It’s a little more than a year from Alaska’s next gubernatorial election, and Republican Gov. Mike Dunleavy would love to talk about some of the issues he ran on: crime rates (they’re down), jobs, his plans to boost the state’s energy industry.

But for now, the state remains in the grips of an intense, delta-driven surge of the coronavirus that’s stressed its hospitals and fueled a caustic public debate over a mask mandate in the state’s largest city. And a special session the governor called to address the Permanent Fund dividend and Alaska’s budget deficit is languishing.

Dunleavy spoke with Alaska Public Media’s Nat Herz this week about the state of the pandemic, his relationship with lawmakers and the outlook for next year.

Listen to the interview (the voice that breaks in partway through is Jeff Turner, Dunleavy’s deputy communications director):

This transcript was edited for clarity and condensed.

Alaska Public Media: On the pandemic: We’ve got those hundreds of contracted workers who showed up to work at hospitals. Cases seem like they are at least plateauing, if not going down. Hospitals are still in crisis standards of care, and if you look at the numbers, we still have lots of cases compared to most other places in the country. How do you think we’re doing?

Mike Dunleavy: We’d love to see the cases come down, and the cases will come down. Back in early August, the most vaccinated state in the country, Vermont, experienced a 245% increase in cases, because the delta variant’s just much more infectious. So, we’re seeing a surge that other states have seen. We want the cases to come down; we believe the cases will come down here, sooner than later.

APM: Are we doing okay?

MD: We still have the fourth-lowest death rate per capita. We did have the third. Forty-six other states have done worse.
It’s a tough one, to say that when somebody dies, ‘Are we doing good?’ Our hospitals are holding, they have assistance. None of what we’re seeing is unnecessarily unanticipated. And I would say that we’re hanging in there, and we’ll get through this.

APM: You’ve been consistent in saying that mask mandates are a choice for local governments. But what would you say to people who see that their local governments, except for in Anchorage, are not doing that, it’s costing lives, and that a mandate is something the governor has the power to put into place — so why not do it?

MD: Government has a lot of power to do a lot of things in people’s lives, which I don’t necessarily believe is good. There are some people that believe that you need government to do the right thing. I have been in government for several years — government is not perfect. Government makes mistakes, as well. I actually thought we did really well with the pandemic, when it first started, because people did what they needed to do to take care of themselves. I don’t believe in mandates, especially putting something into someone’s arms. I know other people do. I don’t.

APM: On the mask mandate, though: Is it not worth the potential reduction in spread that we would see to violate that principle?

MD: What would that reduction be? How much?

APM: I think the state and the municipality have said it’s significant, right?

MD: If everyone wore an N-95 (mask), and wore it properly in the right settings, I think you would see a significant reduction.

Related: Alaska doctors say masks work and some are better than others

APM: You’re not convinced that a mandate would be very effective?

MD: I don’t think so. And can you describe the mandate that Anchorage just passed? People are exempt? I don’t know — is there going to be enforcement?

APM: But wouldn’t you at least accept that probably it will result in more people wearing masks, even if it’s not a lot or everyone.

MD: Probably, but I don’t know. Probably.

APM: In Anchorage, it’s been a pretty difficult couple of weeks, I think, for the local government. Do you have a sense of what is driving the kind of toxic debate and discourse that’s gone on there?

Related: Incivility in Anchorage: Ex-Assembly members do not approve

MD: I think the media is part of it. I think social media is part of it. I think there are a number of things being discussed nationally that are polarizing people. I think there are good people that absolutely believe that their rights are in jeopardy. And I believe that there are good people that believe that certain mitigation efforts such as mask wearing will have some impact

APM: But you don’t really believe that at this point, that mask-wearing will have much of an impact?

MD: It depends on what kind of mask, in what setting, for how long and how well is it fitted. We did a mask 101, many months ago, with mask experts at one of our press conferences. You start with a parent teaching a kid to cover their face when they sneeze, right? That’s a mitigating attempt. Most of us would agree that that probably won’t stop a virus. But it helps deflect, and then you work your way up to a loose fitting cloth mask, all the way up. So, it depends on what you’re wearing.

APM: But generally speaking, the average mask that someone’s going to wear — there’s an idea that either that’s going to help or it’s not going to help. And it seems like you’re kind of backing away from the idea that generally speaking, more people in masks —

MD: Help do what though, is the question? Everyone says help. Help do what? Stop the virus? It won’t stop the virus. It will not stop the virus. Does it help if the guy wearing the mask is a truck driver that goes up and down the North Slope and nobody else is around him? I don’t see how that helps. You’re talking about everyone getting into a crowded room — you’re better off wearing an N-95 if you get into a crowded room. So, it’s a matter of degree.

APM: Okay. To go back to the previous question —

MD: Can I ask you a question? When I answer your question, sometimes you don’t like the answer. I mean, I’m just being polite. But if you have a better answer, you should substitute and say, ‘This was Dunleavy’s answer.’ Or, ‘This is the answer I think he should say.’

APM: I just think that, you know, the public health folks would say —

MD: The public health folks, their job is to look at every mitigating approach you could possibly do. And ideally, you would be wearing an N-95 and be 8 feet away from people. That would be ideal.

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APM: But I think that evidence also says that if you wear a cloth mask or a surgical mask, that’s still a lot better than not wearing a mask at all.

MD: It depends on your setting.

APM: If there’s a city requirement to wear a mask in a public space — that will reduce transmission?

MD: It may.

APM: It may?

MD: You’re absolutely right — it will reduce it by 67.5%. I’m sorry, 80%. How much would Dr. Zink tell you it will reduce it by? How much will it reduce it by?

APM: I don’t know.

MD: Right? Okay.

APM: But I think the point is, we don’t know, but presumably it’s a meaningful amount somewhere between zero and not 100, because we know they’re not 100%.

MD: I think whenever you have a barrier on your face when there’s a virus around, it could have an impact on reducing spread.

APM: Going back to the Anchorage discourse question, around what’s fueling the toxic discourse there. Is it all media? Is it specific media? Is it just social media, or is it media like me, or media like The Watchman and Must Read Alaska and The Blue Alaskan?

MD: I think all of it contributes. Prior to the internet and social media, you had printed media that was pretty static. Usually, the news was dated, because you had to deliver it. But now, it’s instant, all across the world. And there are numerous, too many to even name, how many different sites there are and groups and so forth. So, I think you have a plethora of opinions, interspersed with facts. I just think the whole thing has contributed to a huge questioning situation.

APM: Is there anything government can do to fix that situation?

MD: Government can’t fix everything. I don’t believe so.

APM: What kind of consideration are you giving, if any, to any kind executive action or legislative proposals to ban mask or vaccine mandates?

MD: None, at this time.

APM: Last COVID question: What are you hearing about ivermectin right now, and would you say that people should not be using that for COVID?

MD: I’ll never pose as a doctor and tell you what you should use or shouldn’t use. That should be between your doctor and the patient. There’s ivermectin for livestock. There’s ivermectin that is actually for human beings as well. That’s a decision between the doctor and the pharmacist and the patient.

Related: Alaska GOP politicians are lobbying the governor and pharmacy board for easier access to ivermectin

APM: Would you agree that the focus on ivermectin distracts from the usefulness of vaccines?

MD: No, I don’t think it does. All of these discussions, you can have. We’ve been through this before: I was infected. I got the vaccine.That’s one discussion. There’s other potential therapies. There’s monoclonals. So, no, I don’t think it distracts.

APM: If you got COVID, would you want ivermectin?

MD: Would I want it? I’d have to have a discussion with my doctor to see what was best. (You’re suggesting) it’s almost, like, I have this craving for ivermectin or something. I would just like to be able to know that I could get better if I got infected. That’s all.

Dunleavy’s communications aide, Jeff Turner, breaks in: It’s important to remember what the administration’s done on COVID. We now have 250 health care people coming up that were just licensed under the program that we announced a few weeks ago. So there’s that and other measures going on to address COVID. Those might be good things to bring up as well. It’s more than just face masks.

APM: The special session on the Permanent Fund seems to kind of be stalling out. There was an opinion piece the other day that basically said the governor has it backward with his fiscal plan: Locking in the Permanent Fund dividend and the Permanent Fund in the Constitution is the easy part. And the hard part is filling whatever the budget deficit is that we’re left with, if we go with your plan to divide Permanent Fund revenues 50-50 between government services and dividends. So: Where are the proposals that would give legislators confidence that you’re serious about filling that budget hole?

MD: You’re kidding me. You’re kidding me. You really don’t know where the proposals are? You haven’t seen the proposals, since we started introducing proposals in January of last year, and in subsequent special sessions, you’ve haven’t seen those proposals? We can get you — there’s probably a book that thick of proposals.

Related: Alaska lawmakers say they want compromise on PFD, but it’s unclear how they’ll get there

APM: So, basically, at this point, you feel like the Legislature has the tools in front of them?

MD: Yes, they do. They have the tools in front of them. They know the numbers. They just have to choose, as a Legislature, if they want to solve the issue with the tools that they have.

APM: Do you have the ability to knock heads together and bring everyone into a room and kind of push things forward yourself? Or is that not your job at this point?

MD: They’re having a very difficult time getting into a room with themselves right now. Our job is to lay out a budget and lay out a sustainable fiscal plan. We’ve done that. Our job is to do the research, when they ask for it. We’ve done that. Our job is to come up with as many ideas as possible, to put together a sustainable fiscal plan with all the components. We’ve done that. Our job is to provide them the environment for a special session. We’ve done that.

APM: So if Alaskans are frustrated that they haven’t seen more progress, is it your feeling that there’s really not that much more you could do, and the leadership at this point needs to come and is not coming from the Legislature?

MD: Yes. Yes. And if they don’t come up with a decision, that non-decision is a decision. That they prefer to have the situation that we have now.

APM: Do you see that changing over the next regular legislative session?

MD: I wish it changed in January. I wish it changed this summer. Alaska needs a sustainable fiscal plan. There’s nobody that argues that. What this really comes down to is whether the Permanent Fund and the Permanent Fund dividend are going to be permanent, or whether they’re subject to being spent on government programs. That’s what this comes down to.

APM: What do you feel like the chances are that we do get this resolved before the election this coming year?

MD: I have to remain optimistic. But there’s always the chance that they won’t want to resolve it. And then, the people of Alaska will have to decide if that’s the type of government that they want.

APM: There was that ruling from the federal judge last week, where he said those two psychiatrists had been unconstitutionally asked to resign. And he made a reference that you could be held personally liable. In retrospect, the fact that the request for resignations, at the start of your term, went out to a larger-than-usual group of employees after you were elected — was that a mistake?

MD: I don’t think so. No.

Related: Ex-Alaska Psychiatric Institute docs win federal court victory in challenge to Dunleavy ‘loyalty pledge’

APM: So, you feel like you guys will continue to fight that lawsuit?

MD: We’re having that discussion.

APM: What else do you want people to know?

MD: 500 health care workers are here. Our fiscals are actually looking very good for the state of Alaska. Our crime rates have plummeted over the last three years. I don’t know if I saw anything on that.

APM: Are you frustrated by the fact that people don’t seem to be acknowledging that stuff?

MD: No. I think there’s a lot of good things going on in Alaska. It’s all overshadowed by this virus, nationwide, and the politics nationwide. But there’s plenty of jobs if people want them.

APM: Do you have a sense of when the pandemic will —

MD: (joking) December 1, it will end. No, but you raise a very good question. Let me answer it. This pandemic is not going to ‘end.’ Okay? This pandemic is in many mammal species now. Denmark had to destroy millions of mink because there was a spread going back and forth, transmission. So, people need to realize that we’re going to have to live with this pandemic, this virus. We have the mitigating approaches that I think give us the upper hand. But it’s going to be with us. And, as I mentioned, it’s just a matter of time before everyone has the antibodies, either through infection or vaccination.

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Anchorage health officials say a budget shortfall is forcing them to ration COVID-19 testing while the city endures one of the nation’s worst coronavirus outbreaks.

A spokesman for Mayor Dave Bronson said the administration plans to ask the city Assembly for additional cash “in the near future.” But for now, it’s scaling back its testing contractor’s hours at multiple sites around the city, with reductions totaling 108 hours a week, the contractor said.

Technically, Anchorage’s purchase order with its testing provider, California-based Visit Healthcare, runs through the end of October. But the city is paying a flat rate of $98 a test, and amid Alaska’s delta variant-driven surge, demand has been so high that without the reduced hours, Bronson’s administration would have exhausted its appropriation from the Assembly by Oct. 18, according to Acting Health Director Joe Gerace.

“When we extended the contract, things were very slow,” Gerace said. “Nobody foresaw the delta variant cranking testing numbers up to 1,500 a day.”

Gerace said the latest contract extension, valued at some $7.5 million, was for 90 days. That would mean it started in early August — just as Alaska’s current surge began to take hold, and as hospital administrators warned that their capacity was being stretched.

RELATED: Anchorage’s multi-million-dollar testing, vaccination contracts in limbo as Bronson administration considers its options

News of the reduced hours, which begin Friday, quickly caused anxiety and frustration among some residents and city Assembly members — with some critics speculating that the cuts to testing stemmed from a deliberate effort by Bronson’s administration to suppress Anchorage’s case counts.

“Rationing tests during the highest COVID rates we’ve seen in our community since the pandemic began is dangerous,” Assembly Member Austin Quinn-Davidson said in a message. “It’s also unnecessary. If the mayor and his team need an additional appropriation, I’m certain the Assembly would take swift action to approve that appropriation to protect public health.”

The city’s positivity rate, at roughly 10%, is already high, and some Assembly members and medical experts say Anchorage should be doing more testing, not less.

The mayor, a conservative elected earlier this year, has questioned scientists’ and doctors’ coronavirus guidance. And he’s blamed vaccine mandates, not the virus, for the stress on the city’s health care system — though data released by Alaska hospitals show that very few workers, so far, have been fired for refusing the shots.

Related: Anchorage Mayor Bronson says he won’t push masks or vaccines, hires new top doc

Bronson’s health department has also experienced substantial turnover since he was sworn in July 1: Its public health manager resigned last week, and its epidemiologist and longtime infectious disease specialist both left their jobs during the summer.

In a call with reporters late Thursday afternoon, Gerace said there’s no effort to suppress the city’s case counts and that instead, officials are trying to ensure that testing can continue while remaining available to the people who most need it.

The city is also trying to tighten its criteria for testing and, in accordance with U.S. Centers for Disease Control and Prevention guidelines, discouraging it for asymptomatic, vaccinated people who haven’t had extended close contact with an infected person.

“People that are fully vaccinated shouldn’t be getting tested just because someone in the office walked by,” Gerace said.

“We don’t want people not to go get tested,” he added. “The piece we really want to make sure is that the people that need the test have those services available to them.”

Anchorage officials also pointed out that other testing options are available.

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At a state-funded testing site at the Alaska Airlines Center at the University of Alaska Anchorage, there were no lines Thursday, and Anchorage School District officials also reminded families that it has six sites open for staff, students and household members who either have COVID-19 symptoms or exposure to infected people.

Nonetheless, a number of Anchorage Assembly members questioned the idea of scaling back city-sponsored testing during the middle of the current surge.

All three of Anchorage’s hospitals are currently operating under crisis standards of care, as the extra-contagious delta variant has filled intensive care units and stressed staffing and bed space.

“If there’s a reduction in hours, it seems to make very little sense. Especially since many Assembly members, at the behest of the community, just advocated for expanded services, since lines were spanning parking lots and it was taking hours to get a test,” said Assembly Member Meg Zaletel. “We know, with the current high transmission rate of COVID in our community, testing needs to be readily accessible and convenient so people will use it.”

She added: “We’ve got to have COVID testing right now, more than ever, and reducing that service doesn’t make sense to me.”

Related: Alaska activates emergency crisis protocols in 20 health care facilities

With Visit Healthcare’s testing contract set to expire at the end of the month, the company, in a prepared statement from Chief Development Officer Emily Oestreicher, said it hopes to continue its work.

“Visit Healthcare has no intention of discontinuing its contract with the Municipality of Anchorage nor have we been informed about any plans by the municipality to do so,” she said, adding that the company has tested and vaccinating thousands of people in the city. “We are proud to have made a significant impact on the safety and well-being of this community.”

But Bronson administration officials say they’re examining whether to change Anchorage’s testing program to be more efficient.

Coronavirus testing is reimbursable by the Federal Emergency Management Administration. But that’s the case only if the testing program is “fair and equitable” and complies with CDC guidelines, Gerace said.

The city also has to pay the initial bills for testing before FEMA issues its reimbursement, which can take up to a year, Gerace added. Based on the state’s contract for testing at UAA, Gerace said, he suspects that the city’s current rate of $98 a test is roughly $35 too high.

“The point of RFPs is to make sure the city’s getting the best bang for its buck,” he said. “And that’s the piece no one is talking about.”

Gerace has said that any new testing plans, or an extension of Visit Healthcare’s contract, will have to be introduced at next week’s Assembly meeting to leave members adequate time to approve it before the existing contract expires.

No proposal was on the meeting’s agenda when it was released Wednesday, though it could be added in the coming days.

In an email, a spokesman for Bronson, Corey Allen Young, said that a supplemental appropriation request will be submitted to the Assembly soon.

“Until supplemental funding is secured, the Municipality of Anchorage is actively managing our current resources to continue testing through the end of the month,” he said.

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Trauma can be passed down from one generation to the next, but so can healing. Alaska Public Media’s Jeff Chen has a story about how Rita Pitka Blumenstein’s impact continues to shine, even after her death.

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Beginning Monday, the Denali Borough School District board will again require everyone who enters a district building to wear a facemask to curb the spread of coronavirus. The district school board adopted the policy Tuesday over the opposition of some area residents.

School board members voted 7-to-2 to require universal masking, with Kristen Randall and Nikki DeMers dissenting.

The board voted after several people spoke. Some voiced strong opposition, while others supported the policy. Opponents include Tri-Valley Fire Department Chief Rob Graham, who suggested the pandemic may be overblown because he’s never transported a patient who was known to be COVID-positive. He said those who’ve been advising the district to mandate masks aren’t motivated by a concern for public health.

“I’d also like to make you guys realize that like, those people that come in here and talk about that, they’re getting paid with COVID dollars,” Graham said. “And so they’re pushing that agenda.”

Residents who support the facemask mandate include Emily Tuttle, a businessperson and mother who said she withdrew her child from a district school because its policy made the wearing of facemasks optional.

“Masking is most effective when every person wears one,” Tuttle said.

Superintendent Dan Polta said in an interview Thursday that those who spoke during the sometimes-heated public testimony all have strong feelings about the issue. And he said that all are motivated by a common desire for their children to have the best education possible in a safe environment.

“I believe everybody wants that for their children,” he said. “And I hold that when I hear their comments — whether they’re angry, whether they’re vitriolic, whether they’re kind.”

Polta said he’s been talking with school district officials in Anchorage and Fairbanks on how they’ve managed facemask requirements. And he’s now working on details of the facemask policy that he said will be much like the one the Healy-based school district had last school year. For example, whether to require athletes to wear facemasks during practices and competition.

“Last year, we were not masking during our games,” he said. “And so I need to kind of take a look and go ‘Would we continue that practice? Would we go back to a more stringent practice of requiring the masks during games?’ ”

Polta says board members who voted for universal face masking cited the surge in COVID cases statewide that’s filled Alaska’s hospitals and reduced care for all patients. He said the members hope when they review the policy in November, the surge will have subsided.

“We think that could be different,” he said, “and we also really believe that in November we’ll also most likely have that vaccine availability for kids 5 to 11.”

The board’s decision makes Denali Borough schools the second rural district in the Interior to require facemasks, the other being the Tok-based Alaska Gateway School District. Elsewhere in the Interior, the Delta Junction-based Delta Greely School District is maintaining its policy of recommending but not requiring facemasks, despite a sharp rise in COVID cases over the past couple of weeks.

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We’re a month into the school year and Alaska is experiencing peak Covid-19 cases and a hospital system at max capacity. Nationally, the Covid vaccination rate among 12-17 year olds lags behind the rate for adults.

Alaska Public Media’s Jeff Chen looks at what health care professionals in Alaska are doing to try to boost those numbers.

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A high-seas legal fight is causing havoc for one of Alaska’s biggest commercial fisheries, the Bering Sea pollock harvest out of Dutch Harbor.

The quickly escalating saga involves hundreds of millions of dollars in fines, a miniature Canadian railway and Donald Trump’s personal lawyer. And it stems from the way that one of Alaska’s biggest fishing companies, American Seafoods, is using an exemption in the federal law that typically allows only U.S. ships to move cargo between U.S. ports.

American Seafoods’ shipping subsidiary and an affiliate company, Kloosterboer International Forwarding, sued U.S. Customs and Border Protection in federal court Thursday.

They’re challenging $46 million in fines issued directly to American Seafoods, plus more than $300 million levied against industry partners over the past month — some of which are holding American Seafoods’ subsidiary liable.

In legal filings, the companies say the threatened penalties are paralyzing the Alaska seafood industry’s supply chain to a port called Bayside, on the East Coast, and have stranded millions of pounds of frozen fish destined for American customers.

Related: As the Bering Sea warms, this skipper is chasing pollock to new places

“Cargo vessels are no longer being sent to Bayside with seafood for the eastern United States. Fishing vessels returning from the Bering Sea to Dutch Harbor are facing dangerously tight conditions as the limited cold storage capacity fills up with cargo that was destined to the United States,” an Anchorage-based lawyer for the companies, David Gross, said in a court filing Tuesday. “The entire transportation route used by plaintiffs has been paralyzed and will be irreparably damaged, absent court intervention.”

Officials at the American subsidiary that filed the lawsuit, Alaska Reefer Management, declined to comment beyond a prepared statement. A CBP spokesman also declined to comment.

American Seafoods says it has the world’s largest operation processing $400 million worth of pollock each year, on its huge ships with onboard factories.

The company, like other major Alaska seafood players, sells much of its harvest to Asian and European markets.

But it’s also a major supplier of pollock to U.S. customers, with products like fish sticks that end up at food banks and in school lunches. A little less than 15% of the company’s catch is shipped to the eastern U.S. on ships coordinated by Kloosterboer and American Seafoods’ shipping subsidiary, Alaska Reefer Management, according to court documents.

The Jones Act, a century-old federal law, typically requires American-flagged ships to move cargo between American ports. But the legislation contains an exception known as the “Third Proviso,” which allows companies to use foreign-flagged ships between U.S. ports if the routes include “Canadian rail lines” — and if they’re certified by an obscure federal agency called the Surface Transportation Board.

Alaska seafood companies have been using that exception since 2000, according to court documents.

Vessels flagged in countries like Singapore and the Bahamas first pick up frozen seafood products in Dutch Harbor, then travel to the Canadian port of Bayside, New Brunswick, just across the border from Maine.

From Bayside, the seafood would be trucked to a Canadian train, loaded and moved 20 miles between two stations — sometimes in the opposite direction of the U.S. border. Then the cargo would be loaded back onto the trucks to drive into the U.S.

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In their court filings, the shippers say that both CBP and the Surface Transportation Board signed off on that practice, even though it was clear that the only purpose of the brief rail movement was to satisfy the requirements of the Jones Act.

They also argue that they made customs officials aware of a new, even shorter rail line that they switched to using in 2012 to satisfy the Jones Act: a 100-foot stretch of track that’s entirely within the Bayside port.

“The trucks travel the length of the Canadian rail trackage and back,” Gross said.

The seafood products’ 200-foot train ride now appears likely to be at the core of the companies’ legal dispute with CBP.

Other companies with Bering Sea fishing vessels, including O’Hara Corp., Glacier Fish Co. and Arctic Storm Inc., also ship their seafood with Kloosteboer and the American Seafoods subsidiary. And in court documents, they say they face their own threatened fines from CBP.

In addition to Gross, Kloosterboer and the American Seafoods subsidiary have hired a high-profile New York-based law firm, Kasowitz Benson Torres, which has experience on Jones Act cases.

One of the firm’s partners working on the lawsuit, Marc Kasowitz, represented former President Donald Trump in the investigation into Russian interference in the 2016 election.

In their court filings, the companies say they were “completely blindsided” by what they call the “draconian penalties” proposed by CBP.

U.S. District Court Judge Sharon Gleason, in an order late Friday, granted the companies expedited consideration of their request for a temporary restraining order and preliminary injunction against the agency. If Gleason ultimately grants that request, CBP would be barred from penalizing the companies under the Jones Act for shipping more seafood while the lawsuit plays out.

CBP’s response is due next week.

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Emergency room doctors in Anchorage sounded dire warnings about the city’s hospital capacity Friday at a medical update to the Anchorage Assembly.  

Doctors who work at Anchorage’s main hospitals described heart-wrenching scenes from the last week of last goodbyes to unvaccinated loved ones, nurses quitting their jobs due to burnout, and infants hospitalized for severe cases of COVID-19. 

“We are on the verge of a hospital system collapse,” said Dr. Andrea Caballero, an infectious disease doctor who also works at Providence Hospital.

“And that happens when you have the right number of patients and acuity, staff burnout, which leads to staff shortages, and supply shortages. This is a very, very imminent reality,” she said.

Doctors said that after a year and a half of the pandemic, hospital staff are demoralized from working long hours and treating preventable COVID-19 cases in unvaccinated patients. Doctors said they’ve seen an increasing number of nurses and other health care workers quit their jobs. Increased community transmission also means that those workers are more exposed to COVID, forcing them to take days off. 

The shortage means that ICU patients have fewer nurses assigned to them. 

“The nursing ratio is usually 2-to-1 —  two patients for one nurse — but we are consistently pushing it to 3-to-1, which is a dangerous intervention that is used only in times of desperation,” said Dr. Javid Kamali, an intensivist who works at Providence.

It also means that emergency rooms are forced to keep patients longer instead of passing them off to ICUs, delaying the time before doctors can admit patients with less urgent injuries. 

 “We’re seeing [waits of] four and five hours sometimes now. And that’s really because our flow is so disrupted,” said Dr. Ivan Ramirez, an emergency doctor who works at Providence.  

The number of COVID-19 hospitalizations is at its highest level since December in Anchorage and appears to be growing. Thomas Hennessy, an epidemiologist at the University of Alaska Anchorage, recommended the Bronson administration institute a vaccine requirement for municipal employees and mandatory masking. 

“In Anchorage, we won’t need to wear a mask forever. But while infections are surging, we should take this simple, inexpensive and effective step,” he said. 

But Anchorage’s Chief Medical Officer, Dr. Michael Savitt, signaled that he was unlikely to recommend any mask or vaccine mandates to the mayor. He said he’s preparing a recommendation to the mayor that municipal workers start teleworking, but said that the city will rely on voluntary compliance. 

“I think we’re already at the point where we need to — for lack of a better way of putting it — strongly encourage people to wear those masks, follow those recommendations. That’s going to be our first line of defense. Secondly, get people vaccinated,” he said. 

Bronson was elected on a platform of opposing the Assembly and former mayor’s COVID mitigation measures. On his first day in office, he declared masks were optional in city buildings. 

But experts argued that the situation had fundamentally changed due to the delta variant of COVID, which accounts for over 95% of cases in the state. 

“When the election was held in April in the runoff in May, we were in a situation where the epidemic was waning, case counts were going down or hospital capacity was in a much different place, we had widely available vaccinations. It looked like we were winning,” said Hennesy. “Now we’re in a different position. Right now, we have a new virus that’s more deadly.”

Savitt, and most assembly members, did not wear masks at the meeting, even though the Centers for Disease Control and Prevention recommends them for indoor settings. 

Assembly Member Meg Zaletel says she will likely introduce a resolution at next week’s meeting asking for a mask requirement, but it would have no enforceable component unless the mayor takes action. 

Correction: This story originally misstated the hospital where Dr. Kamali works.

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Alaskans’ participation in a medical school program is threatened by an impasse over how to pay for it.

While lawmakers’ disagree over the program, students, including Jesse Klejka, are worried that they’ll see large tuition increases. 

Klejka was born and raised in Bethel, where his father is a doctor. He’s one of 20 Alaskans who are accepted each year into a program, known as WWAMI, that allows Alaska to support medical education without having to operate a medical school. The program is named for the first letters of the names of the five states that participate — Washington, Wyoming, Alaska, Montana and Idaho. The students graduate from the University of Washington School of Medicine. 

Klejka is in his second year of the WWAMI program. He’s been interested in it since he was 9 years old.

“I was excited to hear about a program that puts special emphasis on training and retaining docs for Alaska, with assistance for those students who are interested in going down the path of rural medicine,” Klejka said.

He said the WWAMI program acts as a pipeline for doctors to serve in Bethel. 

“Our hospital works to recruit talented individuals, but for many who aren’t from Alaska, it’s hard to call it home,” he said. “I’ve seen the same challenge exists across the state, with hospitals having to spend money on recruitment and travel docs to help fill shifts.”

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Klejka is working in a clinical rotation in Ketchikan. Students in the program attend the University of Alaska Anchorage for a year and a half, then get clinical training at locations around Alaska and the other states.

On Friday, he was told that barring a resolution to the Legislature’s budget dispute, his class will have to pay out-of-state tuition this year. While he doesn’t know what that difference will be, last year the average difference was $30,000. In addition, recruitment for Alaska students for the class that would start next year has stopped for now. First-year students, who start class on Aug. 17, will still pay in-state tuition this year.

For many years, the Legislature has voted to fund the WWAMI program from an account that’s separate from the rest of the state budget, the Alaska Higher Education Investment Fund. But this year, the vote failed and students could have to pay tens of thousands of dollars more for tuition.

RELATED: The long backstory behind Alaska House minority caucus votes on PFD, shutdown

So students and others involved in health care in Alaska are asking lawmakers to agree to fund the program in the upcoming special session. They spoke last week at a meeting of the working group of legislators weighing changes to the state budget for the long term.

Dr. Kristin Mitchell, a WWAMI faculty member who lives in Kenai and works in Soldotna, told lawmakers that the state receives an impressive return on its investment, because WWAMI students tend to stay in the state. She moved to Alaska in 1998 to attend the program. 

“Alaska has a primary care shortage, and I know you’re aware,” she said. “And we urgently need to train excellent Alaskan physicians to provide medical care to Alaskans.”

It’s not just primary care that’s a challenge for Alaska. Mitchell said that most psychiatrists in the state are older than 60, as are nearly half of orthopedic and heart doctors.

She said the budget dispute is causing anxiety for students over how to pay for their education. And, she said, a similar budget dispute two years ago caused Alaska to lose future doctors.

“I fielded untold calls from students and families who wondered if they should accept offers of admission from other schools than the University of Alaska and from WWAMI,” she said. “And we lost the opportunity to train some outstanding students over that funding uncertainty.”

Kathryn Mitchell grew up in North Pole and chose WWAMI so she could stay in Alaska. (She’s not related to Kristin Mitchell.) Mitchell said she’s concerned that the funding problem will mean the end of the program.

“I ask you to think about your own experiences in health care and ask yourself what it could mean if you could have a doctor who is from your community, knows your environment and the needs of your region,” she said. 

Not everyone who testified in from of the legislators supported the WWAMI program.

Some who support higher Permanent Fund dividends, said they consider WWAMI a special interest. 

Kerri Mullis of Delta Junction said the Legislature’s first priority should be putting the PFD in the state constitution and paying Alaskans the dividend amounts they would have received the last five years if the state followed the formula in a 1982 law. Including this year’s dividend, that adds up to more than $10,000. 

“The WWAMI people shouldn’t be calling in tonight,” she said. “This is about people and their PFD. The WWAMI people shouldn’t even be allowed to talk tonight. And I just want you guys to do the right thing, which is to do the constitutional PFD and give us back our money.”

Some Republican House members who voted against restocking the fund that would pay for the WWAMI program have said they still support it. But they want the funding to be paid along with the rest of the budget, not from a separate fund. Opponents of that proposal say it would require drawing more than planned from the Permanent Fund’s earnings reserve, and that this would open the door to spending down the Permanent Fund in the future.  

Gov. Mike Dunleavy hasn’t put funding for WWAMI and similar programs on the agenda for the special session, which means lawmakers won’t be able to consider it. But he could add it to the agenda at any time before the session ends. The session is scheduled to start on Aug. 16 and can last up to 30 days.

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Anchorage’s acting health director, David Morgan, has resigned after just over a month on the job, according to a statement from the city on Friday. 

Morgan was appointed by Mayor Dave Bronson and has been serving as health director since July. At a recent work session about his nomination, Morgan faced pointed questions from Anchorage Assembly members who asked about his qualifications and social media comments he made downplaying the seriousness of COVID-19, as well as allegations that he mismanaged finances under previous employers. 

RELATED: Another top doc resigns in Anchorage, health director faces tough questions

Morgan worked for decades in health care finances, but he does not have education or experience in public health. 

He faced a confirmation vote by the Assembly next week.

In his resignation letter, Morgan blamed partisan political opposition that he says caused him to withdraw his nomination. He wrote that after he was nominated, “it became very clear I would be the target of an organized political witch hunt.” He said he felt “great sadness” at withdrawing his name. 

Bronson said in a statement that he “regretfully accepted” Morgan’s resignation.

“The Anchorage Assembly has long acknowledged that a new Mayor should have the authority and ability to appoint his or her own senior leadership team,” Dave Bronson said in a written statement. “However, the Assembly is headed down a very dangerous path that challenges years of precedent and undermines any future Administration from performing its required duties.”

Deputy Health Director DeeAnn Fetko was named acting director of the Anchorage health department. 

This story has been updated.

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Poor weather conditions on Friday hampered recovery efforts at the site of a fatal plane crash near Ketchikan, officials say.

It’s too early to say what caused the de Havilland Beaver to crash in Misty Fjords National Monument Thursday, killing all six on board, according to the National Transportation Safety Board.

NTSB’s Alaska Chief Clint Johnson said investigators plan to spend the weekend investigating the crash.

“We do understand that the wreckage came to rest in a very challenging, very steep, heavily wooded area,” he said. “So, you know, this is not going to be just a one-day operation here. But everything is going to be predicated on weather and safety.”

The plane was operated by Southeast Aviation and was carrying a pilot plus five cruise ship passengers from a Holland America ship, according to the cruise line. Holland America said the passengers had been on a floatplane flightseeing excursion.

The Coast Guard got a distress signal from the plane around 11:20 a.m. Thursday. And, a rescue team reached the site about three hours later, reporting no survivors.

The names of the deceased have not been released. The Alaska State Troopers and Ketchikan Volunteer Rescue Squad will be leading efforts to recover the bodies.

The investigation is slated to begin Saturday morning, Johnson said, but that is dependent on weather conditions.

“What we’re going to do is to document the active site to the best of our ability, the best we possibly can given the circumstances, before the wreckage recovery portion takes place,” he said.

Johnson says the NTSB will try to determine a probable cause of the crash.

Before Thursday’s crash, at least 15 people had been killed in flightseeing crashes in the area since 2015.

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