In Alaska’s remote Yukon-Kuskokwim Delta, COVID-19 surges present distinct challenges

No roads lead to Bethel.

To get to the city in southwestern Alaska, you’ll have to take a plane. The flight from Anchorage takes an hour and costs $200 round trip. Bethel is so remote that most residents forgo car ownership due to the high costs of transporting one to the region, giving Bethel the highest concentration of taxis per capita in America.

Bethel is the hub of the Yukon-Kuskokwim (Y-K) Delta, a region the size of Oregon with just 18,000 residents. Around 50 Alaska Native Yup’ik villages are scattered across the delta. Some are only accessible by helicopter or snowmobile in the winter months.

The Y-K Delta’s isolation has not spared it from the impact of COVID-19. Since October, the area has seen some of the highest covid rates in the country. In early January, the region reported over 200 daily cases per 100,000 people, comparable to Los Angeles during its recent peak. The distinctive nature of life in the delta has presented challenges dealing with the pandemic. But with one of the highest vaccination rates, many in the region are hopeful for the future.

Bethel from afar (Source: KYUK.org)

Officials knew early on that the Y-K delta was uniquely vulnerable to the novel coronavirus. The entire region is serviced by just one hospital in Bethel. Village access to healthcare is extremely limited, requiring evacuation by plane to Bethel or Anchorage. In inclement weather, these journeys can be postponed by several days.

The villages’ dense multigenerational households presented a transmission risk factor. Over a third of regional households are overcrowded, meaning according to a study by the Alaska Housing Finance Corporation — over ten times the national average. This can make quarantining impossible. And since the region is quite cold in the winter, outdoor gatherings are less possible.

YKHC medical center, the only hospital in the region. (Source: KYUK)

Yup’ik elders recall the devastation of past epidemics like the Spanish Flu and diphtheria on villages, even if they weren’t around to experience them. “Stories of the 1918 pandemic are well recognized as part of Alaskan history. Some villages saw an 80 percent mortality rate,” said Tom Hennessy an epidemiologist at the University of Alaska. Many of these deaths happened following the epidemic’s devastation.

Recognizing the risks faced by the region, local officials imposed a strict lockdown in March. Schools closed. Taxis, notorious for being shared, were limited to one party. Masks, however, were not mandated.

These measures kept major outbreaks away for several months, according to New York Times data on covid cases nationwide. But in late October, cases skyrocketed. In Chevak, a village of 1,000, one in four tested positive over just two weeks. “There was a calm before the storm,” said Jess Schroeder, a Bethel nurse. “For a while, I’d have one covid patient. Then suddenly, half of my patients were positive.” Schroeder is currently raising funds for locals to “adopt” overworked nurses by sending gift baskets to show appreciation.

The village of Chevak faced among the worst outbreaks in the entire country in October. (Source: KTOO.org)

“There was a calm before the storm,” said Jess Schroeder, a Bethel nurse. “For a while, I’d have one covid patient. Then suddenly, half of my patients were positive.” Schroeder is currently raising funds for locals to “adopt” overworked nurses by sending gift baskets to show appreciation.

The region responded by offering free testing. On some days, Bethel even hosted $1,000 raffles as an incentive to get tested.

Cases subsided in late autumn but rose again after Thanksgiving and Christmas gatherings.

“Recent increases in cases seem to be directly connected to gatherings around the holidays,” said Ellen Hodges, chief medical officer at the Yukon-Kuskokwim Health Corporation. As of today, almost one in five residents of the region has tested positive for covid.

But with one of the nation’s most successful vaccine rollouts, things are beginning to look up in the Delta. A quarter of residents are now vaccinated, three times the nationwide average. Anyone over 16 is eligible.

Margaret Hannah, a Bethel teacher who received the vaccine last month, sees light on the horizon.

“The vaccine came at the same time as the solstice, when the sun started to come back,” remarked Hannah, referencing Alaska’s short winter days. “It’s two moments of hope at the same time.”