January 8, 2021...January 8, 2021 Report, Page 2 of 12 825 L Street, Anchorage, AK, 99501 | (907) 343-6718 | | @ancpublichealth Table 1: Case Count Measures Cases

825 L Street, Anchorage, AK, 99501 | (907) 343-6718 | www.muni.org/health | @ancpublichealth

Date: January 8, 2021

To: Acting Mayor Austin Quinn-Davidson

Thru: Heather Harris, Anchorage Health Department Director

From: Janet Johnston, Anchorage Health Department Epidemiologist

Subject: January 8, 2021, COVID-19 Risk Assessment Update for the Municipality of Anchorage

This weekly report shares data available on the State of Alaska and Municipality of Anchorage (MOA)

websites for the period of December 31, 2020 – January 6, 2021, with some more recent data. Unless

otherwise indicated, this data is for cases reported in the MOA.

Key Findings

Municipality of Anchorage COVID-19 metric status for the past week:

• RED LIGHT for epidemiology

• YELLOW LIGHT for health care capacity

• RED LIGHT for public health capacity

In the last week, there was a 15% increase in new cases. The current 14-day rolling daily average of

36.83 cases per 100,000 population is lower than one week ago, but may start to increase given the

increased number of cases during the past week. The effective transmission rate (Rt) in Anchorage has

increased slightly but remains near 0.80.

Test positivity is hovering just above 5%, and available ICU beds have decreased to 13, down from 19

beds 10 days ago. The cumulative number of deaths has increased by eight since the last report for a

total of 126.

Epidemiology

These metrics consider case counts and COVID-19-related hospitalizations and deaths.

Case Count Trends and Deaths

Key Findings: This measure remains RED due to the high level of cases at three and a half times the

State’s high alert level. New cases in Anchorage increased by 15% over last week for 106 more new

cases.

• Cumulative cases. As of January 6, there are 23,728 confirmed cases in the MOA. This includes 23,344 Anchorage residents in- and out-of-state and 384 nonresidents testing positive in Anchorage.

• Deaths. There have been 126 deaths among Anchorage residents. This is eight more than were reported in the Mayor’s Report 10 days ago.

http://www.muni.org/health

January 8, 2021 Report, Page 2 of 12


Table 1: Case Count Measures

Cases by Date Reported December 24 -

December 30

December 31 -

January 6 Change Notes

New cases in the last week

717

823 106

New non-resident cases

11 10 -1

One north slope oil

worker, rest unknown

Average new cases per day,

last 7 days 102 118 15 15% increase

Average new cases per day

per 100,000, last 14 days

46.36 36.83 -9.53

SOA's high alert level is

10+. Continues to fall

from mid-November

peak, but likely now at

a relative low.

COVID/PUI Hospitalization Trends

Key Findings: This measure is YELLOW. Hospitalizations decreased during the Christmas and New Years

weekends but are starting to increase slightly in the new year. The risk for hospitalization increases

significantly with age. We continue to see approximately 13% of cases among Anchorage residents aged

60 or older and 5% among residents aged 70 or older in the last three weeks, which is less than last

weeks’ report. We also continue to see racial disparities in cases, hospitalizations, and deaths.

• Current hospitalizations. As of January 6, there were 51 hospitalized COVID-19 cases. The number of hospitalized cases ranged from 38 to 51 this week, lower than the high of 65 from the previous report. As of January 6, there were 5 hospitalized Persons Under Investigation (PUI). The number of hospitalized PUIs ranged from 5 to 12.

• Age risk. The age distribution of cases over the past three weeks is similar to the age distribution seen previously. Forty-five percent of cases are between the ages of 20 and 39, while that age group comprises just 32% of the Anchorage population. Table 2 shows the age distribution for new cases reported in the previous three weeks as well as for cumulative cases, hospitalizations, and deaths. Older age groups are overrepresented in hospitalizations and deaths since the start of the pandemic.

• Risk by racial category. Table 3 shows the prevalence of COVID-19 cases, hospitalizations, and deaths by race. People of color, particularly Alaska Native (AN) and Native Hawaiian/Other Pacific Island people continue to be overrepresented in cases, hospitalizations, and deaths. However, this disparity may be decreasing slightly over time. Alaska Native people comprised 16% of cases in the last three weeks, compared to 20% of cases across the entire pandemic in Anchorage. Alaska Native and American Indian people comprise just 8% of the total Anchorage population. White people comprised 30% of the cases in the last three weeks, which is well below their proportion of the population (62%).




People who identified as an “other race” comprised 22% of cases during the past three weeks, while they comprise just 2% of the Anchorage population. However, approximately half of cases with known ethnicity (Hispanic/non-Hispanic) self-identify as “other race.” Race data is missing for a larger proportion of cases than for hospitalizations and deaths, due in part to our limited capacity to interview all cases. Cases with missing race data are excluded from this analysis.

• Risk by ethnicity. Table 4 shows the prevalence of COVID-19 cases, hospitalizations, and deaths by ethnicity. Ethnicity data is missing for a majority of cases (58%). Where ethnicity is known, people who identify as Hispanic make up 13% of cases, compared to 9% of the Anchorage population. There does not appear to be disparities in hospitalizations and deaths based on Hispanic ethnicity at this time. Data Note: From the beginning of the pandemic, through September 21, 2020, hospitals reported their data through the Alaska State Hospital and Nursing Home Association (ASHNHA) to the CDC. As of September 22, 2020, hospitals report directly to the US Department of Health and Human Services (HHS) TeleTracking System using a template provided by HHS. With this change, ASHNA no longer provides hospital data; therefore, some of the current data may not be directly comparable to previously reported data.



Table 2 Cases, Hospitalization, and Deaths by Age Category

Age Cases Percent Rate* Cases Percent Rate* Cases Percent Rate* Cases Percent Rate*

0 to 9 58 6% 143 27 4% 66 64 8% 158 149 6% 367

10 to 19 92 9% 250 84 12% 228 72 9% 196 248 10% 674

20 to 29 215 21% 479 167 24% 372 196 24% 437 578 23% 1,288

30 to 39 225 22% 496 143 20% 315 178 22% 392 546 22% 1,204

40 to 49 129 13% 389 99 14% 299 102 13% 308 330 13% 995

50 to 59 143 14% 390 94 13% 256 109 13% 297 346 14% 944

60 to 69 100 10% 348 45 6% 157 58 7% 202 203 8% 707

70 to 79 32 3% 197 24 3% 148 28 3% 173 84 3% 518

80+ 18 2% 322 16 2% 287 6 1% 107 40 2% 717

All Cases 1,012 100% 351 699 100% 243 813 100% 282 2,524 100% 876

* Per 100,000

Age Cases Percent Rate* Cases Percent Rate* Cases Percent Rate* Population Percent Rate*

0 to 9 1,399 6% 3,443 6 1% 15 - 0% - 40,630 14%

10 to 19 2,607 11% 7,085 6 1% 16 - 0% - 36,798 13%

20 to 29 5,057 22% 11,267 30 5% 67 2 2% 4 44,884 16%

30 to 39 4,602 20% 10,145 57 9% 126 1 1% 2 45,361 16%

40 to 49 3,256 14% 9,820 62 10% 187 6 5% 18 33,156 12%

50 to 59 2,967 13% 8,093 103 16% 281 12 10% 33 36,662 13%

60 to 69 2,163 9% 7,536 137 21% 477 26 21% 91 28,701 10%

70 to 79 902 4% 5,559 146 23% 900 43 34% 265 16,226 6%

80+ 419 2% 7,506 91 14% 1,630 36 29% 645 5,582 2%

All Cases 23,372 100% 8,115 638 100% 222 126 100% 44 288,000 100%

* Per 100,000

Anchorage population source: 2019 1-Year American Community Survey Estimates

Dec 17 - Dec 23 Dec 24 - Dec 30 Dec 31 - Jan 6 All Cases Last Three Weeks

All Cases, All Time Hospitalizations Deaths Anchorage Population




Table 3 Cases, Hospitalization, and Deaths by Race Category

Twenty-nine (29%) of cases, or 6,862 cases, are of an unknown race and are excluded from this analysis.

Race Cases Percent Rate* Cases Percent Rate* Cases Percent Rate* Cases Percent Rate*

American Indian or Alaska Native 104 14% 472 81 16% 368 92 18% 418 277 16% 1,258

Asian 41 6% 145 28 5% 99 23 4% 81 92 5% 325

Black or African American 24 3% 144 15 3% 90 26 5% 156 65 4% 390

Native Hawaiian or Other Pacific Islander 34 5% 557 19 4% 311 23 4% 377 76 4% 1,245

White 245 34% 135 129 25% 71 153 29% 84 527 30% 290

Other Race 141 20% 2,640 131 26% 2,453 116 22% 2,172 388 22% 7,266

Two or More Races 133 18% 421 107 21% 338 91 17% 288 331 19% 1,047

All Cases 722 100% 248 510 100% 175 524 100% 180 1,756 100% 602

* Per 100,000

Race Cases Percent Rate* Cases Percent Rate* Cases Percent Rate* Population Percent Rate*

American Indian or Alaska Native 3,260 20% 14,803 124 21% 563 38 30% 173 22,022 8%

Asian 1,106 7% 3,912 66 11% 233 15 12% 53 28,273 10%

Black or African American 793 5% 4,754 31 5% 186 9 7% 54 16,679 6%

Native Hawaiian or Other Pacific Islander 911 6% 14,922 102 18% 1,671 15 12% 246 6,105 2%

White 5,965 36% 3,287 181 31% 100 42 33% 23 181,491 62%

Other Race 2,699 16% 50,543 33 6% 618 2 2% 37 5,340 2%

Two or More Races 1,776 11% 5,615 41 7% 130 5 4% 16 31,628 11%

All Cases 16,510 100% 5,663 578 1 198 126 100% 43 291,538 100%

* Per 100,000







Table 4: Cases, Hospitalization, and Deaths by Ethnicity

Ethnicity Cases Percent Rate* Cases Percent Rate* Cases Percent Rate* Cases Percent Rate*

Hispanic 38 11% 141 24 13% 89 25 12% 93 87 12% 322

Non-hispanic 304 89% 116 155 87% 59 183 88% 70 642 88% 246

All Cases 342 100% 119 179 100% 62 208 100% 72 729 100% 253

* Per 100,000

Ethnicity Cases Percent Rate* Cases Percent Rate* Cases Percent Rate* Population Percent Rate*

Hispanic 1,267 13% 4,694 31 7% 115 7 6% 26 26,992 9%

Non-hispanic 8,440 87% 3,234 426 93% 163 117 94% 45 261,008 91%

All Cases 9,707 1 3,370 457 1 159 124 100% 43 288,000

* Per 100,000






Health Care Capacity

These metrics measure our ability to provide hospital care in the case of a surge in people sick with

COVID-19.

Ability and Capacity to Meet Anticipated Case Surge

Key Findings: This measure is YELLOW. The number of available adult ICU beds decreased to 13 on

January 6. The percent of total hospitalizations due to COVID-19 patients still in their infectious period

out of total hospitalized decreased to just over 10%. The effective transmission rate (Rt) for Anchorage

increased slightly to just over 0.8. Overall, the health care system's capacity is sufficient to meet the

current demand in hospitalizations; however, the future impact of holiday gatherings and travel keep us

in a watchful position.

• ICU beds. As of January 6, there were 13 available adult ICU beds out of 67 total staffed adult ICU beds. The number of available adult ICU beds ranged from a low of 7 to a high of 14 during the past week.

• Non-ICU beds. As of January 6, there were 132 available adult non-ICU beds out of 491 total staffed adult non-ICU beds.

• Ventilators. As of January 6, there were 8 COVID-19 patients on ventilators in Anchorage.

• Hospital Impact: As of January 6, 10.3% of all hospitalizations and 6.3% of Emergency Department visits at the three acute care hospitals in Anchorage were related to COVID-19. The hospitalization percentage was similar to the last report ten days ago.

• Reproductive number estimates. See Table 4 below. These data were pulled on January 7, 2020. These numbers are reported using a seven-day lag to be consistent with COVID ActNow’s policy of reporting the most recent seven days as preliminary due to fluctuations in data for several days after reporting from states.

• Projected cases. Projected daily new cases with no mitigation measures in one week is 48 by January 14, 2021. The estimated halving time for new daily COVID-19 cases per day in Anchorage with no mitigation measures is 18 days. The daily growth rate has decreased again to -3.85%.

• CDC COVID-19 Surge model: The CDC COVID-19 Surge model has been updated with data through January 5, 2021. The updated model shows some improvement in the ability of the health care system to meet demand for ICU beds. Based on this updated model, demand for ICU beds due to COVID-19 will only exceed capacity if the effective reproductive number (Rt) increases from the current value of 0.8 to 1.3, the level seen in July. In that case, demand could exceed supply in approximately 8 weeks. If Rt remains below that level, as it has in recent months, demand will not exceed supply.




Table 5: Reproductive Number Estimates

Geography, Source December 20

(last week’s report)

December 20

(updated) December 27

Anchorage, COVID ActNow 0.73 0.78 0.82

Anchorage, SOA model

(in-state residents only) 0.79 0.77 0.82

Alaska, COVID ActNow 0.73 0.79 0.90

Alaska, SOA model

(in-state residents only) 0.77 0.75 0.87

Testing Activity

Key Findings: This measure is YELLOW. The seven-day average for test positivity decreased to a low of

4.61 %on December 25th but has now increased to 5.22% as of December 28th.

This measure reports a seven-day average of tests through December 21, 2020. The State reports test

results according to the date when the sample was collected. Therefore, testing numbers for the more

recent days are low and increase over time until all test results have been reported. We are changing the

time lag for reporting test positivity from four days to seven days to allow for more test results, which

will provide a more stable estimate.

Table 6: Percent Positive Measure

Indicator December 21

(last week's report)

December 21

(updated) December 28

Benchmark

Percent

positive

4.6% 4.74% 5.22%

<5%: GREEN

5%-10%: YELLOW

>10%: RED

Ability and Capacity to Test Widely

Key Findings: This measure is GREEN. Test volume has increased slightly from last week and remains

well above the target level set by the White House task force. Average test turnaround times have

increased slightly since the last report.

Each week's average daily counts are calculated using a five-day lag to allow for sample processing time.

Because some tests take more than five days to process, the average daily counts for more recent weeks

will increase as more test results are received.




Table 7: Weekly Test Count Measures

December 13 -

December 19

December 20 -

December 26

December 27 -

January 2

White House Target

(>2,000 per 100,000

population per

week)

Total Tests in the

week 26,619 20,088 23,725

>5,713

Average Daily Tests

Per 100,000

1,331

1,005 1,187

>285

Table 8: Average Turnaround Time Measures

Lab December 28 January 7 Change

Commercial 1.5 1.7 increase

Alaska State Public

Health Lab 0.9 1.4 increase

Facility 0.6 0.8 increase

Personal Protective Equipment Availability

Key Findings: This measure remains YELLOW. The supply chain remains disrupted, with a small number

of providers requiring PPE from the EOC. The EOC encourages providers to stay in contact with their

normal PPE suppliers as more items become available through the normal supply chain. This light will

turn green when supply chain access to PPE returns to normal.

• Access to PPE. Most health care and first responders can achieve sufficient PPE, with a limited number requiring support from the EOC this week.

• Requests. The EOC continues to receive and fill requests from health care providers within the Municipality, although the last week of the year was extremely slow due to the holidays. The EOC issued 325 PPE items to one agency during the week ending January 1, 2021.




Public Health Capacity

These metrics measure AHD’s capacity to track and follow the positive cases and their contacts, ensuring as many people as possible self-isolate or quarantine depending on the situation, and testing symptomatic contacts. AHD is fully transitioned to using the CommCare system for case interviews and contact tracing.

Track and Follow New Cases and Contacts

Key Findings: This measure is RED. With increasing case counts, the capacity to interview cases promptly and monitor high-risk contacts continues to be stretched thin.

• Positive case outreach. MOA and SOA case interviewers aim to interview or leave a message for each new case within 24 hours of receiving the case assignment; however, with increasing cases and processing times, many cases cannot be outreached to in that timeframe. To maximize the effectiveness of case investigations and contact tracing, cases closest to the date of specimen collection are prioritized for interviews, including source investigation for the 5 days prior to specimen collection.

• Exposure and source investigation. Of the 1,127 Anchorage cases interviewed between December 28, 2020, and January 6, 2021, 208 (18.5%) were identified as part of a cluster. The two largest clusters were at Department of Corrections Facilities with 69 cases from Hiland Mountain Correctional Facility and 56 at the Anchorage Correctional Complex. Fifteen cases were associated with the Red Dog Mine. Most of the remaining cluster cases were associated with shelters or assisted living facilities. The majority of activity identified during source investigations were related to family and friends, including holiday gatherings and travel, as well as work and shopping. Emergency Order 16 was in effect for most of the time periods included in the source investigations, limiting contact at many other locations.

• New contacts. There were 109 contacts newly registered into CommCare between December 30, 2020, and January 5, 2021, who were still awaiting investigation as of close of business on January 7, 2021.

Transmission Trends

This section summarizes trends in infection and transmission found in CommCare or through feedback

from the AHD COVID-19 response team.

• Exposure source. We continue to see cases in congregate residential settings and among employees at a variety of businesses. Of the 576 cases in CommCare with specimens collected between December 28, 2020, and January 6, 2021, 264 (46%) specified an exposure type. The most commonly reported exposure types were household (53%), social events (11%), and employment (8%). Of these 576 cases, 455 (79%) provided information about occupation. Occupation was categorized into the pre-specified list summarized in Table 8, with the largest group (47%) falling into the Other category.




Table 9: Occupation Among Interviewed Cases

Occupation Count Percent

Other 214 47.0%

Unemployed 81 17.8%

Student 52 11.4%

Health care worker 41 9.0%

Retired 32 7.0%

Self-employed 15 3.3%

Food service 10 2.2%

Correctional worker 5 1.1%

Child care 3 0.7%

City 2 0.4%

Total 455 100.0%

• At-risk populations. As of January 7, 2021, 460 cases have been identified within homeless shelters, supportive housing locations, and unsheltered homeless individuals. This is an increase of 17 cases since our last update on December 18, 2020. Twenty-five cases have been hospitalized since the beginning of the outbreak, and seven have died. This is an increase of three deaths since our last report, although death reports are often delayed due to the need for a review of the death certificate. Regular screening continues on an ongoing basis at these locations with confirmed cases and close contacts moved into isolation and quarantine as soon as cases are confirmed.

Vaccination

• As of January 4, 2021, 6,393 doses of COVID-19 vaccine have been administered to Anchorage residents, with the first 453 doses administered on December 15, 2020.

• AHD administered 624 first doses in December to Fire/EMS personnel and AHD and Anchorage School District personnel who administer vaccinations. Second doses are being administered between January 5, 2021 and January 15, 2021.

• AHD will administer a minimum of 700 first doses to health care workers and persons age 65 and older in clinics starting January 11, 2021.

• AHD has organized three mass vaccination clinics to administer a total of 1800 first doses this upcoming Saturday (January 9, 2021), Sunday (January 10, 2021), and Tuesday (January 12) at the Alaska Airlines Center. These clinics are for any resident currently eligible to receive vaccine. Registration for these doses completely filled within approximately four hours of registration being opened.




Public Health Advisory

To prevent unneeded serious illness and deaths, AHD urges everyone to do the following:

• Stay home except to get food, to go to work, or to recreate outdoors. o Where possible, use delivery options and work from home. o Trails and parks are ideal for exercise while distanced from others.

• If you feel sick, stay home except to get tested.

• Wear a mask and stay at least 6 feet from others in public. o Masks are recommended for anyone over the age of two. o Masks are recommended during all indoor exercise or sports. o Masks are recommended during all outdoor exercise or sports unless athletes generally

can maintain ten (10) feet of physical distancing at all times.

• Protect your friends and family by avoiding gatherings, especially indoors. Gatherings are not safe.

• Protect the vulnerable by avoiding contact with those at higher risk of severe illness, such as older adults or those with certain medical conditions.

o Check-in on older and medically fragile family members and ensure they can get food and other essentials without leaving the house.

o If you work among older or medically fragile individuals, keep your number of contacts small and get tested regularly.

o Stores are encouraged to add more curbside pick-up options or special hours for older and medically fragile patrons.

• Proactive weekly testing is encouraged for front-line workers, including teachers with students attending in-person, grocery store workers, and hospitality industry workers.


http://www.anchoragecovidtest.org/

Documents

January 8, 2021...January 8, 2021 Report, Page 2 of 12 825 L Street, Anchorage, AK, 99501 | (907) 343-6718 | | @ancpublichealth Table 1: Case Count Measures Cases