Legislature(2019 - 2020)Anch LIO Lg Conf Rm
09/09/2020 01:00 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
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| Start | |
| Presentation(s): Covid-19 in Alaska on Local and State Pandemic Response | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
ALASKA STATE LEGISLATURE
JOINT MEETING
HOUSE STATE AFFAIRS STANDING COMMITTEE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
Anchorage, Alaska
September 9, 2020
1:02 p.m.
MEMBERS PRESENT
HOUSE STATE AFFAIRS STANDING COMMITTEE
Representative Zack Fields, Co-Chair
Representative Jonathan Kreiss-Tomkins, Co-Chair (via
teleconference)
Representative Grier Hopkins (via teleconference)
Representative Andi Story (via teleconference)
Representative Steve Thompson (via teleconference)
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
Representative Tiffany Zulkosky, Chair (via teleconference)
Representative Ivy Spohnholz, Vice Chair (via teleconference)
Representative Matt Claman (via teleconference)
Representative Harriet Drummond (via teleconference)
Representative Geran Tarr (via teleconference)
Representative Sharon Jackson (via teleconference)
MEMBERS ABSENT
HOUSE STATE AFFAIRS STANDING COMMITTEE
Representative Sarah Vance
Representative Laddie Shaw
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
Representative Lance Pruitt
COMMITTEE CALENDAR
PRESENTATION(S): COVID-19 in Alaska on Local and State Pandemic
Response
- HEARD
PREVIOUS COMMITTEE ACTION
No previous action to record
WITNESS REGISTER
KEVIN BERRY, PhD, Assistant Professor of Economics
Department of Economics
University of Alaska Anchorage
Anchorage, Alaska
POSITION STATEMENT: Provided a PowerPoint presentation,
entitled "Economics of COVID-19," dated 9/9/20.
NOLAN KLOUDA, Executive Director
Center for Economic Development
University of Alaska Anchorage
Anchorage, Alaska
POSITION STATEMENT: Provided a PowerPoint presentation,
entitled "The Economy and COVID-19," dated 9/9/20.
CHRISTY LAWTON, Division Manager
Public Health Division
Anchorage Health Department
Anchorage, Alaska
POSITION STATEMENT: Testified during the presentation on COVID-
19 in Alaska.
JANET JOHNSTON, PhD, Epidemiologist
Anchorage Health Department
Anchorage, Alaska
POSITION STATEMENT: Testified during the presentation on COVID-
19 in Alaska.
JAKE METCALFE, Executive Director
Alaska State Employees Association
Anchorage, Alaska
POSITION STATEMENT: Testified during the presentation on COVID-
19 in Alaska.
ACTION NARRATIVE
1:02:29 PM
CO-CHAIR ZACK FIELDS called the joint meeting of the House State
Affairs Standing Committee and the House Health and Social
Services Standing Committee to order at 1:02 p.m.
Representatives Claman (via teleconference), Drummond (via
teleconference), Hopkins (via teleconference), Jackson (via
teleconference), Kreiss-Tomkins (via teleconference), Story (via
teleconference), Thompson (via teleconference), Zulkosky (via
teleconference), and Fields were present at the call to order.
Representatives Tarr (via teleconference) and Spohnholz (via
teleconference) arrived as the meeting was in progress.
^PRESENTATION(S): COVID-19 in Alaska on Local and State
Pandemic Response
PRESENTATION(S): COVID-19 in Alaska on Local and State Pandemic
Response
1:03:10 PM
CO-CHAIR FIELDS announced that the only order of business would
be a presentation on state and local response to the COVID-19
pandemic.
1:04:02 PM
KEVIN BERRY, PhD, Assistant Professor of Economics, Department
of Economics, University of Alaska Anchorage, informed the
committee that he has been studying the economics of infectious
disease since 2011. He said today, he would provide an overview
of pandemics economics and discuss the impacts of the COVID-19
pandemic on both a state and national level. He directed
attention to the PowerPoint presentation, entitled "Economics of
COVID-19," and on slide 2, explained that there are three steps
in virus economics: control the virus, provide relief, and
recover after the virus ends. He said there are tradeoffs
within the three steps, such as, considering if controlling the
virus is more costly than simply reopening and letting it run
wild. He added that there is extensive recent research that
attempts to better understand the tradeoffs associated with
policy. Slide 3 highlighted a [2020] study by Lin and Meissner
and the National Bureau of Economic Research (NBER) working
papers series. The chart on slide 3 showed the impact on
initial jobless claims of stay-at-home orders by state. He
indicated that it is unclear whether stay-at-home orders
increase jobless claims. Multiple studies have shown that some
portion of the shock to both public health and the economy is
due to people staying at home voluntarily to avoid getting sick,
which is defined as "avoidance behavior." He said it becomes
difficult to determine whether these impacts are influenced by
the stay-at-home orders or avoidance behavior. In Alaska, for
example, one of the conflating factors is that the first cases
arrived in the state at roughly the same time that the stay-at-
home orders were issued, which complicates the estimation. The
research generally concludes that it is unclear that a tradeoff
exists between health and wealth; further, that by fighting the
virus, avoidance behavior is reduced, and it becomes more likely
that people are going to return to both work and spending.
Slide 4 reviewed a study by Dave et al. on whether shutdown
orders reduce spread. One of the key questions is whether
costly policy measures intended to reduce the spread of the
virus, like shelter-in-place orders, flatten the curve. The
research suggests that shelter-in-place orders are associated
with a 5-10 percent increase in the amount of time people stay
at home; additionally, three weeks after a shelter-in-place
order is issued, cumulative cases are reduced by 44 percent,
indicating that stay-at-home orders are incredibly effective in
reducing spread. Dr. Berry explained that these policy measures
potentially cause increased jobless claims, but they are also
reducing the long-term risk of the virus.
1:09:30 PM
DR. BERRY turned attention to slide 5, which highlighted work by
Chetty et al. at Harvard University on case studies of
reopenings in different states. Graph B, he said, shows
consumer spending in re-opened states compared to control
states, indicating that there's not a significant difference
between states that stay closed and those that reopen. He said
to keep in mind that re-opened states are often responding to an
improved situation regarding the virus. He explained that it's
not clear whether the increase in consumer spending is caused by
the relaxed restrictions or by an improvement in caseloads,
which results in people feeling safer and more comfortable.
Graphs C and D performed similar experiments; C, using
employment data; and D, using data on the number of merchants
open. The research suggests that post-reopening, employment is
not increasing rapidly relative to control states. The evidence
suggests that reopening does not cause rapid economic recovery -
people are more likely responding to the risk of becoming sick.
He noted that there are many other costs of lockdowns, including
lost education, domestic violence, drugs, and alcohol, which
must be balanced against the additional risk of the virus and
avoidance behavior in response to higher caseloads. He stated
that while lockdowns might be blunt, evidence suggests that they
are effective and that they are not the sole cause of economic
pain mostly likely due to avoidance behavior.
DR. BERRY continued to slide 6, which examined the cost of
reopening in Alaska. The graph shows that as Alaska reopens,
there is an associated rapid increase in new cases. Evidence
suggests that reducing restrictions on mobility increases virus
spread. He noted that outbreaks have long-term impacts on the
economy, such as potential loss of elders or high-risk
individuals, as well as possible long-term health effects of
COVID-19. He added that the cost of reopening in regard to
additional infections indicates fatalities, which means less
productive workers as people deal with long-term consequences
and fewer people in the economy. He stated that the additional
cases from reopening can be considered an additional cost. He
directed attention to slide 7, which highlighted the cost of
remaining closed. Research by Dr. Guettabi from the Institute
of Social and Economic Research (ISER) indicates that the
tourism and hospitality industry bear a disproportionate burden.
The economy in Alaska has been significantly impacted by the
outbreak. Monthly employment has declined dramatically since
2019 and a recovery isn't predicted until 2022. Furthermore,
certain industries are facing a much larger cost than others.
DR. BERRY directed attention to slide 8, which read as follows
[original punctuation provided]:
? It is unclear that there is a tradeoff between
health and wealth
? People want to avoid getting sick, and stay home
voluntarily
? Estimates of the impact of government intervention
range from 12% decline in consumer mobility to 60% of
lost employment
? The benefits were in lives saved and consumer
willingness to return to normal
? Ending lockdowns and restrictions is not a panacea,
and makes some problems worse
? Alaskans need help now, and some more than others
? There is room for more targeted interventions to
avoid the blunt instruments of lockdowns and
uncoordinated avoidance behavior
1:17:57 PM
DR. BERRY reiterated that Alaskans need help now. He said
implementing policies, such as the AK CARES grant program, as
quickly as possible is ideal. He explained that mask mandates
are only as effective as people are willing to respond to them.
He stressed the importance of making policies targeted. He
continued to slide 9, which demonstrated impact on the leisure
and hospitality industry.
1:19:51 PM
NOLAN KLOUDA, Executive Director, Center for Economic
Development, University of Alaska Anchorage, provided a
PowerPoint presentation, entitled "The Economy and COVID-19."
He directed attention to slide 2 and noted that Alaska was in a
recession from 2015 to 2018. The chart on slide 2 showed the
year-over-year employment change for Alaska, indicating the loss
of 12,600 jobs in that three-year timespan, which was an effect
of low oil prices and state budget complications. Alaska's
economy slowly started to recover at the end of 2018 with a
projected return to 2015 employment levels in 7-8 years.
However, the scale of job losses in 2020 dwarfs the magnitude of
the prior recession. He reported that July 2020 was down 39,900
jobs compared to July 2019, which was a faster pace of job loss
than the Great Depression. Slide 3 highlighted unemployment
claims in Alaska. Before COVID-19, there were typically 1,000
new unemployment claims per week; in early 2020, initial
unemployment claims increased to 12,000-14,000 per week. He
noted that the number of new unemployment claims is dropping,
but the rate is still 4-5 times higher than the normal baseline
in 2019.
1:23:13 PM
MR. KLOUDA continued to slide 4, which demonstrated job losses
by sector between July 2019 and July 2020. At 14,300 job
losses, the leisure and Hospitality industry is suffering the
most because it has the most exposure to the visitor industry
and locals are exhibiting avoidance behavior. Other industries
that took a hit are trade/transportation/utilities,
manufacturing, and local government. Slide 5 examined the
number of small businesses that are open in Alaska. He reported
that as of August 9, 2020, about one-third of Alaskan businesses
are closed. He pointed out that it's difficult when a business
is closed with certainty and whether it's permanent or
temporary. He further noted that stay-at-home orders are not
the only factor in the decrease in business closures, as many of
them closed before those orders were issued. He indicated that
there's not a clear relationship between stay-at-home orders and
[economic] downturn. He turned attention to slide 7, which
addressed consumer spending. In Alaska, consumer spending was
down 14.7 percent on August 20, 2020 compared to pre-COVID-19.
He noted that consumer spending started to increase on April 1;
however, the rate of recovery is slower in Alaska compared the
U.S. as a whole. He expressed concern that Alaska's underlying
economic weakness from the prior recession could slow the
state's recovery from COVID-19. Additionally, research suggests
that the expiration of the supplemental unemployment benefits
caused a contraction, or slower recovery, in consumer spending,
as much of that money was being spent at local businesses.
Furthermore, there was no evidence to suggest that the extra
unemployment benefits were inhibiting people's return to work.
1:28:18 PM
MR. KLOUDA directed attention to slide 7, which provided the
annual average unemployment in Alaska from 2011-2022, as well as
a forecast. He explained that Alaska reached its peak in
unemployment in 2015; after which it subsequently declined until
experiencing a small post-recession recovery in 2018. He
indicated that 2020 would experience an overall loss of 25,000
jobs compared to 2019. He emphasized the long and slow recovery
that lies ahead for Alaska, which is further complicated by
relatively low oil and gas prices and ongoing fiscal issues.
1:30:08 PM
REPRESENTATIVE ZULKOSKY pointed out that a patchwork of
protective health measures is not effective in preventing the
spread of infection. She asked if there has been economic
research on states that have taken a statewide approach to
protective measures compared to states that passed the
responsibility to municipalities.
1:32:05 PM
DR. BERRY said there is a small amount of research from NBER's
working paper series that focuses on coordination between
different locales and their policy responses. He said there is
suggestive evidence that there are proficiency losses from
prevention and control measures when they are uncoordinated
across municipalities. He noted that the aforementioned
research is focused on the Lower 48, which has a different
transportation network than Alaska. He opined that it might not
translate because Alaska has communities off the road system and
different movement around the state. He stated that the
suggestive evidence indicates that coordinated policies are
going to outperform uncoordinated policies; however, whether
that is statewide policy or policy that is otherwise developed
is unclear in the existing literature thus far.
1:33:16 PM
REPRESENTATIVE ZULKOSKY returned attention to slides 5 and 6 and
asked if there has been an analysis of the symbiotic
relationship between economic impact and rates of infection in
Alaska.
1:34:18 PM
MR. KLOUDA explained that there is a consensus among economists
that long-term economic health depends on good public health and
that it's hard to have one without the other. He stated that
people are afraid to leave their houses and spend money as long
as the virus is dangerous, adding that it's hard to understand
whether the stay-at-home orders have more impact than the
general fear of the virus. He said in general, a healthy
economy will depend on the control of the virus.
DR. BERRY agreed that a healthy economy depends on having
healthy workers and consumers. He added that some of the
unexpected costs of the pandemic are in lost education and
potentially long-term health impacts, which suggests that there
could be long-term health impacts from an uncontrolled public
health crisis.
REPRESENTATIVE ZULKOSKY expressed interest in further analysis
of the relationship between the health impacts and the economic
impact in Alaska.
1:38:14 PM
REPRESENTATIVE FIELDS surmised that a health mandate would have
zero negative economic effects. He asked if that is correct.
DR. BERRY said he would expect a mask mandate to have a positive
impact because it would help people feel safer to participate in
the economy. He noted that there are always unexpected
behavioral responses that cannot be accounted for.
MR. KLOUDA added that economists at Goldman Sachs looked into
how a national mask mandate would affect the economy. Their
research suggested that a nationwide mandate would prevent a
loss of around 5 percent GDP because it would forestall closures
and stay-at-home orders.
REPRESENTATIVE FIELDS speculated that targeted interventions,
like a mask mandate or workplace safety standards, could protect
jobs by preventing the necessity of lockdowns.
DR. BERRY answered yes. He explained that the blunt instrument
of a lockdown is probably the most economically damaging way to
control the virus; nonetheless, it's the most likely to have a
positive cost benefit ratio. He said, "it's the difference
between cutting off an entire leg to stop an infection or
treating it with antibiotics."
REPRESENTATIVE FIELDS questioned whether either testifier wished
to elaborate on targeted measures beyond a mask mandate and
workplace safety measures or if those are two key measures that
the state should be working on.
1:41:01 PM
DR. BERRY deferred to his public health colleagues. He said as
an economist, he is most aware of the mask mandate as a way of
reducing transmission, as well as restrictions on spending time
in poorly ventilated areas.
MR. KLOUDA deferred to public health officials.
1:42:07 PM
CHRISTY LAWTON, Division Manager, Public Health Division,
Anchorage Health Department (AHD), explained that she oversees
the Public Health Division, which comprises the clinical nursing
team that was activated in January 2020 to prepare to respond to
the virus. Now, nine months later, 50 percent of the AHD staff
has been activated in either part-time or full-time capacity for
that response, whether it's at the department or part of the
emergency operations center. She noted that since the beginning
of the pandemic, resources have been a challenge; consequently,
the department activated and trained all the nurses and shutdown
most of the essential health services to respond in a dedicated
fashion. She applauded the public health nursing team for
providing an optimal level of response by helping people with
everything from food assistance to contact tracing, as well as
providing emotional support at a time when information on the
impact of the virus was inconsistent. She commended the
division's partnership with the Anchorage School District, which
provided 15 additional nurses. She said that partnership
enabled the nurses to provide individual attention and thorough
contact tracing for every case.
1:47:15 PM
MS. LAWTON explained that initially, people needed a lot of time
and education; however, with enough time and proper counsel, the
public health nurses were able to keep many of those people in
isolation, which helped slow the spread. When the number of
cases started to increase in June, she said things started to go
"haywire." She recalled that the department was behind and
unable to respond to cases in a timely manner. She said they
hit critical levels as the state and UAA were developing a
sizeable collaboration to allow for the staffing capacity to
respond to any number of cases, which the municipality, as well
as any community, could benefit from when numbers exceeded
capacity. She opined that the partnership was innovative and
helped the municipality avoid a dangerous tipping point that it
came close to exceeding. She reported that there are currently
several hundred statewide contract tracers between combined
resources from AHD, the state, the UAA workforce, and
volunteers, which ensures that each new case is contacted and
outreached within 24 hours. She opined that the various
emergency orders have been very effective in helping AHD reduce
the spread that was transpiring from large gatherings. She said
although the mitigation efforts have been painful for business
owners, they helped prevent worse outcomes in terms of the
number of exposures that ultimately required hospitalizations.
She conveyed that the AHD team is currently recruiting 11 new
permanent fulltime staff who would be dedicated to COVID-19 to
help replace the school nurses who have returned to their
regular duties. She further noted that the municipality added a
contractor who built five additional large scale testing sites
and has been the "go-to" person for establishing a testing
schedule for large congregate care settings, like homeless
shelters. To conclude, she opined that the state has been
successful in its proactiveness and responsiveness to [the
pandemic].
1:53:12 PM
REPRESENTATIVE SPOHNHOLZ asked if there is information on how
the CARES ACT pandemic unemployment assistance program and its
subsequent expiration at the end of July specifically impacted
individual Alaskans and the state economy.
1:54:00 PM
MR. KLOUDA said there is a working paper by NBER that shows how
that supplemental benefit was spent by its recipients. The
paper suggests that the loss of that extra $600 per week would
lead to a 44 percent decline in local spending. The research
indicated that the supplemental payments were supporting more
employment because more money was circulating instead of acting
as a disincentive. He pointed out that in terms of local
spending, households that were receiving the supplemental
unemployment insurance are disproportionately below median
income, which means they must spend what they earn on
essentials, like gas, food, and rent. He noted that it's exact
effect on the state is unclear.
DR. BERRY added that there is some work on how quickly the CARES
Act supplemental unemployment supported consumer spending and
kept the economy from collapse. He said the opportunity
insights data suggests that consumer spending has stayed flat
since the expiration of the supplemental unemployment insurance.
He noted that particularly for low-income homes, the
supplemental benefits kept people in their homes.
1:57:14 PM
JANET JOHNSTON, PhD, Epidemiologist, Anchorage Health
Department, reported on metrics pertaining to epidemiology,
health care capacity, and public health capacity. She said in
terms of epidemiology, AHD is tracking the total number of
cases, number of new cases, and the case rate, which is the
number of new cases per 100,000 residents. She noted that the
key number is the 14-day rolling average because numbers can
increase or decrease for various reasons, but the average
provides a sense of where things are going. She explained that
currently, cases are plateauing at a level that is considered
the high-alert level for the state, which is keeping schools
from opening in person. Regarding health care capacity, AHD is
focusing on hospitals' ability to handle surgeon patients if
cases were to increase dramatically, meaning available hospital
beds, ICU beds, and ventilators. She acknowledged that [the
municipality] has helped AHD's facilities serve as the backup
for most of the state in terms of extra capacity in case of
surgeon cases from other parts of the state as well as
Anchorage. Additionally, health care capacity considers PPE
availability for health care providers and first responders, as
well as testing capacity. The third metric, public health
capacity, focuses on the ability to interview cases quickly and
contact and monitor the case's contacts quickly. Currently,
AHD's public health nurses are conducting the first interviews
with major clusters within the city, such as the homeless
outbreak. They are also working with statewide contact tracing
in terms of monitoring contacts and ensuring that people get
tested, particularly those displaying symptoms. She relayed her
focus on the science of how the disease spreads. She emphasized
the importance of masking in decreasing the spread;
additionally, reducing the size of close, indoor gatherings.
She said AHD is trying to get the public to internalize the need
for masking, social distancing, and frequent hand washing.
2:02:20 PM
REPRESENTATIVE ZULKOSKY acknowledged the leadership that was
taken by AHD. She pointed out that the interconnectedness of
Alaskan communities and community health was highlighted as the
surge of COVID-19 cases in Anchorage began to seep into rural
communities in the absence of statewide leadership. She asked
for further information on the existing capacity for contact
tracing and how well it's working on the local level.
2:04:12 PM
MS. LAWTON said [AHD] has been in a better position since the
Municipality of Anchorage, in collaboration with the state,
implemented the CommCare database, which manages COVID-19
information and allows any trained contact tracer to take on a
case regardless of his or her location. She said the CommCare
application helped manage the backlog in July when the
municipality was overwhelmed with new cases. She explained that
CommCare ensures that every new case is immediately assigned in
real time. She noted that the municipality has nine staff
members dedicated to contact tracing on a day-to-day basis. She
said the only disadvantage is that, aside from the clinical
team, many of the AHD staff transitioned to telework, which is
not conducive for ensuring patients' privacy and compliance with
Health Insurance Portability and Accountability Act (HIPPA).
She continued to explain that AHD has the autonomy to manage all
the cases associated with a particular hotspot to allow the team
to focus on the high-risk outbreaks. She opined that the
process has been successful, adding that the AHD team is
continuing to provide high-quality and timely contact tracing
services both locally and statewide.
2:09:50 PM
REPRESENTATIVE ZULKOSKY pointed out that there is a challenge
for different classes of cities and municipalities across the
state, which makes the implementation of a patchwork of
statewide protective measures tenuous for second-class cities or
communities in unorganized boroughs. She asked for insight on
how the Municipality of Anchorage is using metrics to govern
public policy decisions.
2:12:06 PM
DR. JOHNSTON offered her belief that interpreting metrics and
acting on the data is a combination of art and science. She
said a lot of time is dedicated to analyzing metrics related to
case counts, rate of new cases, and healthcare capacity, which
is all channeled to the mayor daily. She added that there is a
meeting held once or twice each week to discuss metrics and the
mayor is concerned about weighing both the public health aspect
with the economic aspect of every decision. She offered her
understanding that the municipality has taken the stance to
protect the public health in order to protect the economy.
Furthermore, Anchorage's population size provides numbers that
are relatively stable and can simulate trends, which is a
challenge for smaller communities in Alaska. She stated that
the municipality is considering CDC guidance, state alerts, and
metric forecasts, all while bearing in mind the life cycle of
the virus. She noted that UAA is conducting surge modeling with
a focus on the conditions that could lead to strain on ICU
capacity. She opined that changes would be made if a surge in
Anchorage or across the state would compromise the
municipality's ability to provide sufficient ventilators and ICU
beds.
2:15:00 PM
REPRESENTATIVE ZULKOSKY opined that Ms. Johnston's response
underscores the complexity of the COVID-19 response and the
importance of having statewide measures to protect small
communities that don't have sufficient capacity.
2:16:13 PM
REPRESENTATIVE SPOHNHOLZ asked for an update on the recent surge
of COVID-19 cases in Anchorage and its homeless population and
questioned whether it's under control.
2:16:45 PM
DR. JOHNSTON said it's difficult to say whether it's under
control. She reported that progress has been made regarding the
implementation of testing to ensure that cases are identified
quickly. She added that capacity for isolation and quarantine
has also been fulfilled. She said the challenge with the
homeless outbreak is that it's a migratory and amorphous
population, which makes it difficult to identify who is truly
homeless and who is at risk of being homeless. She added that
the population difficult to track; nonetheless, testing is being
expanded beyond the shelters to identify cases at the next level
out. She said she is mildly optimistic that it's getting under
control, but it's not totally controlled at this point.
MS. LAWTON added that the homeless providers have been
incredibly responsive. She conveyed that they already had
mitigation strategies in place and have added additional
precautions to prevent the spread. She said AHD is consulting
with the CDC to determine additional recommendations, as well as
with the Division of Behavioral Health, DHSS, for input on this
unique population, many of whom have substance issues that can
be a disincentive to isolate. She further noted that the
Municipality of Anchorage has provided a hotel that has the
capacity to house all of them for safe shelter. She said AHD
would continue to work with the CDC and the state to work on
improvements and to keep this population safe.
2:20:47 PM
REPRESENTATIVE SPOHNHOLZ deduced that [the homeless outbreak] is
not under control right now, but there is a building that has
the capacity to provide people with safe shelter. She asked if
that is correct.
MS. LAWTON answered yes, there is a dedicated place for
isolation and quarantine that is sufficient to meet the current
needs. She noted that it will continue to be evaluated as
weekly numbers are analyzed. She observed that the number of
new additional positives is slowing; however, it will be
continuing issue for the next several months that will require a
high-level effort to maintain and respond to.
REPRESENTATIVE SPOHNHOLZ encouraged AHD to keep the legislature
informed if the building reaches capacity. She pointed out that
if community spread is not managed, it jeopardizes the economy
and the ability to keep the community healthy.
2:22:26 PM
REPRESENTATIVE JACKSON asked if mass antigen testing could help
manage COVID-19 in Alaska. She underscored the importance of
economic recovery and opined that fear of the virus would not
disappear if a mandate is lifted.
2:23:44 PM
DR. JOHNSTON opined that there are additional testing strategies
that could be implemented depending on the processing speed and
the cost. She said Dr. McLaughlin conveyed that if the testing
could be frequent and affordable for a large portion of the
population, it would be a "gamechanger." She offered her belief
that cheaper and more frequent testing is a possibility, but it
depends on the cost. She said, for example, noninvasive saliva
testing that costs $1 each could be implemented in schools to
students as they enter the building. She pointed out that even
if they weren't as accurate as PCR tests, the testing would
still be administered to a large number of people, which could
control the virus and make people more comfortable. However,
she opined that both the municipality and the state aren't quite
ready for that.
2:25:35 PM
REPRESENTATIVE THOMPSON offered his understanding that it
currently takes 3-5 days to receive test results. He asked for
further clarification on the rapid test machines.
DR. JOHNSTON explained that rapid test machines produce results
in 15 minutes, which works for some situations. For other
situations, like the homeless outbreak, test samples need to be
collected from every person in a homeless facility, which would
take hours for one rapid testing machine to process. She
reiterated that there are many different testing options
available. She agreed that it would be beneficial to acquire
the high throughput PCR testing. Additionally, she reported
that depending on the facility, the municipality is averaging
under three days [for test results].
REPRESENTATIVE THOMPSON sought to clarify whether the
municipality is in the process of acquiring rapid test machines.
He offered his understanding that the university is processing
test results in a couple hours.
DR. JOHNSTON said she is unsure of whether the university is
using rapid testing. She noted that PCR tests can be "turned
around" in under 24 hours with access to a lab. She reported
that rapid PCR testing was done in the public health lab when
the case count was low.
MS. LAWTON added that AHD acquired several ID NOW COVID-19 rapid
test machines. She said AHD is considering how to employ those
as strategies in the high-risk congregate settings, particularly
as the weather gets colder. She noted that the national supply
of required cartridges for the rapid test machines have been
intermittently unavailable, which without the proper equipment,
makes it difficult to produce test results quickly.
2:29:31 PM
REPRESENTATIVE FIELDS noted that the state was invited to
participate in this hearing, but they declined. He inquired
about the long-term health impacts that medical professionals
are observing in COVID-19 survivors.
DR. JOHNSTON related that recovering from a ventilator takes a
long time and is often accompanied by long-term [health]
effects. She also recalled seeing people with micro blood clots
that affect the entire body. She said as she is not an MD,
there is a lot that she does not know about the long-term
effects; however, she indicated that they can be serious. She
expressed concern that the large number of asymptomatic cases
makes people forget about the serious ones.
2:31:14 PM
REPRESENTATIVE FIELDS asked if unmasked co-workers who are six
feet apart in an office environment for eight hours are still at
risk of transmitting the virus.
DR. JOHNSTON emphasized that six feet of distance is just a
general rule. She added that significant factors include
activity level, duration of exposure, and ventilation. She
stressed the importance of increasing fresh air in buildings and
improving the ventilation. She recommended masking if people
are in an environment all day with just six feet of distance
between them, adding that masking doesn't cause harm and
benefits the individual wearing it as well as others around
them.
2:32:54 PM
REPRESENTATIVE FIELDS expressed concern about the lack of
statewide standards and emphasized the importance of the public
recognizing that six feet is not adequate distance in indoor
environments. He recalled an op-ed by Alaska State Hospital and
Nursing Home Association (ASHNA) that reported Alaska being on
the verge of overwhelming its ICU capacity, after which the
Municipality of Anchorage issued public health mandates in
attempt to suppress the spread. He asked for the case rates at
that time and how effective the municipal health mandates were.
MS. LAWTON reported that the spread was occurring around
clusters associated with people socializing and gathering. She
anecdotally recounted that AHD was escalating concerns to the
administration and had many conversations about how to respond
knowing that none of the decisions would be popular. She noted
that it can be difficult to pinpoint one particular moment or
decision due to the latent nature of the virus.
DR. JOHNSTON reported that cases began increasing in early July
and spiked at 75 new cases per day. She said currently,
Anchorage is averaging at 34 new cases daily.
REPRESENTATIVE FIELDS surmised that the public health measures
cut the statewide infection rate by approximately half.
DR. JOHNSTON said she is unsure of the statewide rate. She
pointed out that Anchorage's numbers are important because
Anchorage accounts for a large percentage of Alaska's
population; therefore, when the municipality's numbers decrease
it drives the statewide number down with it. Additionally, the
ripple effect can occur when the high number of cases interact
with the rest of the state, spreading the virus in both
directions.
2:36:47 PM
REPRESENTATIVE FIELDS turned attention to a dataset from the
European CDC [included in the committee packet] that showed
cumulative confirmed COVID-19 cases per million people. The
data table indicated that the infection rate in Brazil and the
United States was magnitudes higher than any other developed
country in the world. He directed attention to a second
dataset, dated 9/9/20, from The New York Times [included in the
committee packet] that displayed U.S. states with the most cases
per 100,000 residents in the last seven days. The data
indicated that Alaska's infection rate was higher than many
states, both rural and urban. He asked how the lack of state
policies limits Alaska and whether effective state policies are
necessary to achieve lower infection rates.
DR. JOHNSTON said there are many factors that affect the
infection rate in a specific location. She maintained that
lowering the infection rate would require everyone to wear
masks, social distance, and quality ventilation. She added that
getting to that point would entail a combination of education
and policy.
2:39:33 PM
REPRESENTATIVE JACKSON inquired as to the average cost of PCR
testing.
DR. JOHNSTON said she is unsure of the cost. She explained that
between the supplies and manpower it requires, PCR testing is
not an affordable option for Alaska right now.
REPRESENTATIVE JACKSON asked who would know how much the state
is paying to perform PCR tests.
DR. JOHNSTON surmised that someone at the state lab might know.
MS. LAWTON offered to follow up with requested information.
2:41:57 PM
REPRESENTATIVE FIELDS echoed Representative Zulkosky's comments
and thanked the municipality for implementing public health
measures that significantly reduced the spread of the virus. He
expressed his continued concern that infection rates are higher
than they should be due to a lack of effective state and federal
policies. He introduced Mr. Metcalfe and asked for un update on
whether the state has taken action on any of the expert
recommendations to implement universal masking in state
facilities and upgrade HVAC filters to reduce the risk of
spreading COVID-19 through ventilation systems in state
facilities.
2:42:57 PM
JAKE METCALFE, Executive Director, Alaska State Employees
Association, stated that ASEA is not aware of any action being
taken on those items. Recently, he said, ASEA requested a labor
management meeting, which refers to a clause in ASEA's
collective bargaining agreement with the state. He explained
that the labor management committee is when a group of ASEA
members meets with management from various state departments to
discuss labor management issues with the purpose of
"[facilitating] communication between the parties and promote a
climate conducive to constructive employee relations." He noted
that there are certain state departments, such as DHSS, where a
majority of ASEA's members work. He added that facilities
governed by DHSS, including the Pioneer Home, Office of
Children's Services, and the McLaughlin Youth Center, are a
major concern of ASEA, which is why the labor management meeting
was requested. He explained that per the Department of
Administration's (DOA's) request, ASEA created a list of issues
to be discussed with the state, including test results in
facilities, consistent communication with employees in the
bargaining unit, access to testing, the return to work after
testing, PPE availability/standards, safe work conditions,
travel quarantine, and leave limitations. He said ASEA
submitted the list two weeks ago and no response has been
received. He noted that ASEA has been reaching out and asking
to partner with the state for six months. He added that during
that time, the biggest issue has been both a lack of
communication and inconsistent communication. He stressed
ASEA's interest in working in partnership with the state to
ensure members are safe. He opined that the failure of
leadership in the current administration has created unnecessary
stress and anxiety among the workforce, which could be solved by
a simple "labor management relationship." He expressed
frustration and confusion as to why there is not more interest
in working together on the existing issues. He conveyed that
ASEA would have to file an unfair labor practice.
2:54:02 PM
MR. METCALFE reminded state employees that state law protects
those that have concerns about workplace safety from
retaliation; additionally, federal Occupational Safety and
Health Administration (OSHA) laws protects employees from
retaliation regardless of the context. He asserted that ASEA
will continue to do everything in its power to represent them.
He urged members to work with their supervisors if they aren't
receiving the health or assistance they need. He continued
explained that ASEA educates its members to contact their shop
stewards or business agents. He conveyed concerns from a shop
steward at McLaughlin Youth Center concerning the need for masks
and PPE, as well as hazard pay given the increased risk that
employees are facing at work. Furthermore, her reported that
morale is low, and employees don't feel supported. He urged the
committee to consider implementing a universal mask mandate and
adequate ventilation systems in state facilities. He stressed
the importance of equipping employees and residents of state
facilities to prepare for future outbreaks that may come.
2:56:57 PM
REPRESENTATIVE ZULKOSKY asked Mr. Metcalfe to share additional
information on the outbreak at McLaughlin Youth Center, such as
their mitigation policy when a positive case is identified.
MR. METCALFE explained that ASEA has not been informed of a
mitigation plan from McLaughlin Youth Center. He reported that
a coalition from the public employee union presented a
mitigation plan that they wished to discuss with the state, but
they have not received a response. He noted that DHSS has been
good about contacting ASEA when an outbreak occurs at a
facility. He offered his understanding that McLaughlin ordered
mandatory testing and required employees to return to work
afterwards. He recalled that employees were concerned about
returning to work before they received their test results. He
said ASEA would like to know why that is happening.
3:01:47 PM
REPRESENTATIVE ZULKOSKY said physicians have communicated that
quarantine is the best widely available treatment for COVID-19
and the only tool to prevent transmission. She agreed that
although testing is helpful for detection, it doesn't
necessarily prevent spread. She asked how many state employees
ASEA represents and what the morale has been among that group.
MR. METCALFE stated that the lowest employee morale is in 24-
hour facilities. He opined that inconsistent messaging and
confusing policies are contributing to the low morale.
Additionally, he reported that morale is low among essential
workers who are scared, stressed, and anxious.
3:04:57 PM
REPRESENTATIVE FIELDS noted that the committee held a hearing
where representatives from both the McLaughlin Youth Center and
the Pioneer Home participated in and urged the state to
implement protective measures. He said the state boycotted that
hearing, failed to implement the measures, and there were
outbreaks in those very facilities.
3:05:32 PM
REPRESENTATIVE STORY recommended that the committee ask DOA when
they plan on meeting with ASEA to address the list of questions
that was sent to them. Additionally, she requested a facility-
wide update on masks, hand washing, social distancing, and air
filtration systems.
3:07:33 PM
REPRESENTATIVE FIELDS expressed his disappointment that the
state is not taking steps towards preventing the likelihood of
state facilities becoming vectors for COVID-19.
3:07:58 PM
ADJOURNMENT
There being no further business before the committee, the House
State Affairs Standing Committee meeting was adjourned at [3:07]
p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HSS-HSTA Kevin Berry Slides 9.9.20.pdf |
HHSS 9/9/2020 1:00:00 PM |
Joint HHSS/HSTA COVID-19 Update |
| HSS-HSTA Nolan Klouda Slides 9.9.20.pdf |
HHSS 9/9/2020 1:00:00 PM |
Joint HHSS/HSTA COVID-19 Update |
| COVIDcomparsisonGlobal.JPG |
HHSS 9/9/2020 1:00:00 PM |