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Summary and Resources:
(July 2020) We urge anyone with any COVID-19 symptoms to seek testing. If you experience symptoms, contact your regular provider or our testing hotline at 247-TEST (8378).
To find available testing sites, view the Testing Sites Locator at: https://coronavirus-response-alaska-dhss.hub.arcgis.com/app/2d92b77bc8044329a1ee3954b063bd8c
There are FDA-authorized at-home test kits that may soon be available to travelers:
Pixel system from LabCorp https://www.pixel.labcorp.com/at-home-test-kits/covid-19-test
Everlywell COVID-19 Test Home Collection Kit https://www.everlywell.com/products/covid-19-test/
Vault Health COVID-19 Testing https://www.vaulthealth.com/covid
Picture Genetics COVID-19 Testing https://www.picturegenetics.com/covid19
All arriving passengers must complete the travel declaration form. The declaration form, Health Mandate 10.1, and additional information for travelers is available at: https://covid19.alaska.gov/travelers/
AMHS COVID-19 protocols for passengers are available at http://dot.alaska.gov/amhs/covid19.shtml
Citizens are encouraged to submit questions related to COVID-19 in Ketchikan and local resources to: firstname.lastname@example.org.
Information on the EOC’s response to COVID-19 in Ketchikan is updated daily on the COVID-19 Response page at https://www.kgbak.us/913/COVID-19-Response. Additional current information is available on the State of Alaska’s website at www.covid19.alaska.gov.
Case Count Dashboard
Please explain how the Case Count Dashboard for both the state and Ketchikan works.
(July 2020) The Ketchikan EOC has updated its COVID-19 Testing and Case Count Dashboard to provide more insight on non-resident/resident testing results. The Ketchikan Testing and Case Count Dashboard includes numbers for tests administered, tests pending, cumulative positive cases, resident and non-resident cases, close contact/travel related/non-travel related cases, recovered cases, and hospitalizations.
The State of Alaska’s has its own COVID-19 Testing and Case Count Dashboard. It is used to display data as well as feed raw data into local dashboards and national dashboards. The State’s dashboard operates on a 14-day rolling average of percent positivity of COVID-19 cases, to assess the ongoing risk in each geographical area.
Why do we see different numbers reflected on the State’s Case Count Dashboard versus the local Dashboard?
(July 2020) Ketchikan’s Dashboard is most current because we receive numbers each day from health providers and then confirm these with local Public Health officials. The State data, in contrast, can lag behind a day or two because they receive information from multiple sources and have a deadline for receiving information each day. We work with the State to verify the numbers provided, but our local Ketchikan website is the most current.
When does an active case become a recovered case?
(September 2020) A case is taken out of the active case count and classified as recovered when the case has completed their recommended isolation.
According to the CDC, most symptomatic people with COVID-19 can discontinue isolation and precautions after:
- At least 10 days after symptoms first appeared, AND
- At least 24 hours have passed with no fever, without the use of fever-reducing medications, AND
- Symptoms have improved.
A limited number of persons with severe illness or who are severely immunocompromised may need to isolate for up to 20 days after symptom onset - this is determined in conjunction with a healthcare provider.
For people who have never developed symptoms (asymptomatic cases), isolation and other precautions can be discontinued after 10 days after the date of the first positive case.
What is the timeframe for testing positive to a virus, and why can there be different results depending on when the test is taken?
(July 2020) A Nasal PCR Test, which is the most common test administered in the State of Alaska, picks up pieces of the virus from your nose to run through a testing machine. Different machines require different concentrations of the virus to provide a positive result. Instances such as improper specimen collection, an abnormal medium or swab for the specimen, and length of time before it reaches the testing operator can all have a deteriorating effect on the sample – which can affect the results. Depending on where you are in the time frame of the disease can also impact your test results. If you are tested later or earlier on during your infection, you may not have enough of a viral load to test positive.
I’ve heard that those nasal swabs hurt. Is there an alternative way to do the testing that isn’t painful?
(July 2020) Many people have different reactions to the nasopharyngeal swab, a common swab administered through the nose, used for COVID-19 testing. The swab is not supposed to hurt, but it may be uncomfortable. In order to collect enough cells and fluids, the swab must be inserted along the entire passageway that connects the base of the nose to the back of the throat to get a good specimen. As the body is not used to having an object in that area, it creates a lot of very odd sensations.
If I test positive and test again a couple days later with a negative result does that mean the first test was a false positive?
(July 2020) No. There are many reasons that a second COVID-19 test could be negative. Foremost, the first test could have been taken during the end of the course of the virus, leading to the second test being taken after the disease had run its course and would no longer be present in the body. It is also possible that a second test did not pick up enough of a sample to test positive, even if the virus is still present. Testing results as well as a patient’s clinical history are both used to understand where a patient is within the disease process.
Unless someone takes a rapid COVID-19 test, it is unlikely that a person will receive their test results in less than 5 days. How can someone that is not symptomatic get tested?
(July 2020) Communities have been tasked to provide a wide range of testing options. For example, Ketchikan is operating a Drive-up Testing Site that is available to anyone with symptoms of COVID-19, and is also open to certain asymptomatic individuals, including: those who have health conditions; are age 65 or older; health care workers or care providers; first responders; or those who have recently traveled.. At home testing options are also available for people who need results within 24-48 hours. The State of Alaska has made testing guidelines for individual communities incredibly broad to allow for asymptomatic testing.
What testing options are currently available in Ketchikan?
(September 2020) The Ketchikan EOC has two COVID-19 test sites – the Free Drive-Up Testing Site at Berth 3 and the Ketchikan International Airport Test Facility. Here’s when and how to use each one:
The Free Drive-Up Testing Site: the Drive-Up Testing Site at Berth 3 is now operated daily, Tuesday through Saturday from 09:30 - 11:30 AM and 2:30 - 4:30 PM and now includes those who seek testing related to travel; are using a state issued 7-14 day follow up test voucher; show any symptoms of COVID-19; are asymptomatic individuals who met one of the following criteria: those with health conditions; age 65 or older; health care workers; care providers; or first responders. This site offers a nasal swab PCR test, and there is no fee. Test results can take anywhere from 3 to 7 days to come back.
Testing for travelers arriving from means other than commercial airlines at the airport will be conducted at the Berth 3 Drive-Up Testing Site. These travel-related tests, along with any 7-14 day follow-up voucher tests conducted at Berth 3, will be processed with the tests collected through the Airport Traveler Testing Site. These traveler tests can take up to 7 days for results, but are currently averaging a 2-3 day turnaround time for results. Travelers with a PeaceHealth user account will receive results via email to their PeaceHealth account. All travelers will receive a phone call with their results.
Ketchikan International Airport Test Facility is for
- Travelers arriving on interstate and intrastate flights
- Voucher retesting 7-14 days after arrival
- This site offers nasal swab PCR test, and there is no fee. With a voucher, travelers can return to the Ketchikan Airport for the follow-up test or contact another health care provider in Ketchikan to see if the provider will accept the voucher. Follow-up voucher testing (bring the voucher) at the airport does not require an appointment; an individual can simply show up Monday through Sunday during the following times:
7:45 AM - 9:00 AM
12:15 PM - 2:00 PM
4:15 PM - 9:00 PM
Note: These new times are current as of 09.01.2020
Testing is also available from local health care providers such as Creekside Clinic, Peace Health Medical Center, KIC, Ketchikan Public Health, Legacy, Northway Family Healthcare, and Polaris Health Group.
What criteria does a person doing contract tracing use to determine if someone has been in close contact with a person who has tested positive for the virus?
(July 2020) If you’ve been identified as a "close contact" of an infected person, you will receive a call from a public health nurse. "Close contact" is defined as having been within 6 feet of an infected individual for 10-15 minutes or longer, or if you’ve been coughed or sneezed on by that person.
If you feel you have been exposed and haven’t received a call, consider taking the following measures:
- Hunker down if you are able to do so
- Limit your social contacts for 14 days
- Stay at least 6 feet away from others
- Wear a cloth covering when in public
- Monitor for symptoms and if you start feeling sick, no matter how mild, isolate yourself and call your provider to get tested
When someone coming in from the Lower 48 tests positive, shouldn’t everyone who was on the plane with them be contacted to quarantine or be tested?
(July 2020) “Close contact” has been defined federally as being within 6 feet of an identified positive case for a set duration of time. As the state does not have access to a commercial airline’s manifest, they work closely with their federal partners to access that information to identify and contact the people who were sitting in close contact with the identified positive case. Not everyone on the plane will be contacted by public health, just those sitting within close parameters of the infected person.
AMHS Travel Protocols
Which AMHS ferry trips require a pre-travel test, and when does it need to be done?
(July 2020) Shorter-duration and day-boat passenger travel DO NOT require COVID-19 testing or a sworn statement of a 14-day quarantine.
For passengers departing from Bellingham, Washington, a COVID-19 test must be administered within 72-hours of the day of departure, and a negative result must be presented upon checking in at the terminal or boarding for travel. Passengers already in Alaska that choose to travel on longer-duration routes within Alaska and/or terminating in Bellingham, Washington, must select one of the following two options:
- A COVID-19 test must be administered within five days of the departure date, and a negative result must be presented upon checking in at the terminal or boarding for travel.
- OR a sworn statement signed that affirms the traveler has followed quarantine standards for at least 14 days preceding the date of travel. Forms will be available on the AMHS website and available at check in.
A longer duration travel is defined as any itinerary originating in Alaska that concludes in Bellingham, Washington, a voyage across the Gulf of Alaska, to or from the Aleutian Chain that includes the port of Kodiak.
What paperwork do AMHS travelers need to complete?
(July 2020) AMHS Travelers are required to fill out one of two forms. One is a pre-travel screening document for those traveling within the state of Alaska, asking about symptoms and other COVID-19 related questions that will require “no” answers to continue to board. The second is the State of Alaska’s out-of-state travel declaration form which requires proof of a negative COVID-19 test result.
What if a negative test result is not received by the time a traveler is scheduled for departure on the AMHS?
(July 2020) At this time, travelers coming via Bellingham will be denied service. This is due to the logistics of ferry-based travel and the risk of exposure to an entire vessel’s crew and its passengers. Within the state, travelers are allowed to sign an affidavit stating they have been in quarantine for 14 days prior to travel. The state of Alaska is working to provide testing options to allow for the 72 hour results, which also includes FDA-authorized home-collection COVID-19 tests.
Ketchikan Traveler Testing Site
Is rapid testing an option for the airport testing site? What type of test is currently being used?
(July 2020) The airport testing site uses a standard PCR test which is then sent off to one of two laboratories, Quest Labs and the University of Washington. Rapid testing is not currently an option due to the lack of testing re-agent and other supplies, in order to keep up with testing demand at the airport. The airport testing site administers on average 42 tests a day, which is more than local testing labs can currently handle.
Please describe how the process works for out of state travelers to be greeted, screened, and tested when they arrive at the Ketchikan airport. Is there an actual person at the airport who checks each passenger’s paperwork upon arrival? Shouldn’t the paperwork be checked inside of security as they walk off the airplane?
(July 2020) The traveler testing site is located on the Ketchikan side of the airport ferry terminal. Before a passenger disembarks from the aircraft in Ketchikan, they will have already received the travel declaration form from the airline and many complete the paperwork before they leave the plane.
Stationed in the baggage claim area and at every exit of the Ketchikan Airport terminal, is a greeter to meet each north bound flight passenger to help direct individual travelers and provide information on the testing process. After speaking with a greeter, travelers with proof of a negative COVID-19 test and completed travel declaration form are prompted to drop their forms at a receptacle in the airport.
For those opting to receive a free COVID-19 traveler test at the Airport Testing Facility, once they get off the ferry, proceed to a testing screener, get in line for a PCR nasal swab, and turn in their travel declaration form upon completion of their COVID-19 test.
Those who choose to complete a 14-day quarantine can turn in their paperwork on either the airport or Ketchikan side.
State of Alaska Travel Mandate Information
Per the interstate travel protocols, why are flight passengers provided a voucher for a second test? Why take a second test 7-14 days after the first, even if the first was negative?
(July 2020) Testing strategies by the state of Alaska are based around time frames of symptom onset and virus detection. At 5 days, only 50% of those infected will be showing symptoms, while at 10 days 90%-95% will be showing symptoms. Travelers can be exposed to the virus during transit, so by testing 7-14 days after arrival, there will be a higher percentage of positive cases.
If someone is traveling to Seattle for a medical procedure and will be there for less than 24 hours, when should they be tested? Before or after they travel, considering as both are within 24 hours?
(July 2020) As described in Mandate 10, there is an option on the travel declaration form for travelers leaving the state for less than 24 hours stating that they do not need to receive a negative COVID-19 test result or follow a 14-day quarantine upon return. Instead they are asked to minimize interactions and monitor for symptoms for up to 14 days of their arrival.
Why doesn’t the state of Alaska implement and strictly enforce a 14-day quarantine for all arriving travelers, like what is being done in New Zealand and Western Australia?
(July 2020) As Alaska is a state and not a country, there are restrictions on what a state government can require of US travelers. Due to the commerce clause in the US Constitution, the state of Alaska is prohibited from violating a US citizens’ right to privacy. Instead, the state government has shifted to test-based travel requirements to help curb the spread of the virus from travelers arriving in our state.
For travel mandate 10, what are the requirements for interstate and intrastate travel? Why are there differing restrictions for travel within the state?
(July 2020) The state of Alaska opened up intrastate travel to help minimize the economic impacts of COVID-19. Other than Hawaii, most states have a much higher case count than Alaska. State officials looked at risks associated with travelers coming into the state versus travel within the state, as they found intrastate travel to be lower risk – fewer restrictions were implemented. At this time, the state is in support of local governments to establishing their own travel restrictions, allowing them to impose stricter restrictions based on their community needs. Many communities continue to have a 14-day quarantine required upon arrival for all intrastate and interstate travelers. Ketchikan does not have any additional restrictions for travelers but has expanded their testing parameters to include asymptomatic individuals who have recently traveled.
General Information on COVID-19
Does mask wearing decrease the need for social distancing when indoors?
(July 2020) Dr. Zink relates mask wearing to wearing a seatbelt, although it might not prevent someone’s death, it will reduce their chances of dying. Seatbelts are part of a much bigger set of tools that include speed limits, separate highways, and airbags. Masks and social distancing are much like airbags and seatbelts, where your chances are better if you use both. Masks along with keeping 6 feet apart from others, hand washing, and increased hygiene practices are used to minimize the risk of exposure to the disease.
What is the concept behind herd immunity and is this a viable option for our community to deal with COVID-19?
(July 2020) Herd immunity applies when enough people have been infected and recovered from the disease, so that the virus can no longer spread from person to person. Most times herd immunity in humans can be attributed to the use of vaccines.
There are many diseases to which humans have never developed herd immunity to, such as small pox. The key factor in herd immunity is that the immunity needs to last. One of the major concerns with the Coronavirus is that with common cold viruses like COVID-19, the immunity only lasts 8 months to a year and half. Because of these factors, rapid herd immunity is not being considered a viable option to combat the coronavirus.
Combined with what little research we have on the long term effects of the disease, the amount of deaths it would cause, and the overwhelming of our healthcare system – rapid herd immunity is not a viable option unless it can be done so with vaccinations. At the moment there are 114 different vaccines being developed, a few of which are already in phase two of development. The state of Alaska is being told to expect a viable vaccination option by fall or winter.
School District Plans
What are the state-wide and local directives for opening schools in the fall? Is it realistic to expect that there would be no new cases in order for school to resume?
(July 2020) Education should be occurring across every community regardless of how things progress with the pandemic. Each school district has been tasked with developing an educational plan for every scenario, based on the severity of the outbreak of the disease.
Severity of the situation is broken down into three categories, few to no new cases, moderate, and severe. Each district will need to work with their local superintendent, principals, and public health to make the best decisions for their community – but still continuing to make education a constant for all students.
From a medical standpoint there is not much known about the transmission of the disease as it relates to children and what part they play as an accelerating factor for the disease. So far numbers are showing the spread of the disease being less attributed to younger children and linked more to young adults.
It is also important to note that a third of Alaskans have an attribute that marks them as high risk for this disease, giving us more reason to keep this disease at bay. In the meantime, the CDC is coming out with additional guidance for schools and education as this is a country wide issue.
The actions we all take now to combat this disease - such as minimizing social interactions, hand washing, and mask wearing will keep our kids safe in the fall/winter. The Ketchikan Gateway Borough School District is continuing to work with the local EOC and public health to develop their plans and risk assessments.
What efforts are being undertaken for business and economic recovery?
(May 2020): The BERG is the Business Economy Recovery Group, established by the Ketchikan Emergency Operations Center, the Ketchikan Chamber of Commerce, the Ketchikan Visitors’ Bureau and the Borough Planning Department. The primary focus of the BERG has been to connect individuals and businesses with the available resources during the state of the COVID-19 emergency. During the response phase of the EOC, the BERG has been instrumental in the following:
· The BERG developed a local webpage on the Ketchikan Chamber of Commerce website, accessible through the Ketchikan Visitor’s Bureau and Ketchikan Gateway Borough websites.
· The BERG developed an online Business Directory which is accessible on the Ketchikan Chamber of Commerce website with the intent of assisting Ketchikan residents with shopping locally and supporting community businesses.
· The Ketchikan Chamber website has helpful information for local businesses such as links to state and local mandates, information on tax credits for small businesses, provisions within the CARES Act, and programs administered by the Small Business Administration.
(July 2020 update): The Ketchikan Gateway Borough is accepting applications for CARES Act funding from local businesses and non-profits affected by the pandemic. For more information: https://www.kgbak.us/940/CARES-ACT-Funding-COVID-19-Support-Progr
Are there criteria to determine when to shut things down in the event of a second ‘wave’ of the virus?
(May 2020): It is difficult to determine a point where we would have to shut businesses down. If we continue to take small steps as we see the success of social distancing and applying the current mandate, we should be able to take next steps. With close monitoring of the circumstances and any new cases that arise, we will continue to evaluate each step. We will not move on to a next phase until we have seen flattening of the curve at the current phase.
Are churches able to reopen?
(Updated July 2020): Per Alaska’s Reopen Alaska Responsibly Plan, churches may open and are encouraged to follow the State’s guidance document for Social, Religious and Other Gatherings.
When will the DMV reopen to the public?
(Updated July 2020): Currently, the local DMV is open for appointment only; see the Alaska DMV page for more details. Until July 30:
* The requirement of out of state drivers to obtain an Alaska driver’s license within 90 days of entering Alaska is suspended
* The requirement to obtain an Alaska title and registration within 30 days of purchase is suspended
* The prohibition of driving with studded tires from May 1st to through September 15th is suspended
* Driver’s licenses that expire during the pandemic period will remain valid
The REAL ID deadline has been extended until October 1, 2021.
What services are available for individuals and businesses?
(May 2020): The Ketchikan Chamber of Commerce, Ketchikan Visitors Bureau, Borough Planning Department and the local EOC have created the Business Economy Recovery Group, or, BERG. Its primary focus is to provide economic support and resources to local businesses and households.
If you are interested in submitting comments, questions, and/or suggestions related to the effect of Covid-19 on Ketchikan’s economy, the BERG can be reached at email@example.com.
(July 2020 update): The Ketchikan Gateway Borough is accepting applications for CARES Act funding from local businesses and non-profits impacted by the pandemic. For more information: https://www.kgbak.us/940/CARES-ACT-Funding-COVID-19-Support-Progr
When does the quarantine period start for a vessel arriving from out of state?
(May 2020): The quarantine period starts from the departure from the last out of state port of call provided there are no stops in between or the addition of crew members en route. Upon arrival in Ketchikan the remaining quarantine can be served on the vessel or at an address declared ashore. Persons would have to travel directly from the vessel to the quarantine address.
What if we add a crew member from out of state after the vessel has arrived?
(May 2020): If a vessel adds a crew member from out of state, they will be required to quarantine for 14 days. The quarantine can be served on the vessel. If they can’t be isolated from the rest of the crew during their quarantine then the 14 day quarantine starts over for the vessel and the rest of the crew.
I have had COVID-19 and have fully recovered. Am I now immune?
(May 2020): A recovered person would not transmit the virus if they were truly recovered and no longer carrying the virus. However, there is no evidence that a person who recovered from COVID-19 would be immune from catching the virus again. Essentially, no one is immune from becoming infected with COVID-19 and everyone should continue to take necessary precautions, practice personal hygiene, and social distancing.
If a seasonal worker has had COVID-19 and has recovered, are they still required to quarantine for 14 days upon arrival in Ketchikan?
(May 2020): They would still need to quarantine. It currently is unclear if someone who has had COVID-19 develops long lasting immunity, meaning someone may test positive on an antibody test but we do not know how long that immunity will last and if a person can be re-infected. Early evidence is showing reinfection is possible in people who have had COVID-19 and recovered. So in short, they will still need to quarantine for the 14 days.
Supplies (Personal Protective Equipment (PPEs), hand sanitizer, cleaning supplies)
Masks, gloves, hand sanitizer and other supplies are in short supply in Ketchikan. Is it a good idea for a group of us to pool our money and order supplies from other countries?
(May 2020): It is not a good idea to enter into arrangements with people you do not know when money is involved. If one of your friends or relatives is making the arrangements, ask lots of questions before committing yourself. How do they know the supplier they intend to use? Is the supplier reputable? Have they had dealings with this supplier in the past? In short, be very skeptical before committing your money.
I found instructions for making masks with household materials; if I make a bunch of them can I donate them to local healthcare workers? Can I use them myself so I don’t get COVID-19?
(May 2020): We now recommend that people wear cloth face coverings in public to prevent transmission of COVID-19 if they unknowingly have the virus. Do not use cloth face covering as the primary way to prevent transmission, but in combination with maintaining a 6 foot social distance, staying home as much as possible, and washing hands frequently. Discard or wash your mask in hot water after each use.
Tests, drugs, other therapies
I’ve heard of two COVID-19 therapies: Plaquenil (Hydroxychloroquine, azithromycin-Zithromax ZPAK) and convalescent plasma from recovering COVID-19 patients in Ketchikan or elsewhere in Alaska. Are plans in place to test and use either of these therapies here in Ketchikan?
(May 2020): Currently there are no drugs or other therapeutics approved by the U.S. Food and Drug Administration to prevent or treat COVID-19. Several drugs are under investigation in clinical trials or are being considered for clinical trials for the prevention and treatment of COVID-19, and Ketchikan’s medical community is keeping abreast of the latest approved treatment options.
United Biomedical in Telluride, Colorado is conducting trials of a test that shows antibodies to COVID-19, to better identify and isolate carriers of the virus and flatten the curve of transmission. Will Ketchikan get these tests soon?
(May 2020): Checking to see if someone has coronavirus-specific antibodies is good evidence that they’ve been infected. However, the body doesn’t start to make these immediately, and they might not appear until someone’s illness has run its course. As a result, antibody-based tests can tell providers whether someone has already had COVID-19, but not if the patient currently has it.
Are any of the Ketchikan medical clinics or Peace Health Hospital participating in the FDA "expanded access program" for use of convalescent serum therapy, a potential COVID-19 treatment?
(May 2020): PeaceHealth continues to investigate and adopt best practices for COVID-19 treatment and are considering the appropriate treatment for each patient. This therapy, which uses the blood products (plasma) of immune patients on sick patients, is not being used locally at this point but is one of many treatment options being investigated by PeaceHealth.
What is the difference between the types of tests available for COVID-19?
(Updated from FDA.gov FAQ page July 2020): A diagnostic test can show if you have an active coronavirus infection and should take steps to quarantine or isolate yourself from others.
Currently there are two types of diagnostic tests – molecular (RT-PCR) tests that detect the virus’s genetic material, and antigen tests that detect specific proteins on the surface of the virus. Samples are typically collected with a nasal or throat swab, or saliva collected by spitting into a tube.
An antibody test looks for antibodies that are made by the immune system in response to a threat, such as a specific virus. Antibodies can help fight infections. Antibodies can take several days or weeks to develop after you have an infection and may stay in your blood for several weeks after recovery. Because of this, antibody tests should not be used to diagnose an active coronavirus infection. At this time, researchers do not know if the presence of antibodies means that you are immune to the coronavirus in the future.
If antibody tests are not used for diagnosis or exclusion of COVID-19 infection, what is their purpose?
(Updated from FDA.gov FAQs July 2020): While there is a lot of uncertainty with this new virus, it is also possible that, over time, broad use of antibody tests and clinical follow-up will provide the medical community with more information on whether or not, and how long, a person who has recovered from the virus is at lower risk of infection if they are exposed to the virus again. Samples are typically blood from a finger stick or blood draw.