Covid-19 seizes the legislative spotlight (that it should've had all along)

Oh, and politics, the budget, the reading list and weekend watching.

Happy Friday, Alaska!

In this edition: After what has felt like months of it being all-PFD all the time in the Alaska Legislature, covid-19 surged back into the legislative spotlight on Thursday as the state hit new highs of cases and hospitalizations. Gov. Mike Dunleavy introduced two bills for legislators to consider in an already bitterly divided special session, which many pointed out are measures he could enact via a disaster declaration. The day—which included the launch of a $49,000 weekly giveaway—was then capped by some sincerely heartbreaking testimony from hospitals about the current situation. Oh, and politics, the budget, the reading list and weekend watching.

‘Our world is on fire’

Alaska hit a new record high for covid hospitalizations for a third day in a row on Thursday as cases, hospitalizations and deaths continue to climb. But if you’ve been deeply mired in the Alaska Legislature and its never-ending struggle over the dividend and financial policy—as I and this newsletter have been—it might have all seemed like a distant concern. More of an abstract political fight marked by the occasional “Oh, man, they’re really taking horse dewormer? I guess I should keep on wearing a mask” than a pressing, personal emergency. Of course, it’s a completely different story for the health care workers who’ve toiled away through the waves or the people who’ve been hospitalized and their families, but for most of us that’s perspective we’re fortunate not to have. Our glimpses into the nightmare scenario are limited to things like a Mat-Su doctor’s testimony of what it’s like to put breathing tubes into people.

That’s why the testimony from hospitals around the state to the House Health and Social Service Committee on Thursday afternoon is so valuable. If you have the time—and the heart—please give it a listen. I’ll break down some of the highlights here.

Providence CEO and President Preston Simmons got choked up when explaining the burnout and triage system at the Anchorage hospital, which saw a record number of patients in the emergency department this week.

“You should know we are being tested like never before,” he said. “Patients are coming to the hospital with more serious illness. ... Alaska hospitals are consistently operating near or at capacity and available staffed beds are at a premium. Yesterday, we had 30 patients holding in our emergency department, a record number for Providence Alaska Medical Center. The waiting room was beyond its capacity to safely distance people, as a result people waited in their cars to be triaged. This is not the care that Alaskans deserve and it has taken an emotional and physical toll on caregivers.”

He was nearly brought to tears when explaining the situation for health care workers. It was a similar story from hospitals around the state. Mat-Su Regional Hospital CEO Dave Wallace told the committee that pretty much every health care working is in counseling to deal with the stress and burnout and how some report crying on their way to work and crying on the way home. He said it’s worsening in large part because so many of the cases coming into the hospital could’ve been avoided with the vaccine.

“We are in disaster mode. ... We know we’re at an unprecedented level of stress,” he said. “This disaster is now a year-and-a-half old and it’s now at its very worst state and ironically no one seems to want to even talk about it anymore, let alone recognize that the hospital safety net is starting to fray and is very close to breaking."

The strain on the state’s health care system is reaching well beyond people infected with covid-19, Yukon-Kuskokwim Health Corporation Chief of Staff Dr. Ellen Hodges told the committee. She relayed a recent story of a person from a village needing critical non-covid care and having to wait many hours, their condition deteriorating, while staff hunted for an available bed in the state.

“I would ask you to put yourselves in the shoes of this patient or this family, imagine the fear and hopelessness as the time ticks past and the care that you or a loved one needed was simply not available,” she said. “Put yourselves in the shoes of the doctor, knowing what was right for this patient and not being able to secure the resources. I'm not sure how everyone recognizes we all are in this great state. Choices made by all of us affect the care that we are all able to access. The choice of an unvaccinated person to go maskless in a crowded venue causes a person in a village hundreds of miles away to go without the resources needed to simply survive regardless if that person made the choice to get vaccinated and wear a mask.”

Alaska Native Medical Center Administrator Dr. Bob Onders told the committee, “We are much worse off than where we were in the fall both from a combination of all the hospitals feeling the stress but also the long-standing emotional and physical toll. We’re not doing well and the general perception is no action’s being taken.”

Jared Kosin, the President and CEO of the Alaska State Hospital and Nursing Home Association, explained that his group has largely transformed into a coordinated effort to provide hospitals and nursing homes with resources.

“The situation is intense and is nearing desperation,” he said. “I don’t know how else to say it, our world is on fire and we need help.”

ASHNHA had, on Wednesday, sent Gov. Mike Dunleavy a letter pleading with him to renew the state’s disaster declaration, arguing that it would provide health care providers with the tools necessary to help staff up as well as renew attention to preventing the spread of the virus. On Thursday, Dunleavy met those calls by amending the special session to ask legislators to consider two bills—one that has already been rejected by the Senate Health and Social Services Committee—to bring some limited tools to the fight. By choosing a slower—it’ll be at least a week and that’s if the Legislature is really on the ball—and politically tenuous route to deliver these measures instead a disaster declaration that would anger the Republican base heading into his election year, Dunleavy is making it pretty clear where his priorities lie.

The hospital groups were asked about the disparity between the two routes and for the most part were diplomatic about wanting everyone to work together to find a solution and bring help to the strained hospital system.

“The point here is the world is breaking before our eyes,” Kosin told the committee, “and we’re asking for anything you can do.”

Following the hearing, House HSS Committee co-chairs Reps. Liz Snyder and Tiffany Zulkosky released a joint statement criticizing the governor of taking the politically convenient approach to the needs.

“While we are relieved the Governor is acknowledging the crisis the delta variant is posing to our state’s fragile medical system, his actions today do not provide the immediate relief that our healthcare system so desperately needs,” they said. “The Governor should not spend unnecessary additional state resources to fix this issue when he has already stated his authority to reissue these powers if needed. There is no need to further politicize pandemic response when our health care providers are in crisis. We join Alaska’s health care leaders in urging the Governor to start leading and declare a temporary 30-day disaster declaration.”

While the political process over providing hospitals with additional capacity—Dunleavy’s requests include a temporary expansion of telemedicine and a permanent change entering the state into a nursing compact allowing nurses from other state’s to more easily enter Alaska’s health care system—is important, ANMC’s Onders told the committee that it doesn’t solve the underlying problem: The largely unchecked spread of the highly contagious Delta variant.

“I’m concerned that if people think that alone will provide an immediate solution, I would caution them. There is a very limited number, even with a streamlined process, nationally to get staffing here," he said. "I'm not sure that that solution will be as robust as we need. The prevention of infection is even more critical. ... Public indoor masking is key component of that that could mitigate spread.”

The takeaway message is that there really needs to be far more effort and attention on the front end to avoid infections in the first place. The best treatment, state officials told the committee, is quite literally prevention because the available treatments’ efficacy quickly falls off the more serious and more progressed the infection becomes.

Over the last 24 hours, Alaska Airlines launched incentives aimed at vaccinating existing employees and Fairbanks Memorial Hospital joined the list of hospitals requiring the vaccine.

Politics of disaster declarations

Leave it to Rep. Christopher Kurka, R-Wasilla, to be not only unphased by the testimony but upset that he even had to hear it all, complaining at the end that “this whole hearing has felt politically manipulative.” This is a guy who earlier this week argued that freedom is all about being getting sick with a largely preventable virus, which ought to serve as a pretty good idea of the base that folks like Gov. Dunleavy and Anchorage Mayor Dave Bronson are listening to.

Bronson released a milquetoast statement today that encouraged hand washing, but didn’t mention masks or vaccines. When Dr. Michael Savitt, the city’s health director testified to the House Health and Social Services Committee, he diverted questions about health mandates to Bronson. It seems that he’s putting more attention to reinstituting the suspension on the city’s plastic bag ban.

That Bronson, Dunleavy and company are saying anything at all, regardless of how mealy mouthed it is, still should to be pretty telling about the situation the state is in. Things must be bad, but just not bad enough to step out of line with to the fervently anti-mask base over meaningful measures to curb the spread of the virus, the underlying cause of strained hospitals and a weak economy.

It’s a point that former Gov. Bill Walker has seized upon in his race for governor.

“Leadership means taking strong positions in Alaskans’ best interests, even in tough times. Alaska certainly is in tough times today. Doing nothing about the fiscal crisis as we run out of savings is one thing, but doing literally nothing to promote vaccinations during a pandemic, and the rise of the Delta variant, is an utter failure to lead,” the duo said in an op-ed published with the Alaska Landmine. “Governor Dunleavy seems to lack the ability even to make a clear public statement on the importance of vaccination. Shockingly, he actually issued a press release about the pandemic at the height of this crisis that didn’t even include the word ‘vaccine.’ A governor cannot run from hard decisions, but that is what Dunleavy seems determined to do. For the sake of appeasing his political base, he continues to minimize the critical role that vaccination could play in protecting Alaskans and our economy. But a governor doesn’t just represent his base. He or she must represent all Alaskans, including the immunocompromised and the approximately 120,000 Alaskans under the age of 12 who are ineligible to receive the vaccine. We have watched as Republican governor Larry Hogan of Maryland said loudly into the microphone, ‘Just get the damn vaccine!’ That is leadership.”

Ah, right, the fiscal crisis

It feels like years ago at this point, but it was just on Tuesday that the House passed the special session budget with a $1,100 PFD. It’s since arrived in the Senate, where Dunleavy is also asking for more than 30 additional changes (none being the PFD, interestingly) that includes a do-over on his veto of $1.25 million for the state’s public health nursing program.

Much of the budget currently sits in limbo with disagreements between the Legislature and the governor over the availability of the funding mechanisms, the Legislature is still trying to piece together a fiscal plan despite the House nearly rattling itself apart over the budget and, of course, the Senate still needs to take its votes on the PFD. We’ve seen potential several pieces of a potential fiscal plan emerge this week with hearings on proposed changes to the PFD statute, advisory votes, constitutional amendments and even a hearing on Rep. Geran Tarr’s sales tax proposal.

I’m still skeptical that it can all come together given just how squirrelly the governor has been when it comes to new revenue, a component that even several Republican legislators conceded is needed to reach a compromise. I’ve heard complaints that it’s been difficult for folks to meaningfully negotiate with him giving what seems to be the administration’s constantly shifting positions (we are, after all, still waiting on the administration to release the promised DIY fiscal plan tool or even his preferred revenue measures like legalized gambling and a rework of corporate income taxes to go after streaming services). And, because of course, it sounds like the governor has once again shifted his position, at least according to Department of Revenue officials testifying to the House Ways and Means Committee today where they outlined the governor’s latest demands on a fiscal plan:

  • No income tax

  • 50/50 PFD in the Alaska Constitution

  • Constitutional spending cap

And even then, Dunleavy’s position on allowing a sales tax to go forward is “likely.”

It’s almost like he doesn’t want a solution at all!

All that aside, there really does seem to be a genuine desire among legislators to try to find some sort of compromise. Like the pandemic, folks are just exhausted with dealing with it and would like to see a resolution of any kind. That could mean a fourth special session for this year or it could mean a $0 dividend if things get too sideways.

Reading list

Weekend watching

Ever since coming to Alaska, I’ve always been kinda enchanted by Adak. This video admittedly leans a bit into the corny side of things, but I found its look at the town neat.

And also there’s this comment:

Have a nice Labor Day weekend, y’all!