09/25/2021
This is the letter I sent to city council.
09/22/21
Dear Mayor Scheidt and Valdez City Council Members,
It is my duty as Chief of Staff of Providence Valdez Medical Center to inform you that the Alaska health care system has been forced into Crisis Standards of Care. This means that there are not enough resources to care for those who are sick. ICU beds, equipment, and staff will be rationed based on the probability of patients surviving. Currently all ICU beds in Anchorage are full and several floor beds are being used as ICU beds.
This new policy and will impact the citizens of Valdez who would normally be transferred to Anchorage for care. Transfer at this time will be difficult to impossible and not just for severe COVID illness, but for heart attacks, major illness, and trauma. The medical staff is prepared to do whatever we need to do, but there are limits to the kind of patients we can take care of in Valdez given our equipment, staff levels, and expertise.
The State of Alaska has several programs that are being instituted over the next couple of weeks including bringing in nurses from out of state and organizing a transfer center to send patients to those facilities with open beds. Despite this, the statewide consensus is that we will be seeing a much higher mortality rate, similar to a battlefield scenario.
It is important that the citizens of Valdez know that if they get sick or injured, the appropriate health care resources may not be available. Further, as our hospital census increases there may not be staff available for monoclonal antibody therapy. I recommend that community members refrain from activities where injury or illness is likely.
The COVID numbers in Valdez are very high, and the rate appears to be accelerating. We expect that there will be several people needing hospitalization within the next week, which will be problematic at best. It is important to slow our community infection rate. Please remember that the hospitalization rate lags the initial infection rate by a week. Mortality rates lag behind hospitalization rates by about the same amount.
The ways to reduce the infection rate are very clear. Anyone who has not received a COVID vaccine should get one. Those who have had COVID should get at least one dose of vaccine. The vast majority of ICU COVID beds are filled with the unvaccinated. Masks are also effective as is social distancing at reducing spread.
The physicians and staff of Providence Valdez Medical Center will do all in our power to care for the community. Unfortunately, we are part of a broader health care system which has been overwhelmed with COVID cases and health care rationing is in effect.
John Cullen MD PVMC Chief of Staff
