Oxygen, intubation, regret: Alaska ICU doctor provides a glimpse behind the walls

woman in lab coat and mask stands at podium with others behind her.
Dr. Leslie Gonsette, at podium, was among the health care workers who spoke at the Anchorage Assembly meeting Setp. 13. (Wesley Early/Alaska Public Media)

Dr. Leslie Gonsette, who works in the Intensive Care Unit at Providence Alaska Medical Center, said she feels like she’s living in two different worlds.

One is at the overloaded hospital, where she and her colleagues are united in battle — “World War III,” she calls it — against a deadly pandemic.

The other is outside the hospital, where she sees Alaskans who won’t help by getting vaccinated or even wearing a mask at the supermarket.

The medical staff that practices at Providence declared Tuesday that they are in crisis and have begun rationing health care.

RELATED: Alaska’s largest hospital now rationing care due to COVID surge

Gonsette did a Zoom session with a patient to give reporters a glimpse of what it’s like to work there.

“I started my day off with one of my patients down the hall in the intermediate COVID ICU that unfortunately got intubated,” she said. “The other one is recovering next to me.”

Pablo Diaz-Fontao, a 56-year-old Alaska Airlines employee, said he didn’t think he’d catch COVID-19.

“I know I’m very strong,” he said. “‘I don’t need the vaccine. The virus don’t touch me… ‘ So many things, you know.”

Just a few hours before, he was on a high-pressure machine that pushed oxygen into his lungs. But he improved. By Thursday afternoon he was on low-pressure oxygen, through a nasal tube. He spoke from a chair in his hospital room, wearing a gown. He’s been in the hospital almost a week.

Pablo Diaz-Fontao, 56, landed at Providence Alaska Medical Center with COVID-19. He says he didn’t get vaccinated because he thought the virus wouldn’t hurt him. (Screen shot from Zoom)

Diaz-Fontao, originally from communist Cuba, said he still doesn’t like the idea of the government telling him to get a shot, but he said he regrets he didn’t get vaccinated earlier.

Gonsette said she regrets that, too.

“Because he’s here alone for six days. And I don’t know when he can go home, ” she said. “He’s finally made good improvements. But it’s sad that you have to suffer before you get the picture.”

RELATED: Alaska has one of the worst rates of COVID in the country

Gonsette said as soon as her intubated patient left for the ICU, that bed in intermediate intensive care was filled with another COVID patient, up from the Emergency Department, who needed high-pressure oxygen.

“And next to him, a 32-year-old, also admitted, and another one down the hall who is actively dying with a family outside of the room,” she said. “I’ve had to support my nurses during all of this.”

Gonsette said people outside the hospital are just living their lives, oblivious to how bad it is. They don’t have to hold the hands of dying COVID patients, or talk to their family member. She said she feels an obligation to tell them what she’s seeing. She also pleaded for the public to help by getting the shot, even if they feel they aren’t at risk.

“You may be one of the lucky ones that doesn’t get it. But we live in a society, and everything you do will affect the person next to you,” she said. “So the one thing you can do in this war is get the vaccine.”

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Alaska reports 1,095 COVID cases, a new daily high

a row of cars lined up behind a sign that reads "covid-19 drive-thru testing"
Cars line up for drive-through Covid-19 testing on the Alaska Native Medical Campus on Aug. 24, 2021. (Jeff Chen/Alaska Public Media)

The state health department reported a record 1,095 new COVID-19 cases on Wednesday.

It’s Alaska’s highest-ever daily tally of new cases, and it comes a day after doctors at Providence Alaska Medical Center announced the hospital was rationing care due to staffing shortages and an overload of patients infected with the coronavirus.

The state on Wednesday also announced two additional COVID-related deaths, an Anchorage man in his 70s and an Anchorage man in his 60s.

There are 201 people hospitalized with the virus, 34 of them on ventilators, according to Wednesday’s report. COVID hospitalizations hit a record 210 on Monday.

Hospital workers, however, have cautioned that the state’s tally of hospitalizations is likely an undercount.

Local health officials have also underscored that the ongoing surge of cases has led to a backlog in testing, and also in state reporting of new infections.

RELATED: Alaska’s largest hospital now rationing care due to COVID surge

In Juneau, the city’s emergency manager, Mila Cosgrove, told KTOO it’s a good idea to look at the seven-day average test positivity rate because it helps to flatten peaks and valleys in the number of positive tests that are reported each day. 

Right now, Alaska’s seven-day average test positivity rate is at a record high 9.6%. Health officials say that anything above 5% indicates that more testing needs to be done.

The 1,095 COVID-19 cases reported by the state on Wednesday include 1,068 Alaskans and the rest nonresidents.

KTOO’s Rashah McChesney contributed reporting to this story.

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Private company to take over operations at Anchorage’s largest shelter

Cots spread out on the floor of the Sullivan Arena on Tuesday, Feb. 2, 2022. Shelter managers found that even with a few COVID-19 cases, nearby cots weren’t getting infected. (Lex Treinen/Alaska Public Media)

Anchorage’s largest homeless shelter will have a new operator starting Wednesday, but city officials say there will be no disruption of services for the 400 people who stay there each night. 

99 Plus 1, a private company, was awarded the contract to operate the Sullivan Arena shelter for the next six months, Mayor Dave Bronson’s administration announced on Sunday. The company will take over the job from Bean’s Cafe, a nonprofit and longtime operator of Anchorage’s largest soup kitchen. 

99 Plus 1 previously provided transportation for guests at the Sullivan shelter. The company was formed last September, according to state records.

The city’s purchasing department released a document in August seeking an operator for the shelter. It said the requirements included at least three years of experience providing homeless services. 

Corey Allen Young, a spokesperson for Bronson, wrote in an email that “the contractor must have staff with this experience but they do not need to have gained it working for this contractor.”

Bean’s Cafe had operated the mass care shelter at the Sulivan since it was set up in March 2020, at the start of the pandemic. That contract was set to expire on Sept. 15.

The new contract with 99 Plus 1 will run until March 31, 2022, with the option for six one-month extensions.

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Lisa Sauder, Bean’s Cafe executive director, said she was proud of the work the Bean’s had done over the past year and a half in setting up the shelter. She said that Bean’s would continue to serve Anchorage however it could. 

Meanwhile, city officials are hoping to move people out of the Sullivan Arena as soon as possible.

A group of Anchorage Assembly members and representatives from Bronson’s administration are trying to narrow down new shelter options

But those talks reached a tense point last week following a barbed Twitter post from the mayor after the group said it was unlikely that they’d find an alternative shelter site before spring.

In a Twitter post, Bronson asked residents to contact Assembly members and “let them know you expect them to accelerate their efforts.”

After the mayor’s tweet, Downtown Assemblyman Chris Constant spoke to reporters outside City Hall on Friday, and he questioned whether the mayor’s team was working in good faith. 

“Up until the mayor’s little Tweet — which he just couldn’t help himself — I thought we had a really great working relationship established between him, his team, and us, this delegation working on behalf of the Assembly,” said Constant. “At this point, there’s a lot of questions.”

RELATED: Anchorage working group narrows down potential shelter sites to 7

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Alaska House leaders call on Dunleavy to ease hospital crisis with disaster declaration

Gov. Mike Dunleavy discusses the state of the coronavirus pandemic during an August news conference. (Matthew Faubion/Alaska Public Media)

With the number of COVID-19 patients in Alaska hospitals hitting a new peak this week, the Alaska House Majority is calling on Gov. Mike Dunleavy to declare a 30-day disaster.

House Speaker Louise Stutes, R-Kodiak, said in a written statement that a disaster declaration would cost the state nothing and would give health care workers tools they need to deal with the surge.

The Alaska State Hospital and Nursing Home Association says a declaration would accelerate the hiring of hospital staff, make it easier to transfer patients and expand the use of telehealth.

RELATED: Hospitals say a disaster declaration would help Alaska cope with record hospitalizations

But in a letter Friday to Senate President Peter Micciche, Dunleavy said he had no intention of issuing a disaster declaration.

“Issuing a Disaster Declaration should be use sparingly, in the direst circumstances, and in the absence of a viable alternative,” said Dunleavy.

Instead, Dunleavy is asking the Legislature to pass a bill he submitted Thursday that would expand telehealth and suspend background checks for health care workers until next summer.

RELATED: Sharing harrowing details, hospital officials implore Alaska lawmakers to help quickly

Among those who’ve also called on Dunleavy to declare a disaster are two men who hope to replace him in next year’s election: former Gov. Bill Walker, an independent, and former Democratic legislator Les Gara.

Walker wouldn’t speculate about why Dunleavy won’t make the declaration. Gara said it was politics.

“He’s not doing it because he’s playing to his political base and that’s more important to him than to do the right thing to help deal with this disaster,” Gara said.

Everything in Dunleavy’s bill, Gara said, could been accomplished in an instant with an executive declaration that should have come a month ago.

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With deadline looming, Alaska lawmakers still disagree over PFD amount

A photo of a multi-story building.
The Alaska State Capitol in Juneau. (Andrew Kitchenman/KTOO and Alaska Public Media)

The Alaska House of Representatives defeated an amendment on Monday that would have paid permanent fund dividends this year of roughly $3,800. The House is debating a bill that would pay a PFD of up to $1,100. 

But Gov. Mike Dunleavy’s administration said nearly half of the funding in the bill isn’t available. That would reduce the PFD to roughly $600.

Meanwhile, a deadline is looming: The Permanent Fund Dividend Division says legislators and the governor must agree on PFD funding by Wednesday for dividends to be paid on time — in the first week of October. If the funding amount is finalized later, dividends would be paid roughly 30 days after that.

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The state hasn’t paid a dividend that follows the formula since 2015, after oil prices fell. Supporters of the higher PFD amount say recent growth in the permanent fund means the state can afford it. 

But opponents say drawing more than planned would threaten tens of billions of dollars of permanent fund earnings in the long term. They point to the state’s history of spending down savings. 

Lawmakers have been debating the amount of the 2021 PFD for months.

In July, Dunleavy vetoed a $525 PFD, saying it was an insult to Alaskans

Earlier this month, he added proposed $2,350 PFDs to the Legislature’s agenda for its third special session of the year.

House members also introduced bills on Monday that are intended to balance the state budget in the long term.

Rep. Geran Tarr, D-Anchorage, introduced bills to raise oil and gas taxes and introduce a 2% statewide sales tax. 

The House Special Committee on Ways and Means introduced a bill to raise revenue by lowering the tax credits oil and gas companies receive. It also also introduced a bill that would change the formula in state law to pay permanent fund dividends. The PFD would equal 25% of the annual draw from the permanent fund. The current amount of the dividend under the new formula would be roughly $1,200

The House is scheduled to resume its floor session Monday evening.

RELATED: Dunleavy adds proposed $2,350 PFDs to special session agenda

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Dunleavy lays out steps to try to help Alaska hospitals with COVID-19 surge

Gov. Mike Dunleavy discusses the state of the coronavirus pandemic during a news conference at the Atwood Building in Anchorage on Thursday, Aug. 26, 2021. It was the governor’s first news conference about COVID-19 in months. (Matthew Faubion / Alaska Public Media)

Gov. Mike Dunleavy announced on Thursday a series of steps intended to help hospitals deal with a surge of COVID-19 cases. 

They include speeding up the process for allowing licensed health care providers to work in hospitals. The state is also looking to use state-contracted workers to temporarily staff hospitals, said Dunleavey during a news conference Thursday evening.  

“I strongly urge you to talk to your physician” about being vaccinated, Dunleavy said, emphasizing the importance of talking with someone who you know and trust. “I have no doubt most physicians will suggest to their patients that they get the vaccine.”

RELATED: Alaska reports highest daily COVID-19 count since December as Dunleavy warns about hospital capacity

The state also is considering amending hospital safety rules so that they can make more efficient use of temporary sites outside of their hospitals. The state will use its bulk-purchasing power to buy supplies for hospitals, said Dunleavy. 

Dunleavy said health care workers have been working long hours. 

And he said he’s hopeful that if Alaskans are careful and take other steps to reduce the strain on hospitals, the current surge in cases will peak and then drop over the next month. 

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Heidi Hedberg, Alaska Department of Health and Social Services public health director. (Matthew Faubion / Alaska Public Media)

State Division of Public Health Director Heidi Hedberg urged Alaskans to consider wearing masks around others and to keep their social circles small. 

She also said monoclonal antibodies are available to treat those who contract COVID-19. Those are man-made antibodies that act like human antibodies in the immune system.

Alaska Chief Medical Officer Dr. Anne Zink. (Matthew Faubion / Alaska Public Media)

State Chief Medical Officer Dr. Anne Zink noted the fast spread of the COVID-19 delta variant.

“Together, we determine where this pandemic goes,” she said, adding that there’s been a 24% increase in vaccinations so far this week compared with the same time period last week. 

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Landslide forces Denali National Park to close road near halfway point

A narrow road cuts through valleys and mountains.
The lone road through Denali National Park and Preserve. Photographed on July 25, 2020. (Tegan Hanlon / Alaska Public Media)

Road access in Denali National Park and Preserve is being restricted due to a long-running landslide issue that has been exacerbated by climate change, the park announced Tuesday.

The lone road through the park spans 92 miles. Nearly half it — the area west of mile 43 — closed Tuesday to nonessential vehicles, pedestrians and bikes because of unsafe conditions caused by a landslide in the Polychrome Pass area, according to a statement from the park.

Buses, the main way for visitors to access the park, will continue to run to mile 42.

According to the park, slides have affected the area since at least the 1960s but used to require maintenance every two to three years.

“During the 1990s, the landslide, which occurs below the roadbed, only caused small cracks in the road surface,” the statement said. “However, by 2018 the slumping increased to almost half an inch per day, and then to three and a half inches per day by August 2020.”

Rains earlier this month appear to have caused the rate to increase significantly, with much of the landslide moving downhill at over 10 inches per day, the park said.

RELATED: Indiana man stable after bear attack in Denali National Park

Climate change “has taken what was previously a problem solved by maintenance staff performing road repairs and made a challenge too difficult to overcome with short-term solutions,” the statement said.

Don Striker, the park superintendent, said the National Park Service is working with the Federal Highway Administration and other agencies on a long-term solution to maintain road access through the area.

The statement says front-country trails and backcountry access remain open, as does the Kantishna airstrip, which is near the end of the road. The visitor center, near the park entrance, will continue providing daily ranger services, the statement said.

Campers at the Wonder Lake Campground, near the end of the road, and in backcountry areas west of Polychrome Pass will be relocated to areas east of the closure in the coming days, according to the statement.

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The Wonder Lake Campground and Eielson Visitor Center, at mile 66, were closing Tuesday for the rest of the year.

The park road typically closes to vehicle traffic beyond mile 30 in mid-September.

Several days in September traditionally are set aside for winners of a special lottery to drive as much of the road as weather conditions allow. Paul Ollig, with the park, said he did not have an update Tuesday on this year’s lottery.

More than 601,100 people visited Denali National Park in 2019.

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Anchorage doctors sound alarm about ‘imminent’ hospital system collapse

A woman sits in a hospital room wearing a face mask, face shield and gown.
Anchorage doctors say that that forced isolation from COVID-19 exposure, burnout from a year and a half of pandemic, and increased patient loads are taxing healthcare workers at unprecedented rates. (Photo by Rashah McChesney/KTOO)

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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Dunleavy adds proposed $2,350 PFDs to special session agenda

A white person in a suit speaks from a podium
Gov. Mike Dunleavy at a news conference on June 17, 2021. (Andrew Kitchenman/KTOO)

Gov. Mike Dunleavy on Thursday added proposed permanent fund dividends of $2,350 to the agenda for the legislative special session. 

Without the move, it was possible Alaskans wouldn’t receive PFDs this fall for the first time in 40 years. 

The change to the agenda also would allow funding for $18 million in scholarships and need-based grants to pay for students to attend college, as well as $3.3 million for the state’s medical education program, known as WWAMI

Dunleavy is proposing to pay for this year’s PFDs and the other programs by drawing $1.53 billion from the permanent fund’s earnings reserve account. 

His proposed bill would also transfer $1.47 billion from the earnings reserve to a separate savings account, the Constitutional Budget Reserve, or CBR. This amount could be used for the budget in future years. 

Dunleavy said in a statement that he may add funding for more programs to the special session agenda, as his administration works with the Legislature. When both chambers failed to get enough votes to draw from the CBR, the programs left unfunded included oil and gas tax credits, as well as some of the funding for 16 other programs.

“Alaskans are still in recovery mode from the economic impacts of the pandemic,” Dunleavy said in the statement. “With this in mind, and following recent encouraging conversations with legislators, my administration has put forth a vehicle for the legislature to fund the PFD and student scholarships — two critical programs that directly impact Alaskans.”

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The additions to the agenda by the governor, a Republican, drew immediate praise from legislative leaders across caucus lines. 

Dunleavy originally left the appropriation bill — which includes the funding for the PFDs — off of the agenda for the third special session that started on Monday. He wanted the Legislature to focus on his proposals to amend the state constitution to include PFDs and to reduce the state limit on spending for government services. 

But legislators, including House Speaker Louise Stutes, a Kodiak Republican, said an appropriations bill for dividends and other programs was needed.

After months of back-and-forth earlier this year, the House and Senate passed a state budget that would have set PFDs at $1,100, but a failed vote to draw money from the CBR shrunk the amount to $525.

And Dunleavy vetoed that remaining amount in July, saying Alaskans would regard it as a “joke.”

But most members of the both chambers have been opposed to drawing more from permanent fund earnings than a 2018 law would allow. Dunleavy is now proposing drawing $3 billion more than that law says. 

The House and Senate are scheduled to hold floor sessions on Friday, when Dunleavy’s newly proposed bill could be introduced. 

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Earthquake may have triggered sunken fishing vessel to spill diesel off Kodiak Island, officials say

A blue ship sails in the water with mountains in the background.
Ships deploy a boom in Women’s Bay to contain a 300-foot sheen believed to be from a shipwreck disturbed by last month’s massive earthquake some 260 miles away. (Judy Heller via KMXT)

A shipwreck from decades ago has begun leaking diesel fuel off Kodiak Island. State officials suspect last month’s massive earthquake disturbed the submerged vessel.

“We know that this is a vessel that sank in 1989 in Women’s Bay and it’s been resting there since,” Jade Gamble, the state’s on-scene spill coordinator, told CoastAlaska on Friday. “It started leaking after the earthquake.”

She says it’s not clear how much diesel and other contaminants are on the former fishing vessel Saint Patrick.

“They’ve been able to minimize the leak,” she said. “Our main goal is to ensure we don’t have some type of catastrophic release.”

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The former scallop boat was hit by a rogue wave during a stormy November night in 1981 near Marmot Island. The captain ordered the crew to abandon ship. Only two of its 12 crew members survived the frigid waters.

The crippled 138-foot vessel was adrift in rocky seas for several days before being towed to shore and anchored in Women’s Bay. The tragedy was the subject of lawsuits filed by survivors and families of the victims.

Authorities say they got the first reports of a sheen less than a week after the earthquake.

The Coast Guard flew over Aug. 6 and confirmed what appeared to be a spill in about 30 feet of water.

But whether the 8.2 earthquake — the state’s largest in more than a half-century — could have been the cause isn’t clear, according to seismologists who have modeled the areas affected by the earthquake.

A map shows Kodiak Island and a purple line goes around it.
Federal authorities say the sheen’s source appears to be the 138-foot F/V Saint Patrick, a scallop boat that sunk in 1989, The sheen is a narrow band that’s roughly estimated as 300-feet long. (NOAA)

The earthquake’s epicenter was about 260 miles southwest of the Saint Patrick’s resting place in Kodiak’s Women’s Bay.

“Kodiak didn’t experience anything significant” Alaska Earthquake Center seismologist Natalia Ruppert told Coast Alaska. “And this shipwreck being even farther away from the earthquake source, I guess it’s possible.”

RELATED: Why a major Alaska earthquake triggered warnings but no major damage

Kodiak Island has also experienced major earthquakes that were much closer to Women’s Bay which would’ve produced stronger ground shaking, she said.

“I don’t know if this most recent 8.2 earthquake was the final straw that could have caused this shipwreck to move significantly,” she said. “Maybe it was a cumulative effect of these multiple earthquakes that over the years kind of reached a critical stage — it’s just hard to tell.”

A contractor is on scene helping with the containment, the Coast Guard said.

“Boom is in place and is being replaced as necessary along with absorbents to contain the sheening,” according to Coast Guard Petty Officer Ali Blackburn, a Kodiak-based spokeswoman.

The Coast Guard says it’s not clear who the responsible party would be since the vessel doesn’t appear to have an owner. It has activated the Oil Spill Liability Trust Fund and continues to monitor the situation.

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