Jared Kosin is president and CEO of the Alaska State Hospital and Nursing Association, which represents more than 65 hospitals, nursing homes, and other healthcare organizations that employ over 10,000 Alaskans.
The Watchman sent several questions to Kosin in order to clarify the impact of COVID-19 on Alaska’s hospitals. In particular we wanted evidence for recent claims in the mainstream media that COVID-19 is overwhelming some Alaska hospitals. While Kosin could not provide that evidence, he did respond to our questions and provided some insight into the state of local healthcare facilities at this time. His answers are published below.
Do hospitals keep track of hospitalizations due to COVID related illnesses vs. hospitalizations in which someone is admitted for another reason, but tests COVID positive? For example, a woman who is hospitalized in order to give birth, but who also tests positive for COVID without exhibiting any COVID symptoms?
KOSIN: Yes, this generally would be considered clinical information that is documented in the patient’s medical record.
It has been repeatedly said that hospital capacity is not accurately portrayed merely by looking at the number of available beds and ventilators, but that healthcare staff is also important to keep in mind when thinking about hospital capacity. How does the state determine whether a hospital is over-burdened because of a lack of health care staff? Is there a concrete number that indicates when staffing has fallen to critical levels? What is this number?
KOSIN: It is correct that bed capacity cannot be defined by physical beds because there are more physical beds than caregivers (i.e. “staff”) available to render care for those beds. “Staffed capacity” constantly changes, especially as caregivers are pulled off the front lines for extended periods of time due to COVID infections or exposures in the community. Based on these dynamics, there is no number for Alaska’s total bed capacity.
Health care and health care delivery are significantly different depending on the location/market. For example, hospital care in rural Alaska looks completely different than it does in Anchorage. Excess capacity in one market is often limited to that market, so it is not necessarily available to other areas in need, and a statewide view of capacity fails to account for this. For these reasons, regular, direct communication with the facilities is the way to determine if a hospital is being overburdened because of lack of health care staff (or other reasons). The Alaska State Hospital and Nursing Home Association is in regular communication with the hospitals and the State, and communication has been effective so far on all ends.
ALASKA WATCHMAN DIRECT TO YOUR INBOX
Are hospitals historically understaffed at this time of year?
KOSIN: There always is a need for staff/workforce to some degree. Hospitals are often busier this time of year due to flu season and other factors. Generally, when operations are busier, there is more pressure on staffing. With that said, the pressure from COVID-19 on facilities and staff has been extraordinary and incomparable to prior years.
How does current hospital staffing compare to the staffing levels in recent years (2019 and 2018)?
KOSIN: This is not actively tracked at the state level, and it would be highly variable from facility to facility.
How does hospital availability (in terms of beds) compare to recent years at this time of year?
KOSIN: This is not actively tracked at the state level, and also is highly variable from facility to facility. The state dashboard that highlights bed capacity was set up in April 2020 and did not exist before then, so there is no prior year benchmark for comparison.
To your knowledge, are any Alaska hospitals turning patients away because of being understaffed or due to a lack of beds?
KOSIN: No. Hospitals take pride in caring for our patients and making sure all their needs are met. We do not turn patients away. Hospitals are subject to EMTALA (federal law) and have a duty to treat all patients who come to the Emergency Department. Moreover, hospitals frequently work together on patient transfers between facilities when higher level of care or more resources are needed.