Alaska can halt the rapid spread of COVID-19, although we are not able to stop it. We can show that Alaska is a special place; that we truly are the Last Frontier where we don’t do things the same way as everyone else. To save us from disaster we must immediately close our borders, stop all travel, and enforce stay-in-place and quarantine; along with additional measures as necessary.
Two strategies have been used elsewhere to stop the spread of the virus: mitigation and suppression. Mitigation refers to steps to slow the escalation of cases. It includes things like self-quarantine, social distancing, and telling nonessential businesses to close. Suppression means shutting down all physical contact within the society, quarantine as needed, and stringently enforcing it. It can include universal testing and vigilantly tracking down and contacts of those infected.
Immediate aggressive suppression is our only hope of avoiding what has happened in other parts of the world, and is happening now in the rest of the U.S. The only in-bound travel should be supply ships and planes. In-state travel must be stopped. Resources like police, troopers and the National Guard are needed to enforce mitigation efforts. Other countries have demonstrated that without enforcement suppression will not work.
We have examples of both mitigation and suppression strategies and their outcomes. After the virus began, China attempted mitigation strategies. When cases and deaths accelerated rapidly, China instituted stringent suppression strategies, with enforcement. A week ago the only new cases came from individuals traveling into the country. In South Korea, once their cases began to escalate dramatically, they began aggressive suppression tactics, including massive testing, isolation of all suspected individuals, quarantine, and no movement of individuals within the community, with armed enforcement of these measures. Their rigorous actions effectively stopped the continued escalation of the virus. Other countries are now implementing suppression, but only after they have already got huge case loads.
Iran and Italy are examples of the failure of mitigation. Only in the last week has Italy put in place suppression methods, with enforcement. We do not know the real numbers in Iran because the government has not reported accurate figures; the reported numbers show continuing exponential escalation. It can be argued that the U.S. has now become another example of the failure of mitigation.
How can this information guide us here in Alaska? It indicates that mitigation will not stop acceleration and only suppression will. Anchorage has taken mitigation measures, and the state has now followed the city’s lead in many ways. But these actions won’t save us. Telling people they must self-quarantine after travel won’t work. “Hunker down” will work for those who are concerned about their health and that of others. For those who believe the risks are acceptable, or that the concerns are overblown or a hoax, these voluntary actions will not change their behavior. Without enforcement, it is up to the conscience of each individual whether they comply or not.
One advantage we have is our relative isolation. With the U.S.-Canada border closed, no ferries or cruise ships running, the only way into or out of the state is via planes and cargo ships. Many have already urged a ban on all travel into or out of the state, and a ban on nonessential travel within the state.
The distance between Alaskan communities is both a hindrance and an advantage; it causes difficulty getting needed medical supplies, equipment and personnel; distance also makes isolation easier. During the 1918 Spanish flu Alaska was hit bad; however, a few communities survived by implementing aggressive suppression, having armed guards outside their village preventing anyone from entering; now some small Alaskan communities are implementing similar measures, stopping nonessential flights into or out.
The effect on our economy will be severe, as others have written. It is already hurting small businesses and their workers. But consider the relative economic effects of 2,500 dead statewide, and 100,000 infected versus 200 dead, with 25,000 infected. Although these figures aren’t mathematically based, they are not unrealistic given what has occurred elsewhere.
Please don’t think I am fear-mongering or being hysterical. Extrapolating from the on-going exponential spread of the virus elsewhere, without aggressive suppression we will not begin to reach peak numbers until mid-June at the earliest. We must close our borders and implement active suppression methods. We will probably have to continue suppression methods for at least 18 months or until an effective vaccine is available, or a cure is found. We as a state have hard decisions to make, and they must be done immediately, without more political wrangling. The coronavirus is changing our world permanently. Welcome to our Brave New World.
Jamelia Saied, MBA, ME.D, moved to Fairbanks in 1959 as a small child. She has had several careers, primarily in hospitality and mental health, and is now retired.