Providence now “rationing medical care and treatments” amidst COVID surge

On Tuesday night, Providence Alaska Medical Center’s Medical Executive Committee released a letter stating that they’re now having to ration care. The letter comes amidst one of the worst COVID-19 surges in the state. 

The Committee says physicians and medical staff are “no longer able to provide the standard of care to each and every patient who needs our help” and that they must now prioritize resources for the patients who have the potential to benefit most. 

The Medical Executive Committee’s full letter is available below. 

 

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Fellow Alaskans, 

We are writing  to you as the Medical Executive Committee at Providence Alaska Medical Center. We are an apolitical body of physicians that represents the independent medical staff at Providence. Each of us is a member of the Alaskan community; we live, work, and play here. Our children attend school here. 

At this time, we feel we have an ethical obligation to be transparent with our community and share with the public the distressing reality of what is happening inside the walls of our hospital. The state’s COVID-19 Dashboard isn’t equipped or designed to demonstrate the intricacies of providing medical care during this unprecedented time. More than 30% of the adult patients hospitalized at Providence have tested positive for COVID-19. 

Our caregivers are doing their best, just as they have been for the past 18 months of this pandemic. We believe that the Providence administration has acted in good faith throughout the pandemic, following the guidance of local and national experts to create policies and procedures that protect patients and caregivers.

While we are doing our utmost, we are no longer able to provide the standard of care to each and every patient who needs our help. The acuity and number of patients now exceeds our resources and our ability to staff beds with skilled caregivers, like nurses and respiratory therapists. We have been forced within our hospital to implement crisis standards of care. 

What does this mean? In short, we are faced with a situation in which we must prioritize scarce resources and treatments to those patients who have the potential to benefit most. We have been required to develop and enact policies and procedures to ration medical care and treatments, including dialysis and specialized ventilatory support. 

As a result of these limitations, elective surgeries, some of which have already been delayed for months as the result of the pandemic, may be continually postponed.

What happens at Providence Alaska Medical Center and in other Anchorage hospitals impacts our entire state. Many specialty medical cares can only be provided in Anchorage. People from all around Alaska depend on Providence to provide medical care for people statewide. Unfortunately, we are unable to continue to meet this need; we no longer have the staff, the space, or the beds. Due to this scarcity, we are unable to provide lifesaving care to everyone who needs it. Our emergency room is overflowing; patients wait in their cars for hours to see a physician for emergency care. On a daily basis, our transfer center is unable to accept patients who sit in emergency rooms and hospitals across the state, people who need care their current facility is unable to provide. If you or your loved one need specialty care at Providence, such as a cardiologist, trauma surgeon, or a neurosurgeon, we sadly may not have room now. There are no more staffed beds left. 

As we watch the case rates rise in our community, we anticipate an escalation in COVID-19 hospitalizations in the coming two to four weeks. What is already a stressful situation could rapidly progress to a catastrophe. 

We are doing absolutely all that we can. Now, more than ever, we need your help. For the next month, there are things each of us can do to reduce the strain on our healthcare system so that we can provide the best care to you and your loved ones. 

First, wear a mask, even if you are vaccinated. Masks are neither perfect nor foolproof, but they do help. If we all wear our masks when indoors with people apart from our household, the risk of community transmission of COVID-19 decreases significantly. For the time being, please consider avoiding unmasked indoor activities. 

Second, if you are sick or exposed to someone with COVID-19, please get tested and stay home. Testing is available for free at a number of local testing sites. Getting tested allows our municipal and state epidemiologists to track and predict case rates. It allows our hospitals to make important decisions and attempt to prepare for the needs of our community. 

Third, if you are eligible, please get vaccinated. This is the single most important thing you can do to help yourself, your community and the healthcare system. While this will not reduce cases in the next four weeks, the best way to achieve sustained remission of the pandemic is through widespread vaccination. Vaccination reduces your risk of catching, spreading, being hospitalized and dying from COVID-19. 

Lastly, avoid potentially dangerous activities and situations that may increase your risk for needing emergency services or hospital care. Unfortunately, if you are seriously injured, it is possible that there will not be a bed available at our trauma center to save your life. 

We ask that you commit to these things for at least the next four weeks for the sake of your loved ones, your neighbors, and your communities. We ask that you help us to open our beds again so that we may continue to care for all Alaskans. Please, wear your mask and get vaccinated. 

It is an honor to serve our fellow Alaskans. Thank you. 

 

Kristen Solana Walkinshaw, MD

Chief of Staff, on behalf of the Medical Executive Committee

Providence Alaska Medical Center