good morning to you, Chief Kirko. I was wondering if you could begin to talk about City services reopening in Phase II we're in now and it would appear that Phase III is coming up soon.

 

Chief Kirko: That's correct. And right now the City staff are working very hard at trying to get plans in place for some departments to reopen to provide that service out to the community again.

I can tell you right now that at Port and Harbor, they're working very hard to make sure that everything is coming back to a normal pace, given the season with fishing starting up, they're really ramped up and working hard at doing that right now.

I believe they have their fish tables are out. They are still practicing, and have signage for, social distancing to maintain that safe zone for everybody but I believe everything other than the office space is opened up just about all normal use right now.

There's a few things that'll probably happen under Phase III, which Brian is still working on some of those details and we'll report those as soon as we have them

I know that the campgrounds: Mariners Park, the Fishing Hole and Karen Hornaday are all open, they’re, as a matter of fact, they're kind of filling up quickly. So, if people are listening and they want to reserve a spot, they better do something about that pretty quick because it's beautiful weather and people are getting out there.

So those places are all open yet trying to stay within the guidelines that the Governor's mandates are requesting of us and the public: the little bit of spacing, and the continuation of sanitizing commonly touched surfaces and restrooms and things like that, and additional hand washing stations are in place to help with some of those needs of sanitization.

The library is continuing with their drive up, I believe, book exchange and drop system, and hopefully very soon they're going to have the computer access available back to the public on a limited basis, to control that flow of social distancing concern throughout the library itself. That should be coming up and there will be more information on that soon.

And then the last thing, I think, as far as the services is, parks and rec department is starting to open up parts of their normal program. So pickle ball and Zoomba dance and karate, those kinds of things are going to be happening here very shortly. Mike Illg, we'll probably put out some stuff on the website explaining the dates and details for those. I know that there's other things.

The City hall staff, I'm reviewing some of their plans right now that they've submitted to try to get things back to normal at the planning department and the clerk's office and things of that nature. So once those plans have been reviewed and they meet with all of the safety precautions and guidelines, we'll probably see some changes in that too, and that should be some information that we'll hopefully be able to share again maybe next week.

 

KBBI: So if parks and rec is opening up things again, like pickle ball, what's the status on playgrounds?

 

Chief Kirko: That part hasn't been decided yet. There's still some discussion on that. I know Mike is working very hard at trying to look at all the other communities and the State's plans on how to do things so that we are trying to follow suit with some of that so we're making sure that we stay within the safety guidelines.

 

KBBI: Well, thanks so much. I would like to, if you don't mind my going off topic, I'll bring it back to the topic. Were you at the response to the gas leak on Heath Street yesterday?

 

Chief Kirko: I was briefly. The assistant Chief Joe Sallee and the duty crew responded to that to help maintain a good safe traffic flow because it was right in the middle of the intersection and obviously the traffic, the folks not knowing about it, quickly became a congested area.

 

KBBI: Okay. And so also next week on the Thursday morning brief, I'll probably have a few more questions for you because I'm going to focus the second half hour entirely on the Harbor, and so I'm definitely going to have some questions for you leading up to that.

 

Chief Kirko: Perfect. I will talk to Brian and if you could give me a little heads up on that, I will try to make sure I can get good information for you from Brian and then we'll talk about it on here.

 

KBBI: I will. Thanks. And I want to go to Jenny Carroll, Jenny, I know you have a list of things to talk about. What's on your list this morning?

 

Jenny: Well, one is a discussion of life at the City under COVID. I want to say that while Chief said that City hall was looking at how to get back to normal, everyone should know that you can still do all your normal business with City hall that you would do, paying bills, seeking permits, contacting your City manager, that all those things are available through telephone, online, drop box for bills, so that has all been going on all along.

And the one thing I wanted to highlight that happens, City hall is staying connected with Homer City Council, commissions and boards. Because of the close down and trying to keep this social distancing, there are now new ways that we've developed for people to connect with their Council.

I just wanted to make sure people were aware that not only can you listen to the Council meeting on KBBI, but now you can also watch and listen via Zoom so you can actually see your Council members in action and you can go to those meetings by going to the City of Homer website, it's https://www.cityofhomer-ak.gov/ and on the main page there is a button that says, stay connected with City Council.

Commissions will be coming on again. Some of the commissions have been meeting, as business has dictated, but we're going to be going into rolling out a schedule for commissions to begin meeting again and boards, those will also be available via Zoom. So if you go to the main page of the website, again on the right hand side, there's a calendar of upcoming meetings.

So that's how people can tell what's going on and access agenda items and business that's before Council and commissions. So that's watching and listening. The other piece is how do you actually talk to your Council members or give some testimony or your opinion about a business topic that's coming up?

There's three different ways to do that. One is by submitting written testimony. You can email the City Clerk or you can submit your comment online on a web form, and again, you would go to the City Clerk's page on the City website for that.

The other thing is that we have developed telephonic testimony during meetings, so you can sign up to phone into the meeting and speak, there is also a web form online for that. You need to do that no later than 4:30 PM the day of the Council meeting. Then the other third option for giving your public comment is in person in City chambers.

The chamber opens five minutes before each public meeting. We limit the capacity to 10 people at a time to accommodate social distancing and we require people to wear a face covering or a face mask that covers both nose and mouth just because it's the best practice to keep the transmission of the virus down so people can come in and give testimony five minutes before each public meeting. So I just wanted to make people aware that's a little bit of a different practice than what we've had in the past.

It's expanded because of COVID 19. So there are still, the City has worked very hard to develop the technologies and the ways that people can still connect and have a voice in their community.

 

KBBI: Mary Griswold asks: Nonessential businesses in Alaska are being allowed to open with mandates for owners and patrons to wear masks or face coverings. Are these mandates enforced? If so, by whom and at what penalty for noncompliance?

 

Jenny: I'm really happy to answer that. I know you'd like to hear a diversity of voices, but I definitely can say that I'm one….

 

KBBI: If you're the one who can speak to this, go for it.

 

Jenny: I sure can. So under the Governor's reopen Alaska responsibly plan, there are many different attachments that apply to different businesses and the attachments provide health guidance that's based on best practices for businesses to help participate in lessening the transmission of COVID and keeping that curve flat.

So, two attachments in particular relate to retail businesses and restaurants. Attachment E and F, those attachments strongly encourage cloth face coverings to be worn by all employees interacting with the public and by all patrons.

Notice that the language here is “strongly encouraged”. It's a strong recommendation, but the Governor has been very clear that it's up to businesses to decide how best to protect their employees and customers, just as it's the customer's personal responsibility to follow these best recommendations for keeping everyone healthy.

There is no enforcement for face coverings, just education on why it's important and reliance on personal responsibility that everyone pitches in to share in the obligation to keep Alaska safe and to continue to combat the spread of COVID 19 doing these practices. Early practices that the Governor mandates, that the government put out, the hunker down that got our curve really flat and gave the Governor confidence, and the health team that works with him, the confidence to begin opening up as long as people continue to practice these things, these prevention practices.

They allow us to go forward to open up our businesses, which is really important for the health of our economy and for people to get back to work and be able to put groceries on the table. It's really important. So, Mary, thanks for the question. It's a strong health recommendation under the mandates, but there is no enforcement associated with it from the State level.

 

KBBI: And Mary has a followup, which is that patrons and workers at essential businesses in Alaska, particularly grocery stores, which are visited by more people than many non-essential businesses are not required by State mandate to wear face coverings. Can somebody confirm that? And if so, why are they not required to wear face coverings?

 

Jenny: I did look into that to try to find the guidance and again, I think all face covering guidance is a strong recommendation. So I know that essential businesses, especially if they're traveling, if they're sending essential workers around the State, that those essential businesses need to develop a protective plan that they provide to the State that says how they plan to travel around the State, especially if workers are coming from the lower 48 or places where there is a higher transmission, what practices they will be doing to protect against the spread of COVID 19.

And those practices include having your employees wear face masks when they're interacting either with one another or with the public and the cleaning practices, the hygiene practices, those kinds of things.

So again, these practices are strongly encouraged and I would say the best encouragement is that we're healthier when we do it and it's allowed us to be able to open up our businesses and provide the services that people expect from essential services and to help get us all back to work and not see the spikes that could lead to closing businesses back down again and hunkering in.

KBBI: Derotha Ferraro from South Peninsula Hospital, and Nurse Lorne Carroll, do either one of you have anything to add to that?

 

Derotha Ferraro, South Peninsula Hospital:
Good morning Kathleen, it's Derotha. I would like to echo the concept of evidence-based best practice and at the hospital, you know, outside of COVID 19, just as a healthcare provider in general, evidence-based best practice is what guides and informs decisions daily in a hospital and healthcare environment.

And it is evidence-based best practice that wearing a face cover helps decrease the spread of droplets from a mouth or nose, which is one of the main ways that this particular virus spreads. So just using that as kind of the underlying decision, whether there's a mandate or not, or whether it's a recommendation or not, you know, people can vote with their feet, and if there's an establishment that you don't feel comfortable in, then don't go there, I think, is the most important thing.

We are all pretty informed now on this virus and we can use our own decision making process as we decide where we're going to go during the day and what environment we're going to remain in. And so just kind of create those personal mandates of what you're going to follow during the day, given all of the information and evidence-based best practices that you're aware of.

 

KBBI: Okay. Thanks for that. Nurse Lorne, do you have anything you want to add?

 

Nurse Lorne: Yeah, maybe just two things. And I've been thinking about what are the things that we can focus on, or what are the things that I have control of? And I feel that what's embedded in all of these comments is that each of our actions really impacts the rest of the community. That's a really powerful thing and we should feel good about that.

And quite frankly, Alaska's demonstrated that we don't need a hundred percent participation in community mitigation measures; that's not really possible. So making the choice to participate is really impactful in a positive way and that can be empowering. And then secondly, and lastly, I think that up to this point, we've seen a lot of changes and we've learned a lot, but I think that we're going to continue to see a lot of changes.

And so I just want to highlight a couple of places that folks can go with their questions and get answers. One of them is called 211 and that would be just for general questions and assistance and then secondly, if you have access to an email account, you can email general questions especially related to mandates and alerts to covidquestions@alaska.gov. That's covidquestions@alaska.gov

 

KBBI: Thanks so much, Nurse Lorne and Derotha. We're going to return to you a little later. I still have a couple of questions here that are mailed in for the City, and I know that Jenny Carroll, you'd like to speak about the JBER flyover that's happening this weekend, tomorrow.

 

Jenny: Yeah. JBER has alerted us that tomorrow they will be doing a salute to Alaska in honor of all the frontline responders, during the COVID time especially.

They will be doing a route leaving Anchorage, going through Eagle River down through Whittier, Seward, and then onto Homer, and then back up the other side of the Kenai Peninsula. They are expecting the flyover in Homer to be just a little after two o'clock in the afternoon, give or take 10 minutes on either side. So I want people to know that that's happening so you can get out and enjoy it and know that that's a salute to all of us for pitching in and doing our part to have done so well so far through the Coronavirus pandemic.

 

KBBI: Well, thanks for that. And Nurse Lorne, can you remind us all of the best practices if you're gonna be around other people while you go out and enjoy the flyover?

 

Nurse Lorne: Yeah, sure thing. Social distancing is defined as keeping six feet or more away from others, especially for 10 minutes. So this would be for folks outside of your household. So if you're outside enjoying the weather or watching the show, it's OK to hold hands and hang out with folks closely for those that are in your household but for those outside of your household, keep at least six feet distance at all times. And then if you're doing something like dancing or running, it’s best to widen that distance to more like 20 feet.

 

KBBI: Okay, and back to Jenny Carroll from the City, because I've got some mail in questions. Here's one. The PPEs from Skiff Chicks that were available, also that were available at Homer Saw and Cycle and at the Cyclogical, they're no longer on the COVID 19 webpage for the City of Homer. Is distribution of masks still happening?

 

Jenny: Well, the production has slowed down to the point where we all made the decision that we wouldn't have enough to distribute through those two outlets anymore. And there were so many made in this community, I just have to tip my hat to everybody who was home producing those masks because obviously they have been put to good use. People have appreciated them and still want them.

There are still some being made and people can get in touch with Skiff Chicks, on our website there's contact information to put a request in and that's how you would access them. Now, I also know that, since this first began, there are many more avenues and outlets to get cloth face coverings.
 

I know that NOMAR is making them, I know that they're available for purchase at a variety of our retail stores in Homer as well as online, so I encourage people to look around to see where they can obtain these through normal markets as well.

 

KBBI: So, the last one I have for the City is, on the City webpage…..

I just want to point out... Public Works is making chlorine bleach. It's a bring your own container kind of situation, if you need something for disinfectant and you're unable to get it.

So, is that at Public Works down at the bottom of Heath Street?

 

Jenny: It is. It's down there at the bottom of his street, near the animal shelter. You can make an appointment by calling Public Works department. We ask that you bring your own container, we limit everybody to two gallons who are coming to get the bleach. That should be plenty for businesses or people who need it to be disinfecting surfaces at a regular interval.

You would obviously be diluting that down for your cleaning purposes so that we wanted to make sure that that resource is available to businesses as they reopen. So if they need some, feel free to call the Public Works department.

 

KBBI: Also, Frontier CBD is making hand sanitizer. It says on the City's webpage, I can't stress enough if anybody here is interested, if you have unanswered questions and things you want to know about - go to the City of Homer webpage and click on the COVID 19 button.

There's a lot of good information. https://www.cityofhomer-ak.gov/ So, Frontier CBD is making hand sanitizer here in Homer. Are they making it available for sale, Jenny, or is it for distribution for people who need it?

 

Jenny: They're making it, as far as I know, it's primarily for sale.

 

KBBI: Okay. Thanks for that. And I have one more question, but this one's going to go to Derotha Ferraro from South Peninsula Hospital and Nurse Lorne Carroll. The question is about antibody tests. Is there any reason to do them?

I know I've heard you say you've performed some at South Peninsula Hospital. The question here, is there any evidence to show that if antibodies are present it keeps you from getting COVID 19 again? Go ahead, Lorne.

 

Nurse Lorne: Well, the easy answer is, there's very limited information at this point and given that COVID 19 and new coronavirus is still incredibly new to the world of science. And so this makes it very different than diseases such as mumps and measles, pertussis or even things like tuberculosis where we've known these, in some cases, for a thousand years or several hundred years.

So the short answer is, at this point, we don't know. But the global science community is working.

 

Derotha: And I will just kinda add, Kathleen, that, yes, we do offer the testing and some of that was out of public interest. And I don't want to say demand, just that many people are asking for that service. We have an arrangement with the Mayo clinic where they were the first ones to get, and possibly the only ones to get, the FDA approval to do it.

And so it's a blood test and we take it and send it in to the Mayo clinic. So it's several days turn around. There haven't been very many people that have done it yet. I think there's teams and the teams of the numbers of tests that we've sent in, and as the pandemic unfolds, and there's more people who were confirmed positive, who then do the antibody test later, that's where the kind of the data points will start coming together and maybe being more meaningful. But at this moment, what Lorne says is definitely the thought at the hospital as well.

 

KBBI: And Chief Kirko and Jenny Carroll, I want to give you guys one last opportunity to make any comments you like. Nurse Lorne and Derotha have agreed to stay on a little later this morning to answer a few more questions. Jenny Carroll from the City. Is there anything else on your list today?

 

Jenny: No, I can't think of anything. I just wanted to let everyone in Homer know that the City of Homer EOC (Emergency Operations Center) is available. You can get in touch with me via email or phone. We have a call line number as well. That that number is 435-3197. So if anyone feels like they have more questions or want to know more about access to resources or anything in the community, that we are here.

That's our purpose, is to help educate and connect people with the information and resources that they need to keep everyone safe and moving along. So I just want to make sure everyone knows that we're very available and happy to work with you to the best of our ability.

 

KBBI: Okay. Thanks, Jenny Carroll, How about you, Chief?

 

Chief Kirko: So, yeah, I have a couple of additional things. I just wanted to really, you know, sing out a great kudos to our businesses in Homer that are doing their very, very best to stay open and do it in a safe manner. Some of them are just really, really taking this thing to heart and making sure that they can deliver goods safely to our people of Homer, to the community. So really big kudos out to them.

And then a quick reminder also that just because we had a little rain the other day does not mean we're not still in a fire danger kind of condition for a while. So, just because of rain, please understand that burn permits are still not being distributed right now and that it's still a very, very cautious time to be doing any kind of outdoor burning. So that said, I'm going to go ahead and sign off too, because I got another meeting to attend to. But as Jenny said, if there's any questions, don't hesitate to contact us at the EOC or me directly at the Fire department.

 

Public Health Nurse Lorne Carroll from Alaska Department of Health and Social Services
Credit KBBI

Transcript
Part II:
Now, Lorne Carroll, Nurse Lorne Carroll from the Alaska Department of Health and Human Services and Derotha Ferraro from South Peninsula Hospital. I wanted to get to this after our main conversation. Thanks for staying on.

I'll preface it a little bit. Last Friday, Representative Sarah Vance of Homer publicly released a letter to Dr. Zink at Department of Health and Social Services. And then, all weekend, lots of gossip on the internet. Monday morning, she went on commercial radio to talk about it some more, but has not publicly spoken about the response to the letter.

Department of Health and Social Services says they did respond to the letter on Monday, but Representative Vance's office says that they are still clarifying information with DHSS and won't release DHSS's response. DHSS also says they will not release their response to the letter. And so KBBI has filed a freedom of information act request to get the initial response from DHSS.

But, that's really not the point here. The point here is there are six questions, three of which seemed to be the same question, rephrased or extended. Let's just go through this because I see three things on this list that we address every single week, live, with the people who have the expertise and the authorization to answer.

So let's do that right now. First question being, what is the difference between dying with COVID 19 and dying from COVID 19?

 

Nurse Lorne: Okay. I wanted to preface my response by saying, these questions are great. I mean, what a brilliant way to increase awareness and education about what in the world is a local public health system. And what are the roles and responsibilities of each person, including community members in improving community health. So I just really would like to encourage everyone to keep these questions coming. They're brilliant.

But in terms of what's the difference between, I think I heard the question as dying with COVID 19 and dying from COVID.
One of the main things is dying from COVID would mean that COVID 19 goes on the death certificate as a primary or contributing cause of death. For someone dying with COVID 19, say dying from a car crash while having a positive COVID test would not be listed on a death certificate.

For some context, more than one cause of death can be put on a death certificate. That's my initial response. Oh yeah. Then also, just also noting that the cause of death section of the death certificate, that's a standardized process across the nation, and within that process, it's the healthcare provider, their role and responsibility to complete that death certificate. So the determination comes from the healthcare provider.

 

Derotha: Ditto to everything that Lorne said and just to kind of help people visualize things, there are four lines on a death certificate, or four areas, if you will, and there's kind of meanings behind each of those areas, whether it's kind of like the immediate cause, the intermediate cause of death, underlying cause, or contributing conditions. And so there's lots of different layers and opportunities for the physician to be really telling the whole story of that person's condition and all of the factors that might have gone in to that person's passing. And so it's not just like one answer. There's a lot of answers and lots of data and information that gets put onto the death certificate.

So I think that that concept of contributing causes, underlying, intermediate and immediate, I think that really helps people understand, Oh, this isn't just one answer, COVID 19 or not, it's a pretty layered, complicated answer.

 

KBBI: Next I have, what guidelines do physicians have in attributing the cause of death to COVID 19?

 

Derotha: I would say that the CDC, Center for Disease Control, they provide guidelines to physicians as far as, kind of, attributing causes of death and whether it's COVID 19 or different causes. So they have written guidelines and they even kind of give them some presentations and visuals to go from. So for the most part, a provider is using defined guidelines from the CDC. And the purpose of that is so that in a situation like whether it's a pandemic or even as we're as a nation dealing with things like chronic disease we often hear, Oh, the leading cause of death in our, in a community is, heart disease or cancer or you know, different diseases.
 

Because the CDC gives guidance to all of the physicians on how to report, that's what allows us to see what's trending in a community or a state or a nation as a leading cause of death. Which then allows educators and providers to define what things we need to focus on to prevent unnecessary deaths. So it's all, kind of a piece of a much larger picture. It's not just a specific thing for COVID 19.

 

Lorne: That's a very good response. The only thing that I would add is that, in terms of reporting, this gives us a picture of the leading causes of death in any particular area of a state or in the nation and this also plugs into a broader, and perhaps additionally important conversation, what are causing these health challenges within our communities, state and nation. And so what reporting deaths can also do is help to feed a conversation about the impacts of things like intergenerational trauma on chronic diseases.

And so as we continue to explore what it's like to be in a new public health system, within this new century, it really highlights that cross sector collaboration or like thinking about health care and all other partners outside of healthcare and what our contributions to increasing resilience throughout the community and what are those impacts on chronic disease.

 

KBBI: Thanks Nurse Lorne. And, how, is a suspected COVID 19 death confirmed? What's the role of the coroner and the medical examiner? Anybody?

 

 

Nurse Lorne: I think I'm hearing the question correctly. The one thing that's important to highlight is, the Department of Health and Social Services does not confirm deaths. So that is the responsibility, in most cases, of the health care provider when filling out the death certificate. And then the Department of Health and Social Services receives data from the death certificates in order to offer epidemiological data for the entire population regarding things like COVID.

 

KBBI: Okay, thanks for that. Are patients automatically tested when admitted to the hospital for other health conditions? We answer this one every single week on this program because the answer changes.

So Derotha, can you start with, are patients automatically tested for COVID 19 when admitted to the hospital for other health conditions?

 

Derotha: Yes, they are, a few weeks ago, I believe, is when we started. And you're right, it has been changing. First we had a lack of testing available in the state, so we had to really conserve and be particular with how the tests were being used, but as more testing has become available, we are able to do that.

So probably three, almost three weeks ago, the State put out new testing guidelines. I think it was April 21st, April 28th they put out new testing guidelines, which they do regularly. Sometimes those change daily, sometimes weekly. And when those guidelines came out they recommended that all hospitalized patients be tested for COVID 19 upon admission.

 

KBBI: Is that a mandate?

 

Derotha: I don't know that it's in the mandate, by name, by law. The mandate says that we are asked to enact testing practices as necessary to protect patients and healthcare workers so that's kind of like what's in the mandate.

But in the testing guidelines, it is very clear that the State is asking hospitals to test all admissions if and when possible for COVID 19. And it really does help us as providers stay safe and have good practices in place, and protective PPE if possible, because it's not like there's an endless supply of equipment and supplies, but it also helps the physician come to a diagnosis faster based on symptoms and conditions of admissions and also rule things out.

So, yeah, South Peninsula Hospital is doing COVID 19 testing on all patients that are admitted. And then also part of opening healthcare services was to do tests on patients who are coming for different procedures.

And so we're just now defining that exact list and making that list known to the public, but based on what the procedure is and the type of interaction that will happen between a provider and a patient, there's a growing list of procedures that then also require a COVID 19 testing within 48 hours prior to the procedure. You'll find many dental procedures are on that list, surgical procedures, different things like that. So, we'll definitely make that full list available on the website when we have it finalized. But that's a growing number of reasons that folks would get tested.

And I would like to take this moment to just talk about testing, that testing is no charge to an individual if they have symptoms of COVID 19 and they can get tested in the hospital parking lot and they just show up and if they have symptoms, they will receive the test at no charge to them. And as of this morning, I think we were at 615 tests that we have performed and submitted for results, 615 and of those, 573 were negative and four positive and the balance are pending; we're still waiting on those results.

 

KBBI: And a person who needs the test can literally just drive into the hospital parking lot and then there are numbers posted for you to text or call. Is that right?

 

Derotha: That's right. Yep. You just drive up. Call that number. There's a tent that is set up outside the main entrance, and you call that phone number and somebody will come out. We were stationed right inside the door so it doesn't take but seconds to a minute or two. You know, they put on some gowns and some additional PPE and come out and meet you at the tent. You stay in your vehicle and the swabs are done just from the comfort of your vehicle and you fill out the paperwork and off you go.

 

KBBI: And what's the turnaround time on a test?

 

Derotha: Right now, it’s depending on the time of day that you come in, because remember, we're driving those tests to Anchorage every day. And so depending on what time, if you're there super early morning, your tests will get in that day's batch. If not, you go in the following day’s batch so turnaround time is two to three days. Because the State lab has such good capacity right now, we are sending all of ours at the moment to the State lab.

And you might remember a week ago, I was telling you that half, some were going to ANMC because of the need for faster turnaround time and some to the State of Alaska. But right now the State lab has good capacity. So all of them are going to the State as of today.

 

KBBI: Okay. So we're about 10 minutes out from the end of the hour, and I don't want to give these last two questions short time. Derotha, this is definitely for you.

Lorne, if you have anything to add as the representative from DHSS, I'd love to hear it, but I think I'm going to start with Derotha.

Question number five is, do hospitals in Alaska receive additional funding for reporting deaths attributable to COVID 19?

 

Derotha: Okay. I'll start with the answer just to that question you just said. To the best of my knowledge, no. Hospitals in Alaska do not receive additional funding for reporting deaths attributed to COVID 19 through SBA.

 

KBBI: Right. because everybody does everything differently.

 

Derotha: That's right. So, I can tell you what South Peninsula Hospital’s situation is and that is that we are designated as a Critical Access Hospital.

So, not to bore people to tears with government lingo, but that is a designation from Medicare, that says, from the federal government that basically says we're a rural general hospital, we’re so many miles from the next hospital, our average length of stay is so many days, we have under 30 beds, it defines you as a small rural hospital and as a Critical Access Hospital of which there are over 1300 nationwide.

We have special arrangements with CMS for how we are paid, and so that is for Medicare and Medicaid. And our commercial payers pretty much follow, the kind of, I'm trying to think of the right word, the framework there, and that is that we are not paid based on a diagnosis, we are simply paid on cost, but it's not the cost of an individual's visit or stay. It's this overall cost that's based on a formula that's reevaluated every year, every so many years.

So it's kind of a big picture formula that helps Medicare figure out the average cost of a patient's day and that's basically how we are reimbursed for Medicare, is just based on this formula that can be a year or so old based on average cost of a patient stay. So it doesn't matter, your diagnosis.

We're not entering that diagnosis. When we're asking Medicare for reimbursement, we're entering that a person was hospitalized and using the formula for what the average cost is and what we are not reimbursed based on the diagnosis and where we are absolutely not reimbursed based on a death - death as, something that happens at the hospital and is reported from the hospital. But we are not reimbursed in any way for a death, no matter what the cause or diagnosis.

 

KBBI: And what about things like, the PPP funding, and the funding you get because you had to be closed for two months. Is any of that dependent upon number of cases? Not even deaths, but number of cases?

 

Derotha: No, none of the funding that we currently secured has a relationship to the number of patients that we care for in regards to the COVID 19 pandemic. The stimulus funding, it was specifically to help hospitals offset loss of revenue from being closed for over two months, and that funding is specifically to offset the loss of revenue. The funding that we accepted, the stimulus funding is not related to number of patients that we're caring for COVID 19.

 

KBBI: Thank you. And Nurse Lorne, I wanted to start with you on the final question, which is, who determines the criteria for someone to be listed as a COVID 19 death on the official State list that's reported to the CDC?

 

Nurse Lorne: Well, all deaths regardless of cause are reported to CDC. If COVID 19 is on a death certificate as a contributing cause it would be counted by CDC as a COVID death. And so again, the cause of death is determined by the medical professionals in the healthcare field, and thereafter, that information is forwarded on to State and federal levels as a permanent vital record.

 

KBBI: Okay. Thank you so much for going through all of these, Nurse Lorne Carroll from the Department of Health and Social Services for the State of Alaska, any final comments for you?

 

Nurse Lorne: Oh, I just say, keep those questions coming.

Kathleen: Thank you. And, Derotha Ferraro from South Peninsula Hospital, any final words from you?

 

Derotha: Yes. Thanks, Kathleen. Hey, I would echo what Lorne just said is thanks for the questions because they help all of us understand a confusing big picture.

Most of us have never walked through a pandemic and so it's really helpful for everybody to understand. It helps build trust in our local providers, that helps build trust in our statewide leaders and decision makers. And it really helps us kind of understand what's going on.

We at the hospital, we appreciate having the State to provide some guidance in this; to have CDC provide some guidance and it also really helps that we learn from those States that went before us. And as we see things change from week to week as we visit with you live on the radio and we say, oh, not doing that anymore, now we're doing this because we learned from the states that go before us.

And it's very possible, some of the reportings or processes may change in the future, but it's really nice to be able to rely on those that went before us to learn and help us practice best practices and use evidence-based protocols.

 

KBBI: Well, thanks so much to both of you. If anyone has any questions, this panel reconvenes every Thursday morning at nine. We also do a check-in for Tuesday morning. So if you have any questions that you would like to ask the panel: to Nurse Lorne Carroll, to Derotha Ferraro from South Peninsula Hospital, to Chief Kirko and Jenny Carroll with the City of Homer, you can email kathleen@kbbi.org. This has been the COVID 19 Thursday Brief. I'm Kathleen Gustafson for KBBI Homer, AM 890.