COVID-19 Health Alerts

Issued: April 7, 2020

By: Commissioner Adam Crum, Alaska Department of Health and Social Services

Dr. Anne Zink, Chief Medical Officer, State of Alaska

Health Alert 011 – Safety Guidelines for Religious Services

COVID-19 Health Mandate 11: Social Distancing, Item I.5 prohibits private and public gatherings of non-household members, regardless of the number of people involved. This includes, but is not limited to, weddings, faith gatherings, graduations, and funeral events.
https://gov.alaska.gov/wp-content/uploads/sites/2/03272020-SOA-COVID-19-Health-Mandate-011.pdf

However, the following practices will be allowed for places of worship, including churches, synagogues, mosques, temples and other similar religious facilities of any faith:

1. Live-streaming of religious services at their place of worship (absent the congregation) is allowed under the following conditions:
   1. Minimum number of necessary personnel to be used.
      1. No group larger than 10 is allowed.
   2. Social distancing of six feet or more to be used.
      1. If singing or projecting of voice, then minimum of 10 feet between each person.
   3. Non-speaking, technical assistance personnel to wear cloth face coverings.
2. Drive-in religious services: Churches, synagogues, mosques, temples and other similar religious facilities of any faith may conduct “drive-in” services, where participants gather in their vehicles near the religious facility and participate in the service together by remote means, subject to the following requirements, which are intended to protect public health, safety and welfare:
   1. Participants may leave their homes to travel by vehicle to and from the religious facility, and must remain in their vehicle at all times.
   2. Only household members are allowed in each vehicle.
   3. Vehicles must be parked with six feet of separation between vehicles.
      1. This will be ensured by clearly marked parking stalls or directed by parking lot staff wearing reflective clothing and face coverings.
   4. Participants may not interact physically with clergy, staff or participants in other vehicles. This includes, but is not limited to, collecting donations by basket or plate.
   5. Social distancing of six feet or more to be used.
      1. If singing or projecting of voice, then a minimum of 10 feet between each person. 
3. Easter basket assembly:
   1. Faith-based groups may assemble and distribute Easter baskets under the following conditions:
      1. Anyone assisting with basket assembly or distribution must be screened and not allowed to participate if they meet any of the following criteria: a) have a fever, cough, shortness of breath, or other symptoms of respiratory infection; b) have a history of out-of-state travel within the past 14 days, or c) have a history of close contact to a person with COVID-19 or an undiagnosed respiratory infection in the past 14 days.
      2. No gathering may be of more than 10 people and a minimum of six feet must be between every person included in assembly and distribution of baskets.
      3. Wash hands with soap and water for at least 20 seconds prior to and after handling baskets or basket contents.
      4. Maintain at least six feet or more distance from people other than household members.
      5. Wear a cloth face covering when around people other than household members.

This is not a mandate.
State of Alaska COVID-10 Health Alert #011

Issued: April 3, 2020

By: Commissioner Adam Crum, Alaska Department of Health and Social Services

Dr. Anne Zink, Chief Medical Officer, State of Alaska

Health Alert 010 – Recommendations Regarding the Use of Cloth Face Coverings

Scientific evidence available to date indicates that asymptomatic and presymptomatic shedding of the virus that causes COVID-19 is occurring.  This means that people who have no symptoms whatsoever may be infected with the virus and capable of transmitting the virus to others when interacting in close proximity—for example, speaking, coughing, or sneezing.  This heightens the need for community-wide implementation of control measures to prevent the spread of COVID-19 among people who are not experiencing symptoms of illness. 

The primary ways to do this are through social distancing, frequent hand-washing, and disinfecting high-touch surfaces. Another tool that may help to minimize transmission while people are around others outside of their household is the use of face coverings. Because we are experiencing a nationwide shortage of medical supplies, including facemasks, we recommend that Alaskans make their own face coverings and wear them in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies) — especially in areas of significant community-based transmission.  This recommendation aligns with current national guidance: www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html

The following measures are highly recommended for all Alaskans:

• Wear a cloth face covering in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies).
• Make sure the face covering covers both the nose and mouth.
• Do not remove the face covering until you return home.
• When removing the face covering, avoid touching the front of the face covering (because it may be contaminated). Remove it by grasping the ear loops, ties, or bands and immediately discard or place in a designated container for laundering. 
• Wash your hands immediately after removing the face covering and before touching anything else.
• Wash face coverings in hot, soapy water between uses.
• Do not wear N-95 or surgical masks; these are needed by health care workers and first responders.
• Do not rely on face coverings as the primary way to prevent COVID-19 transmission, and be careful to avoid developing a false sense of security through the use of face coverings. Continue to follow social distancing measures, including maintaining at least six feet between yourself and others, staying at home, avoiding touching your face, and washing your hands frequently.

What is a cloth face covering? A cloth face covering is a material that covers the nose and mouth. It can be secured to the head with ties or straps or simply wrapped around the lower face. It can be made of a variety of materials, such as cotton, silk, or linen. A cloth face covering may be factory-made or sewn by hand, or can be improvised from household items such as scarfs, T-shirts, sweatshirts, or towels.

How do I make a homemade face coverings? Cloth face coverings can be fashioned from household items or made at home from common materials at low cost. There are a number of instructional websites and videos that people can refer to for making face coverings; two such videos are available at https://youtu.be/VgHrnS6n4iA and https://youtu.be/1r2C1zGUHbU

How well do cloth face coverings work to prevent spread of COVID-19? There is limited evidence available on how well cloth face coverings help reduce COVID-19 transmission. Their primary role is to reduce the release of respiratory droplets into the air when someone speaks, coughs, or sneezes, including people who have COVID-19 but have no symptoms. Cloth face coverings are not a substitute for physical distancing and washing hands and staying home when ill, but they may be helpful when combined with these primary interventions.

How should I care for a cloth face covering? Wash your cloth face covering frequently, ideally after each use, or at least daily. Have a bag or bin to keep cloth face coverings in until they can be laundered with detergent and hot water and dried on a hot cycle. If you must re-wear your cloth face covering before washing, wash your hands immediately after putting it back on and avoid touching your face. Discard cloth face coverings that:

• No longer cover the nose and mouth
• Have stretched out or damaged ties or straps
• Cannot stay on the face
• Have holes or tears in the fabric

This is not a mandate.
State of Alaska COVID-10 Health Alert #010

Issued: March 20, 2020

By: Dr. Anne Zink, Chief Medical Officer, State of Alaska
Commissioner Adam Crum, Alaska Department of Health and Social Services

The State of Alaska and the Alaska Department of Health and Social Services (DHSS) acknowledge the importance of suspending all non-essential travel across the Alaska border as well as minimizing intrastate travel to avoid introducing new COVID-19 cases into Alaska from out of state, and slow the spread of the virus in state. Greater than 80% of proven COVID-19 cases have come from out of state, primarily from the lower 48. It is imperative that Alaskans heed these guidelines.

Health Alert 9.1 – Out of State Travel
To prevent the spread of Coronavirus Disease 2019 (COVID-19), the State of Alaska is issuing the following strong advisory:

That all Alaskans cease non-essential out of state personal, business, and medical travel now. Alaskans currently out of state are encouraged to return home now if they had plans to return to Alaska within the next 30 days.

We strongly advise that any tourist and non-essential business travel to Alaska be suspended now. We strongly recommend that visitors to Alaska return to their home communities now.

Airlines operating interstate travel are mandated to immediately post this recommendation to their customers on their webpages and at the airports in a place that is easily seen.

Airports in Alaska are mandated to prominently post all travel recommendations.

Tour operators should immediately suspend reservations for any out of state visitors.

Businesses that depend on interstate travel should immediately assess their travel needs and only move essential personnel or travel for emergency reasons. Any travelling employee is expected to self-isolate for 14 days after arrival in Alaska.

All travelers returning from a Level 3 area are mandated to self-quarantine for 14 days as previously outlined in COVID-19 Health Mandate 004.

Any returning resident or worker is expected to self-quarantine for 14 days after returning to Alaska and monitor for illness. If you cannot work from home, you should not return to work until this period has passed, unless your work supports critical infrastructure (see Attachment A). If your work is a part of critical infrastructure, it is the expectation that every attempt will be made to comply with the 14-day quarantine or that appropriate steps are taken to protect workers, the public and spread of COVID-19.

Any visitor to Alaska is expected to self-isolate for 14 days after arriving in Alaska, monitor for illness, and follow appropriate social distancing protocols while in Alaska.

Health Alert 9.2 – In-State Alaska Travel
To prevent the spread of Coronavirus Disease 2019 (COVID-19), the State of Alaska is issuing the following strong advisory:

That all Alaskans cease any non-essential in-state long distance personal, business, or medical travel, with specific heightened concern for travel to remote areas with limited medical resources.

We strongly recommend that non-residents cease any non-essential personal, business, or medical long-distance travel within Alaska with specific heightened concern for travel to remote areas with limited medical resources.

All air, road and maritime services operating in Alaska are mandated to post on the web and in their terminals, these travel recommendations.

All airports, ports, and bus terminals are mandated to prominently post these travel recommendations.

Any tour operator depending on clients moving long distances across Alaska should strongly consider suspending operations.

We expect any traveler who leaves a community with known cases of COVID-19 to self-isolate for 14 days upon arrival to their destination community and monitor for symptoms of illness. Following that period, appropriate social distancing should be followed.

The sacrifice of all Alaskans during this public health emergency is notable. While social distancing is one arm of slowing the spread of COVID-19, minimizing travel is an equally important part of slowing the spread of disease. We are aware of the impact these health advisories have, specifically on our travel industry, already hit hard by the coronavirus pandemic. The state is committed to continue to work with businesses and employees impacted by the pandemic and will continue to work to mitigate these impacts. The safety and health of all Alaskans is our primary concern.

This health advisory does not apply to medical, personal, or business emergencies.

This is not a mandate.

State of Alaska COVID-19 Health Alert 009

Issued: March 17, 2020
By: Dr. Anne Zink, Chief Medical Officer, State of Alaska
Commissioner Adam Crum, Alaska Department of Health and Social Services

The Alaska Department of Health and Social Services is committed to the health and well-being of Alaskans.
Child care is a critical support for working families, their children and businesses. At this time, per guidance
from the Centers for Disease Control and Prevention (CDC), we are recommending that child care facilities stay
open if they safely can do so. We do not want children to be cared for by elders, because people aged greater
than 60 years are at increased risk for severe COVID-19 illness. Employers are encouraged to talk to their
workforce. We also know that children, while they may carry the disease, get sick from COVID-19 much less
frequently than adults.

Until further notice, we recommend that every child care site adhere to the following recommendations:

• Follow aggressive measures to screen children for respiratory infection and do not allow any ill child
  into a child care center.
• No child who has been outside of Alaska in the last 14 days should be allowed in a child care center.
• No one who has a fever or respiratory symptoms should be allowed to work in a child care center.
• Keep numbers below 10 for group settings.
• Cohort kids, keeping the same group of kids together.
• Adhere to social distancing (at least six feet) to limit mixing.
• Spend time in well-ventilated spaces as much as possible.
• Practice frequent and rigorous environmental cleaning.
• No one over the age of 60 or with underlying medical conditions should be working in child care
  centers.

Families should consider alternative child care opportunities, if possible.
CDC guidance: www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/guidance-for-schools.html

This is not a mandate.
State of Alaska COVID-19 Health Alert 008

Issued: March 17, 2020
By: Dr. Anne Zink, Chief Medical Officer, State of Alaska
Commissioner Adam Crum, Alaska Department of Health and Social Services

Department of Health and Social Services (DHSS) is suspending statewide, all long-term services and supports
that occur in congregate settings, including senior centers, adult day services, and any site-based day
habilitation or supported employment activities where individuals gather together. DHSS is working with
federal partners to determine if services may be offered in a more flexible manner within home settings.

The state recognizes the importance of these settings and the services they provide, but is seeking to prevent
harm to those we serve through the promotion of social distancing. Please continue to follow guidance posted
on the State of Alaska COVID-19 website at coronavirus.alaska.gov. More guidance will be distributed through
the Division of Senior and Disabilities Services’ (SDS) email subscriber list for providers and families as updates
to service categories can be provided. If you are not yet a member of SDS E-Alerts, please sign up here:
http://list.state.ak.us/mailman/listinfo/sds-e-news.

This is not a mandate.
State of Alaska COVID-19 Health Alert 007

Issued March 16, 2020
By: Dr. Anne Zink, Chief Medical Officer, State of Alaska

DHSS strongly advises that all Alaskans follow this guidance from U.S. Surgeon General Jerome Adams and the
American College of Surgeons: www.facs.org/about-acs/covid-19/information-for-surgeons. In light of this
advice, all patients, providers, hospitals and surgical centers are requested to consider minimizing, postponing
or canceling all non-urgent or elective procedures for three months to decrease the overall impact on the
Alaska health care structure.

Given Alaska’s distances and limited health care capacity, it is especially important to open acute health care
beds for anticipated COVID-19 care. The State of Alaska believes that by delaying non emergent procedures,
individuals will receive optimal care.

This is not a mandate.
State of Alaska COVID-19 Health Alert 006

Issued March 15, 2020

By: Dr. Anne Zink, Chief Medical Officer, State of Alaska

DHSS strongly advises that all Alaskans read and comply with the following guidance for returning travelers:

Higher Risk: For travelers returning within 14 days from the time you left an area with widespread, ongoing community spread such as Europe, China and other countries (i.e., a CDC Level 3 Travel Health Notice Area) you should:

• Stay home and avoid contact with other household members.
• Contact your employer and do not go to work or school for this 14-day period after you return.
• CDC Level 3 Travel Health Notice Area
  • China, Iran, South Korea, Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, Switzerland, Monaco, San Marino, Vatican City.

Medium Risk: For travelers returning within 14 days from outside of Alaska (including the rest of the United States) you should:

• Discuss your work situation with your employer before returning to work.
• Minimize contact with people as much as possible, self-monitor and practice social distancing.
• This may mean not going to work or school if you cannot safely be distanced from others – especially if you traveled in a location where community transmission is occurring.

Health Guidance for Returning Travelers in the Higher and Medium Risk Groups

1. Take your temperature with a thermometer two times a day and monitor for fever. Also watch for cough or trouble breathing.
2. Do not take mass transportation during the time you are practicing social distancing.
3. Avoid crowded places (such as shopping centers and movie theaters) and limit your activities in public.
4. Keep your distance from others (about 6 feet or 2 meters).
5. If you get sick with fever (>100.3°F), cough, or shortness of breath, please call your health care provider.
6. If you seek medical care for other reasons, such as dialysis, call ahead to your doctor and tell them about your recent travel.

All Alaskans should follow previous guidance including regular hand washing, cleaning surfaces and avoiding large gatherings (March 13 COVID-19 Health Alert: Recommendations for Keeping Communities Safe).

This is not a mandate. This guidance is based on CDC’s guidance, which can be found here:
www.cdc.gov/coronavirus/2019-ncov/
State of Alaska COVID-19 Health Alert 005

Issued March 13, 2020

By: Dr. Anne Zink, Chief Medical Officer, State of Alaska

DHSS strongly advises that all Alaskans read and comply with the following CDC guidance for workplaces, schools, homes, and commercial establishments:

Practice good hygiene:

• Stop handshaking – use other noncontact methods of greeting.
• Clean hands at the door and schedule regular hand washing reminders by email.
• Create habits and reminders to avoid touching their faces and cover coughs and sneezes.
• Disinfect surfaces like doorknobs, tables, desks, and handrails regularly.
• Increase ventilation by opening windows when able.

Be careful with meetings and events:

• Use videoconferencing for meetings when possible.
• When videoconferencing not possible, hold meetings in open, well-ventilated spaces.
• Consider adjusting or postponing large meetings or gatherings.

Special travel considerations:

• Assess the risks of travel including the location and rapidly changing events.
• At risk individuals and communities with limited health care infrastructure or high-risk populations should considering limiting all non-essential travel.

Handle food carefully:

• Limit food sharing.
• Strengthen health screening for staff working with food and their close contacts.
• Ensure staff working with food and their close contacts practice strict hygiene.

Special consideration for businesses:

• Use booking and scheduling to stagger customer flow.
• Use online transactions where possible.
• Consider limiting attendance at larger gatherings.
• Promote tap and pay to limit handling of cash.

For transportation businesses, taxis, and ride shares:

• Keep windows open when possible.
• Increase ventilation.
• Regularly disinfect surfaces.
• Encourage social distancing during rides.

If you don’t feel well:

• Stay at home if you are feeling sick.
• Do not go to work, out in public or around others if you have a fever and for 72 hours after your last fever.
• Consider staying at home if you have a sick family member in your home.

Households with sick family members are recommended to:

• Give sick members their own room if possible, and keep the door closed.
• Have only one family member care for them.
• Consider providing additional protections or more intensive care for household members over 65 years old or with underlying conditions.

Households with vulnerable seniors or those with significant underlying conditions:

Significant underlying conditions include heart, lung, kidney disease; diabetes; and conditions that suppress the immune system.

• Have the healthy people in the household conduct themselves as if they were a significant risk to the person with underlying conditions. For example, wash hands frequently before interacting with the person, such as by feeding or caring for the person.
• If possible, provide a protected space for vulnerable household members.
• Ensure all utensils and surfaces are cleaned regularly.

These recommendations are based on the CDC’s guidance, which can be found here: www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications.html

This is not a mandate. 

Issued March 13, 2020

By: Dr. Anne Zink, Chief Medical Officer, State of Alaska

Under the authority of Governor Dunleavy’s emergency order, the Alaska Department of Health and Social Services (DHSS) is issuing a policy to limit exposure to COVID-19 at long-term care facilities. DHSS is taking this action to protect Alaskans who are at greatest risk for the most severe outcomes of this disease.

“Our elders in nursing homes are particularly vulnerable to this disease and our actions are intended to protect vulnerable adults.” said Dr. Anne Zink, Alaska’s Chief Medical Officer. “Our desire is to establish a close partnership with long-term care facilities and we’re asking families, friends and others who work in and visit these facilities to help us protect the health and safety of our parents, grandparents and other loved ones.”

This guidance directs skilled nursing facilities and nursing homes – including those providing memory care – to incorporate the Centers for Disease Control and Prevention (CDC)’s minimal to moderate mitigation strategies for long-term care facilities with additional measures, as follows:

• Implement a screening process for anyone entering the facility who is not a resident or staff member. Screening should occur before, or immediately upon, entering the facility.
• Change visitor policies to further limit exposures to residents and staff, including:
  • Limit visitation to essential individuals (e.g., family members and medical providers).
  • Screen all visitors for illness. If visitors have symptoms of respiratory illness/COVID-19 (e.g., fever, cough, shortness of breath) or have had recent travel to an area with known COVID-19 transmission, ask them to use an alternative means to visit with the resident, such as by phone or virtual visits.   
  • Limit visitor movement in the facility.
  • Keep a detailed log of all visitors and health care personnel (HCP) that includes information about which resident and areas of the facility they visit.
• Limit resident activities that involve community outings and group gatherings.
• Support residents’ access to socialization by offering lower-risk opportunities.

In addition:

• Actively monitor absenteeism and respiratory illness among HCP and residents. Follow facility infection control plan for surveillance and tracking of illness within the facility.
• Actively monitor personal protective equipment (PPE) supplies.
• Establish processes to evaluate and test large numbers of patients and HCP with respiratory symptoms (e.g., designated clinic, surge tent).
• Follow CDC Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease (COVID-19). Work with your Employee Health or Occupational Health Department to evaluate HCP exposure and to determine if work restrictions are needed.  If you need additional guidance, contact DHSS Section of Epidemiology at 269-8000.
• Consider staffing contingency plans in anticipation of staffing shortages.

Issued March 12, 2020

By: Dr. Anne Zink, Chief Medical Officer, State of Alaska

In order to prevent or slow the spread of Coronavirus Disease 2019 (COVID-19), the State of Alaska is recommending all Alaskans become familiar with the Centers for Disease Control and Prevention’s (CDC) guidance on community mitigation. We are advising Alaskans to implement protective measures outlined in the “preparedness phase” and to strongly consider implementing the “minimal to moderate” activities (see page 3). Examples of social distancing strategies that should be followed now include:

For the General Public

• Stay home if you are sick with a respiratory illness. If you develop a fever, stay home for at least 24 hours after the fever subsides.
• Stay at least 6 feet away from anyone who is coughing, sneezing, or feeling feverish.
• Avoid large gatherings and crowded places as much as possible.
• Avoid shaking hands and hugging as much as possible.
• If you live in a rural area, consider limiting non-essential travel to protect your community.

For High-Risk Groups

• This group includes persons aged 60 years and over, and persons with underlying medical conditions such as heart disease, lung disease, diabetes, or other immune compromising illnesses.
• When you go out in public, try to maintain at least 6 feet distance from people – especially from people who are sick.
• Avoid crowds as much as possible, especially large gatherings.
• Avoid cruise travel and non-essential air travel.

For Businesses and Employers

• Use videoconferencing for meetings when possible.
• When not possible, hold meetings in open, well-ventilated spaces.
• Consider adjusting or postponing large meetings or gatherings
• Assess the risks of business travel.
• Encourage liberal leave policies and teleworking options for staff.

For Schools

• Consider adjusting or postponing gatherings that mix between classes, grades, and other schools.
• Adjust after-school arrangements to avoid mixing between classes, grades, and other schools.

Considerations for Event Planners

• Please read CDC’s guidance for event planners: cdc.gov/coronavirus/2019-ncov/community/large-events/mass-gatherings-ready-for-covid-19.html
• Consider cancelling, postponing, or adjusting large in-person events.
• Explore offering video/audio/electronic alternatives.

For Religions and Faith-based Organizations

• Please read CDC’s guidance for religious and faith-based organizations.

Guidance on community mitigation: www.cdc.gov/coronavirus/2019-ncov/downloads/community-mitigation-strategy.pdf

Issued March 11, 2020

By: Dr. Anne Zink, Chief Medical Officer, State of Alaska

To reduce the possibility for spreading Coronavirus Disease 2019 (COVID-19), the State of Alaska issues the following advisory related to the ASAA regional/conference basketball tournaments being held March 10-14:

People who have any of the following criteria should avoid attending the regional tournaments:

• Persons aged over 60 years;
• Persons with underlying medical conditions, such as heart disease, lung disease, diabetes; OR
• Persons who have symptoms of an acute respiratory illness or fever.

We encourage people who are unable to attend in-person to watch webcasting, where available.

The state tournament that was to be held in Anchorage will be postponed until further notice.

Conference tournaments being held after March 14 are postponed.