COVID-19


July 1, 2020

As of today, in Alaska, there is a cumulative total of 978 positive COVID-19 cases, 528 recovered, and 14 deaths. The total number of current active cases {physically} in the Bristol Bay Borough is 23. Several people who were reported positive are recovered or have left the community.

Between Monday and today, we have detected nine more positive cases in seafood workers. They have all been in quarantine since arriving in Bristol Bay Borough and are now in isolation.

There is a lot of confusion when comparing the state reported cases and our cases. One reason is that we are a combined region with Lake and Peninsula Borough. Another reason is there are delays in the state reporting and when we report. We are reporting to the community as we detect cases. However, the state may delay their reporting until they have received more information regarding residency. At Camai, we feel it is essential for you to know when we are detecting cases, and we can identify if the are seafood workers, fishermen, or a resident. This information is what is vital for us for decision making. Since testing began, we have reported a total of 41 positive persons, but again, only 23 are physically in the community. Over the next few days, we expect more to leave the community to complete their isolation in Anchorage.

This week Friday, Saturday, and Sunday, we will be seeing patients at the Camai clinic instead of the Leader Creek clinic. If you need to see a provider, please call 907-246-6155 to schedule an appointment.

Free testing is still available to the community. If you are experiencing any symptoms, please call Camai at (907) 246-6155. If you don’t have symptoms but still want to get tested, walk-in testing is available at our testing site located at the BBB Pool.

All of the staff at Camai CHC wishes everyone a safe and prosperous fishing season.

If you are sick or suspect that you may be infected with the virus that causes COVID-19, you should remain at home and contact Camai CHC at (907) 246-6155.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay well,

Mary Swain

Executive Director/CEO

June 29, 2020

As of today, in Alaska, there is a cumulative total of 904 positive COVID-19 cases, 525 recovered, and 14 deaths. The total number current active cases {physically} in the Bristol Bay Borough is 26. Several people who were reported positive have left the community. For the time frame of June 20 – June 26th we processed 1821 tests.

Last week saw a jump in positive cases in Bristol Bay Borough. Although the amount may look concerning, we anticipated that to happen once the processors began bringing in their workers. All seafood workers that tested positive had been in quarantine since their arrival. The testing was conducted as part of the processors Community and Workforce Protective Plan they filed with the State of Alaska. All were immediately isolated. Close contacts were identified, isolated, and tested as well.

Over the last couple weeks have had several volunteers from Samaritan’s Purse help us with our testing site. They would swab for us, help with paperwork, and support our staff in our efforts. Without their help we could not have been able to keep up with all the behind the scenes work our staff was doing. Thank you to everyone at Samaritan’s Purse for coming along side of us to help keep the community safe. Everyone as Camai CHC appreciates you.

As the fishing season gets underway, we are pivoting our focus a little as we begin developing and testing our strategy for the opening of the sport fishing lodges in our community. We have many protocols in place and we are confident we will be able to support the lodges in their operations like we have the commercial fishing. We have reached out to Katmai National Park and are working through the needs they have and will develop a system for testing as needed.

If you are sick or suspect that you may be infected with the virus that causes COVID-19, you should remain at home and contact Camai CHC at (907) 246-6155.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay well,

Mary Swain

Executive Director/CEO

June 26, 2020

As of today, in Alaska, there is a cumulative total of 836 positive COVID-19 cases, 519 recovered, and 14 deaths. Today we reported 3 new cases in non-resident seafood workers. This brings the current active cases physically in the Bristol Bay Borough to 24. Several people who are positive have left the community. As of Thursday, June 25th we have processed 5,012 tests.

As more positives are detected in the community it is important that everyone takes precautions. We can not tell you how to do this, but we can tell you what has been proven to help and they are simple to do. Dr. Anne Zink, Alaska’s Chief Medical Officer, stated in a press release today “I also want to remind Alaskans to buckle down on prevention. As case counts continue to rise in Alaska, we must be diligent about keeping six feet away from others, wearing a cloth face covering when you’re out in public, washing your hands often and isolating and calling a health care provider to ask about testing if you’re experiencing even mild COVID-19 symptoms.”

CDC GUIDANCE: According to the Centers for Disease Control and Prevention, everyone should:

· Wash your hands often with soap and water for at least 20 seconds, especially after you have been in a public place or after blowing your nose, coughing, or sneezing

· If soap and water are not readily available, use a 60% alcohol hand sanitizer and cover all surfaces of your hands and rub them together until dry

 · Avoid touching your eyes, nose, and mouth with unwashed hands

· Avoid close contact with people who are sick, even inside your home; if possible, keep 6 feet between the person who is sick and other household members

· Stay at least six feet, about 2 arms’ length, from other people

· Remember that some people without symptoms may be able to spread virus

· Do not gather in groups; stay out of crowded places; and avoid mass gatherings

· Wear covering over nose and mouth when around others; this is not a substitute for 6’ distancing!

· Cover coughs and sneezes; if you’re in a private setting and do not have your face covering, remember to always cover your mouth and nose with a tissue then throw the tissue in the trash and immediately wash your hands or use hand sanitizer

· Clean and disinfect frequently touched surfaces daily (tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, sinks)

· Monitor your health: watch for fever, cough, shortness of breath, or other symptoms such as difficulty breathing, chills, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea

If you develop any symptoms, please do not hesitate to contact Camai CHC at (907) 246-6155 or another health care provider.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay well,

Mary Swain

Executive Director/CEO

June 24, 2020

As of today, in Alaska, there is a cumulative total of 792 positive COVID-19 cases, 507 recovered, and 12 deaths. Today we reported 8 new cases in non-resident seafood workers; however, we think there will be more in the next few hours; if so, we will report those tomorrow to the public. This brings the currently active cases in the Bristol Bay Borough to 16.

Free walk-up testing is available to anyone in the community, fishing industry, and visitors Monday – Friday 1 pm – 3 pm at the swimming pool area by the clinic, follow the signs. If you are experiencing symptoms, please call the clinic at (907) 246-6155 to speak with a healthcare provider prior to going to the walk-up site or clinic. If you are not experiencing symptoms, please use the walk-up site for testing. We recommend everyone to get tested.

As the fishing season progresses, we would like to offer some medical guidelines we use in the clinic. Today we will describe how to manage an amputation. Amputations come in many forms, as an example, it can be the tip of the finger or the whole finger.

If someone severs a limb, finger, toe, or other body parts, you should call for medical help right away. First, take care of the person, not the body part.

  1. Control bleeding by applying pressure to the wound. Raise the injured area above the heart. Only place a tourniquet if the bleeding is life-threatening.
  2. Keep the person warm and out of water.
  3. Prevent shock. Lay the person flat, raise feet about 12 inches and cover with a coat or blanket. DO NOT place the person in this position if a head, neck, back, or leg injury is suspected.
  4. Save the severed body part. Wrap the part in a clean gauze moistened with sterile saline or clean water and place it in a plastic container. Transport the container surrounded by a mix of ice and water but, DO NOT PLACE THE PART DIRECTLY ON ICE; THIS COULD IRREVERSIBLY DAMAGE THE TISSUE.
  5. Once bleeding is under control, check for other signs of injury.
  6. Stay with the person until help arrives.

We have used these guidlines in the clinic and have seen successful re-attachments from them. However, there will be times a saved part will not be viable no matter how you handle them.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay well,

Mary Swain

Executive Director/CEO

June 22, 2020

As of today, in Alaska, there is a cumulative total of 761 positive COVID-19 cases, 491 recovered, and 12 deaths. Today we reported 1 new case in a non-resident seafood worker. This brings the active cases in the Bristol Bay Borough to 8 currently. As of Friday, June 19th we have processed 3,786 tests.

Last week we reported all cases known to us. Unfortunately, the state had a failure on their provider reporting line. This caused a delay in the daily reports and showed all 7 of our reported cases in one day. We have been told the system is fixed and we should not have this problem going forward.

Now that fishing is closer and more processors are being brought in, we have begun testing bigger groups multiple times a day along with our walk-up testing. We have not set a date to close the walk-up site and if there are people coming to get tested, we plan to be open Monday – Friday 1pm to 3pm. Our next concern is the tourism traffic and we are still developing a testing strategy for that.

Medically, the clinic has been busy. We have opened the Leader Creek clinic, so we now have availability seven days a week for appointments. The Leader Creek clinic is open Wednesday – Sunday 8 am – 3 pm the number to call for an appointment there is (907) 246-4064. The main clinic is open Monday- Friday 8 am – 5 pm; however, on Wednesdays, we have staff meetings/training, so appointments are limited in the morning, but we are open until 7. As a reminder, we are asking you to call for an appointment instead of a walk-in appointment at both clinics.

This time of year, everyone is busy, and we forget to take time for ourselves. This can lead to accidents. Slow down when you are around heavy equipment or fishing gear. According to OSHA, 12% of fishing related injuries are a result of slips, trips, and falls and 8% are a result of exposure to harmful substances. At Camai this translated to lacerations, concussions, amputations, and breathing difficulties sometimes resulting in the need for a medevac. Taking your time and ensuring your workspace is free of debris and hazards can help prevent injury. We want everyone to have a safe and prosperous fishing season.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay well,

Mary Swain

Executive Director/CEO

June 17, 2020

As of today, in Alaska, there is a cumulative total of 696 positive COVID-19 cases, 438 recovered, and 12 deaths. Today we issued a press release reporting 3 new identified cases, of which one is not located in Bristol Bay Borough. This brings the active total for Bristol Bay Borough to 4 however, 1 has left the community.

As I have been reporting for weeks now, with all the testing we are doing and the number of people that come to our community, we are bound to get positives and that is happening. Because all but one of our current cases have had negative results prior to the positive one, we are confident we are catching them early. Everyone at Camai CHC is taking every precaution we can to ensure the community is protected. We need the help of everyone to keep any case from becoming a situation where we have spread within the community.

CDC GUIDANCE: According to the Centers for Disease Control and Prevention, everyone should:

· Wash your hands often with soap and water for at least 20 seconds, especially after you have been in a public place or after blowing your nose, coughing, or sneezing

· If soap and water are not readily available, use a 60% alcohol hand sanitizer and cover all surfaces of your hands and rub them together until dry

 · Avoid touching your eyes, nose, and mouth with unwashed hands

· Avoid close contact with people who are sick, even inside your home; if possible, keep 6 feet between the person who is sick and other household members

· Stay at least six feet, about 2 arms’ length, from other people

· Remember that some people without symptoms may be able to spread virus

· Do not gather in groups; stay out of crowded places; and avoid mass gatherings

· Wear covering over nose and mouth when around others; this is not a substitute for 6’ distancing!

· Cover coughs and sneezes; if you’re in a private setting and do not have your face covering, remember to always cover your mouth and nose with a tissue then throw the tissue in the trash and immediately wash your hands or use hand sanitizer

· Clean and disinfect frequently touched surfaces daily (tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, sinks)

· Monitor your health: watch for fever, cough, shortness of breath, or other symptoms such as difficulty breathing, chills, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea

If you develop any symptoms, please do not hesitate to contact Camai CHC or other health care provider.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay well,

Mary Swain

Executive Director/CEO

June 12, 2020

As of today, in Alaska, there is a cumulative total of 625 positive COVID-19 cases, 403 recovered, and 12 deaths. The new case that was reported in the combined Lake & Peninsula, Bristol Bay Borough today is NOT in Bristol Bay Borough. It is a contact to one that was reported earlier this week in Lake & Peninsula Borough.

We are incredibly pleased to report the 2 positive cases that have been in Bristol Bay Borough are now cleared and are reported as recovered by the State of Alaska Public Health. The fact they were identified early by testing and were quarantining and isolating as appropriate allowed for no further spread.

This week Camai CHC performed 777 tests for a combined total since May of 2,023. I have attached pictures of some of our send-outs this week. Each is over 200 tests.   Our testing site at the pool is currently open from 1-3 Monday through Friday. We have been asked by many if we will have alternate hours because of crews coming in on Thursday and Friday and later flights in the day, yes, we will. I will post alternate hours next week, and we will have signs on the road and our testing site with those times. We may also be open on Saturday as well next week. Stay tuned for more information.

I would like to express my sincere appreciation to Sharon Schroeder for all her years at Camai. Many years ago she was the captain of the King Salmon EMS team and I had the privilege of working with her then and the last 3 years at Camai with her have been some of the best times I can remember. Her unwavering support for patient rights is admirable. She is compassionate and caring to all of those she meets. I will miss her mentoring and leadership. When you see her around town, please wish her well in her retirement. She will be missed greatly by all of us.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay well,

Mary Swain

Executive Director/CEO

227 tests ready to be shipped to Anchorage
245 tests to be shipped to Anchorage – We have decided fish boxes work extremely well for this.

June 10, 2020   

As of today, in Alaska, there is a cumulative total of 593 positive COVID-19 cases, 392 recovered, and 11 deaths. There are 2 active positive cases in Bristol Bay Borough. The patients have been in quarantine since arrival, they are now in isolation and the community is not at risk of exposure. Both patients continue to be symptom free. Retesting has started and will be done in intervals throughout the next couple weeks.

Testing remains to be a big part of our daily tasks. Today, we performed 69 tests. We are experiencing an issue with receiving the results back from the state lab for those that we send in. Some days we get them quickly, other times it takes up to 8 days. We are working with the state on this and unfortunately, we do not have all the answers yet. Although we are not getting the results back timely, they are being processed within 2-3 days if not sooner, this means we will know if someone is positive within a couple of days. We continue to have results available every day for pick up at the testing site. You can also email covidresultscchc@outlook.com  to inquire about your results. If you have a positive result, we will call you and Public Health will call you also to begin their investigation.  

On Monday I discussed commercial fishing mandates and that brought up what the mandates are for Alaska residents who come out to Bristol Bay Borough for subsistence fishing. As of now, if you live in Alaska and travel here to visit family or to subsistence fish there are not any mandates for quarantine and testing. However, I would caution you to please take all safety precautions such as wearing a mask in public, keeping physically distant from those who are not in your household, and not go into crowded spaces. Remember, if you are commercial fishing, even if coming from another Alaska community, you must follow health mandate 17. The only guarantee we all have for not getting this virus is to not be exposed to it.

I was also asked about lodges and what mandates pertain to them. This is more complicated. The lodge worker are considered critical infrastructure and if the lodge has people arriving from out of State or moving between Alaskan communities, they are required under HM10 and HM18 to submit a Community/Workforce Protective Plan to cover travel/quarantine procedures for their employees. The clients however are not critical infrastructure and must follow health mandate 10. Here is an outline of what is expected:

Requirements for Residents or Visitors: All residents or visitors arriving in Alaska from outside the state must self-quarantine for 14 days unless the traveler falls under one of the following four categories (a, b, c, or d, below):

A. Pre-travel molecular-based test for SARS-CoV2:

  1. The traveler produces a molecular-based test for SARS-CoV2 result showing that the traveler tested negative for COVID-19 within 72 hours before departure to Alaska; OR
  2. The traveler produces a molecular-based test for SARS-CoV2 result showing that the traveler tested negative for COVID-19 within five days before departure to Alaska and the traveler obtains a second molecular-based test for SARS-CoV2 upon arrival in Alaska, and minimize interactions until the second test result is received and that test is also negative;
  3. All travelers with negative results from a pre-travel test will need to minimize interactions until (1) they receive negative results from the second test for COVID-19; (2) for 14 days after arrival; or (3) they leave Alaska, whichever is soonest. If a second test is needed, they will receive a voucher upon arrival.

B. Molecular-based Test for SARS-CoV2 upon arrival:

  1. The traveler obtains a molecular-based test for SARS-CoV2 upon arrival in Alaska that shows the traveler is negative for COVID-19. The traveler must self-quarantine, at their own expense, while waiting for the test results. The traveler will receive a voucher for a second test that must occur within 7-14 days after arrival and should minimize interactions until the result from the second test shows the traveler is negative for COVID-19.
  2. If the molecular-based test for SARS-CoV2 comes up positive, the traveler must isolate at their own expense, and will not be able to travel unless cleared by public health.

C. Prior confirmed positive results:

  1. No molecular-based test for SARS-CoV2 is required for either immediately before travel or upon arrival, if all three (3) of the following conditions are met:
  2. The traveler shows evidence of previously positive results of a molecular-based test for SARS-CoV2 that occurred at least three weeks prior to arrival in Alaska; and
  3. The traveler is currently asymptomatic; and
  4. The traveler can show a medical provider’s note of recovery.

Alaska residents who travel out of state for a period of five days or less are not required to be tested before leaving (note: destination state or nation may have testing requirements) or prior to returning to the state.

I hope you find our updates to be informative and if there is a subject you would like to know more about, please do not hesitate to reach out to me.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay well,

Mary Swain

Executive Director/CEO

June 8, 2020

As of today, in Alaska, there is a cumulative total of 563 positive COVID-19 cases, 384 recovered, and 10 deaths. There are 2 active positive cases in Bristol Bay Borough. The patients have been in quarantine since arrival, they are now in isolation and the community is not at risk of exposure. Both patients continue to be symptom free. Retesting has started and will be done in intervals throughout the next couple weeks.

Staff went to South Naknek and tested anyone who wanted a test. We had 20 people show up for a test. We will try and go to South Naknek again at least one more time.

We may change the hours of our testing site later this week to morning hours. We would like to be able to run as many same day tests as we can and if we offer walk up testing in the morning it will allow for more time for those tests to be ran. Just a reminder that we have a new protocol for testing results. We may not call you, we will have your results available for pick up during testing times or you may email covidresultscchc@outlook.com to inquire about your results. All positive test results will be called by us and public health.

I have received a lot of calls regarding quarantining if you are commercial fishermen. Health Mandate 17 still applies to all commercial fishermen and the quarantine requirement has NOT been removed. Please be mindful of our community and do you part to follow the recommendations and mandates. If you are just arriving to Alaska do not visit local public spaces such as the post office, store, or any eating establishments while in quarantine. All businesses in Bristol Bay Borough welcome you back for the fishing season but we want to protect our employees as well. I have not heard of any business that will not allow you to call in an order and/or offer curbside pick-up or delivery. There are a couple businesses that offer delivery services for a reasonable rate, please use them. If you need to pick up packages/mail at the post office, call them to find out what you need to do before going there.

I have also received calls for fishing lodges about their requirements. I asked the State of Alaska Unified Command what exactly needs to be followed for them. I got a response, but I have not had a chance to look at it close enough to give credible information. I will include that in my Wednesday update.

As always, Camai Community Health Center stands ready to do all we can to help the residents and fishing industry in Bristol Bay Borough. We have remained open for the entire pandemic and we will remain open to anyone who needs to come in for care.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay well,

Mary Swain

Executive Director/CEO

June 5, 2020

As of today, in Alaska, there is a cumulative total of 524 positive COVID-19 cases, 380 recovered, and 10 deaths. There are 2 active positive cases in Bristol Bay Borough. The patients have been in quarantine since arrival, they are now in isolation and the community is not at risk of exposure. Both patients continue to be symptom free. Retesting has started and will be done in intervals throughout the next couple weeks. We have begun testing our staff weekly to ensure we catch any exposure early.

Tomorrow, June 6th we will be in South Naknek for testing. Staff will be in the area around the library between 11:30 and 1:00pm. If you would like a test, please stop by, anyone can get a test. Our hope is to be able to do this a couple times during the season to ensure anyone who needs a test can be tested.

Camai has done 1,248 tests since May 1st, and this week we have done 442. Walk-Up testing is still available between 1pm – 3 pm Monday – Friday. We schedule groups of 10 or more around that time. A new process has been developed for receiving test results, I will include it with this update. We can test anyone who would like a test.

This week we invited providers from the area to meet with the Medical Director and providers that will staff the Samaritan’s Purse (SP) field hospital. They were able to hear about the experience’s SP had in Italy and New York and ask questions. Being able to talk with those that have been on the front lines of this virus was invaluable to the providers.

All but 1 of our summer Medical Providers have arrived.

Timothy Jones, PA

Amy Cantrell, PA – Amy is taking the lead on our testing program

Kiira Christianson, PA

Lorraine Depree, PA

Erica Foster, MD – Many of you know Erica and her family. She was raised in Bristol Bay

Riley Bennett, PA – Riley will arrive at the end of June and be here through July

Jamie Millar, RN – Jamie is working with Amy on our testing program

 Of course, we also have Teresa Catlin, NP and Gayle Claus, NP as we do for the entire year. Katie Van-Atta, PA was with us all of May and will return for the month of August.

Camai remains committed to seeing all patients, as we have done for over 30 years. Please do not hesitate to contact us with any question you may have.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay well,

Mary Swain

Executive Director/CEO

June 3, 2020

As of today, in Alaska, there is a cumulative total of 505 positive COVID-19 cases, 373 recovered, and 10 deaths. There are 2 active positive cases in Bristol Bay Borough. The patients have been in quarantine since arrival, they are now in isolation and the community is not at risk of exposure. Both patients continue to be symptom free. Retesting has started and will be done in intervals throughout the next couple weeks. We have begun testing our staff weekly to ensure we catch any exposure early.

There is not anything new to report today so I thought I would discuss another service we offer. At Camai we know that a person’s mental health can have a significant impact on their overall wellness. Previously we discussed some ways to cope in times of increased stress and now that the fishing season is ramping up, I think it is time to review these tips.

  •  Try to get at least 30 minutes of outside activity every day. Walks, biking, jogging, or playing with kids and pets can help us stay active. Activity, fresh air, and sunshine help our bodies and minds.
  • It is normal to feel fear or anxiety when facing uncertainty, or to be less productive than usual. Cut yourself some slack, you have never done this before!
  •  It can be helpful to put energy into things we have control of rather than things we do not. That helps us feel effective rather than powerless.
  • Take care of yourself even as you care for others. We must remember to prioritize our well-being so that we are healthy enough (mentally and physically) to continue caring for others. 
  • Structure and routine bolster our sense of safety and ability to manage stress. Little things like consistent bedtimes, predictable schedules, and daily hygiene can boost our mental health.  
  • You might try setting an hourly chime on your watch, when it goes off, take a breath, look inward and notice what sensations you are experiencing. If there’s discomfort, that is a cue to intervene with mindfulness, exercise, self-care, or doing something that brings you joy.
  • It is worth noticing the relative temporary nature of our present challenges, this will pass, we will grow, and life will go on despite the challenges ahead- that can be hard to remember.
  • Our personal histories and genetics impact our response to stress and fear. Previous exposure to trauma makes us vulnerable when facing future traumas. Be forgiving towards yourself, you are doing the best you can. If you are not doing the best you can, there is always tomorrow!
  • Look for meaning in the present moment. Maybe this is the year to start that garden. Maybe stripping nets is a father son activity this year. Time to build a new steam? Seagull eggs anyone?
  • Although many things are currently out of our control, there is much that we can do, we can wash our hands, do acts of kindness for elders and loved ones, sew masks, spend quality time with our kids.
  • Look for signs of safety. Notice that despite everything, people are still helping other people, good still outweighs bad, the fish still return, berries grow. We have much to feel safe about!
  • We must remind ourselves that wearing masks, social distancing and other precautions are not because the present environment is so dangerous. These precautions are a collective effort to protect one another- our sacrifices are out of concern for the most vulnerable among us.
  • Practice gratitude. Look for things to be thankful for, take time to meditate, pray, or reflect on those in your life who bring you joy.
  • Fear can hijack our brains and bring out our worst impulses. If we are self-aware and notice our fear, we can consciously choose to respond to it rather than react.
  • Did you know that taking care of your mental health boosts your immune system?
  • It can be helpful to remind ourselves that our kids will remember this moment for the rest of their lives, how do we want them to remember us and how we behaved during this moment of global challenge?
  • These days it is easy to be overwhelmed with scary information that activates the most reactive parts of our brains. Limiting how much information we ingest can help us maintain perspective.
  • Try to “catch” other people doing nice things, look for signs of strength and consistency-they are everywhere if we are looking for them.
  •  Extend kindness and grace to those around you, remember that everyone is having their own reaction and that those reactions are informed by their personal histories and experiences that you (and maybe they) are not aware of. None of us have been through a “global pandemic” before, be forgiving!

Camai has been offering mental health services since 2014 and we are proud to be continuing that work during this time. Due to changes in federal and state regulations we have additional opportunities to utilize video for support in ways not typically available. Now is a great time to reach out for support!

If you are interested in speaking with a mental health professional or learning about services available, call our behavioral health director Pete Tallman at 469-1111 or ask your primary care provider for information at your next visit. 

Pete has been working with all the staff since COVID-19 has begun and we all appreciate his compassion and thoughtfulness during our time of increased stress. Do not hesitate to reach out to him.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay well,

Mary Swain

Executive Director/CEO

June 2, 2020

As of today, in Alaska, there is a cumulative total of 487 positive COVID-19 cases, 371 recovered, and 10 deaths. There are 2 active positive cases in Bristol Bay Borough. The patients have been in quarantine since arrival, they are now in isolation and the community is not at risk of exposure. Both patients continue to be symptom free. Retesting has started and will be done in intervals through out the next couple weeks.

Yesterday, June 1st, was a busy day. I apologize for the delay in the update.

Samaritan’s Purse arrived with the field hospital. Currently they are just staging the equipment but not setting it up completely. This will allow for a quicker response time when needed. For clarification, the hospital will be set up inside a building and not outside.  We are now working with the team on transfer criteria, and logistics. This will include working with EMS and the Police department.

Camai also received our stand-alone exam room that has been placed behind the clinic. This offers an additional space to see patients and allows for separation from the main clinic to limit exposure. We are working to get the generator and once that happens, it will be ready to start seeing patient there, if needed.

Work on the pad for our isolation/quarantine facilities should be finished in a couple days. The units are here and as soon as the pad is finished, we will have them placed and the utilities installed. Then they will be ready if needed. We are working on admission criteria for these units as well.

Patient visits are still unlimited at the clinic. If you are in need of primary, urgent, sick, or emergency care. We are staffed to allow for the safety of all patients and staff. Please do not hesitate to call for an appointment.

Camai is looking for person{s} to hire for janitorial/sanitation services for June and July. If you or someone is interested, please let me know.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay well,

Mary Swain

Executive Director/CEO

Clinic in a Can – Photo Credit Denali Moorcroft
Inside the Clinic in a can

Camai Community Health Center, INC

Naknek, Alaska

FOR IMMEDIATE RELEASE: MAY 29, 2020

COVID-19 | 2 POSITIVE CASES IN BRISTOL BAY BOROUGH

We have detected 2 positive test results for COVID-19 in Bristol Bay Borough. The individuals are not acutely ill and are in isolation. They have been in quarantine since arriving in Bristol Bay Borough.

Camai Community Health Center and Alaska Public Health officials have made contact with the individuals and will continue to monitor their condition to ensure continued self-isolation. Public Health officials have initiated a contact investigation and will reach out to any person who may have come into contact with these individuals. Public Health will notify and isolate additional persons as appropriate.

We want to assure the public that we are working closely with Alaska Public Health to identify anyone who may be at risk for having contact with this individual. We will keep the public informed of any information that is needed for community health and safety. The individuals are non-seafood related workers or fishermen. The State of Alaska daily reporting will not show as Bristol Bay Borough positive cases because they are not local residents. They were identified through the walk-up clinic and the positive results were detected with Camai CHC’s in house point of care device. If you would like to be tested for COVID-19 our walk-up testing site is open 1PM – 3PM Monday – Friday across the parking lot of the clinic. Testing is free to anyone who would like a test.

We also want to encourage our community to continue to follow the Centers for Disease Control (CDC) recommendations for precautionary measures such as handwashing, social distancing and mask wearing in public which can be found at www.CDC.gov.

If you are sick or suspect that you may be infected with the virus that causes COVID-19, you should remain at home and contact Camai CHC; you should also take steps to help prevent the disease from spreading to people in your home and the community. Additional information on COVID-19 is available through the Alaska Department of Health and Social Services (DHSS) at www.coronavirus.alaska.gov.

If you are not sick, please continue to take precautionary measures to stay healthy:

  • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
  • Cover your cough or sneeze with a tissue, or cough or sneeze into your elbow.
  • Clean frequently touched surfaces and objects daily (e.g., tables, countertops, light switches, doorknobs, and cabinet handles) using a regular household detergent and water.
  • Avoid visiting public places as much as possible
  • Wear a mask when out in public
  • Maintain social distancing (keep six feet of distance between you and others) when out in public.

# # #

May 27, 2020

As of today, in Alaska, there is a cumulative total of 412 positive COVID-19 cases, 364 recovered, and 10 deaths. Although there are cases in Southwest Alaska including Lake and Peninsula Borough there are NONE in Bristol Bay Borough.

Today was the first day of our testing site and we collected over 40 samples. All the ones we collected will be shipped to Anchorage for the results. Our Cepheid point of care machine was installed, and we will begin using it tomorrow. The testing site is still a work in progress so please be patient with us over the next couple of days as we work out the bugs. Please follow the sign and if you have any questions, do not hesitate to ask. Next week we will have different hours and will update you on what they will be on Friday.

Just a reminder, if you are being seen for an appointment in the clinic, we ask that you do not bring extra people with you to the appointment. We will begin taking temperatures with a non-contact infrared thermometer this week for all patients when they enter our clinics. We have also begun using a digital device for all your paperwork and screening questionnaires. Let us know what you think of this process. We have a limited number of devices so if there are multiples in use you may have to fill out the paper documents or you may be able to check in online with your smartphone. Ask the front desk for more information when you call for your appointment and they will be able to help you with this. The number that will send you the link for check in will not be a 907-area code but will have our information in the text you receive. Smart phone check in is not available for all appointments and may not be available for same day appointments.

Thank you for all your support over the last few months as we prepare for the season. If you have any questions or need more information, please do not hesitate to reach out to me.

Staff has not had time to study all the new CDC guidance’s that I discussed last week. We hope to have more information on these topics by the end of the week.  

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay well,

Mary Swain

Executive Director/CEO

May 22, 2020

As of today, in Alaska, there is a cumulative total of 404 positive COVID-19 cases, 356 recovered, and 10 deaths. Although there are cases in Southwest Alaska including Lake and Peninsula Borough there are NONE in Bristol Bay Borough.

Our testing site will open on Wednesday, May 27th at the pool across the parking lot from the clinic for walk-up/drive-up testing. The hours will be Monday-Friday 1:00pm – 3:00pm. Appointments are not needed but we do ask you to follow all staff direction, such as stay in your car, or to wait in a certain spot if there are too many people in the building at once. Here is a list of rules for the testing site – all are subject to change.

  • If your group is larger than 10 people, we ask you to call for an appointment for your group. We will be scheduling groups outside of the walk-up/drive-up time of 1-3pm. The number to call to schedule a group is (907) 246-6155 and state you would like to schedule a group for testing.
  • The testing site is for persons who do not have symptoms. If you have symptoms, please call the clinic for an appointment – (907) 246-6155.
  • All persons are to enter the testing site through the back door; there will be signs.
  • All persons are to wash their hands as soon as they enter the testing site. Please allow for distance between yourself and the person in front of you; do not crowd the washing station.
  • All persons are to wear face coverings prior to and after having their test.
  • You will be required to fill out paperwork, including a screening tool, prior to the test. We will collect your date of birth and social security number. This information is vital for the reporting of an infectious disease as well as Camai’s grant reporting. We will need a good contact number for you so we can reach you with results.
  • Currently there is not a charge for testing. However, we may need to charge in the future if grant funds run out.
  • The provider doing the test will decide on which test you will get {rapid or send out}. Each case will be decided individually based on your circumstance. Although we have enough testing supplies for the site there is a limit to the number of rapid tests we can perform, based on available inventory.  
  • Depending on the test you get, is the time frame for results. If you get a rapid test, you will receive those results by the end of the day. If we send your test out, it may take up to 4 days for the results.
  • All rapid tests that are negative will be sent to the state of Alaska lab for confirmation. During that time, you will be reminded to practice all safety precautions and/or quarantining.

The State of Alaska is committed to supplying Camai CHC us with the supplies needed to comply with all fishing mandates. However, testing is not limited to the fishing industry. If you are not sure if you qualify for a test: the answer is YES, you can get tested at our site.

Today the CDC put out new information on Serology {antibody} testing. I have included the link here but will address it in its entirety next week after discussing it with our providers and state officials. There is still a lot of unknowns regarding COVID-19 and the CDC is warning using this kind of testing for confirmation of being infected/exposed to the virus.

https://www.cdc.gov/coronavirus/2019-ncov/lab/serology-testing.html

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay well,

Mary Swain

Executive Director/CEO

May 20, 2020

As of today, in Alaska, there is a cumulative total of 402 positive COVID-19 cases, 352 recovered, and 10 deaths. Although there are cases in Southwest Alaska, including Lake and Peninsula Borough, there are NONE in Bristol Bay Borough.

We have been watching and staying in contact with our neighboring partners at BBAHC regarding the cases that have been reported in Dillingham and the Lake and Peninsula Borough. One was a seafood worker and the other was not. The seafood worker was in monitored quarantine and to comply with state mandates needed to be tested to come out of quarantine. The person was tested 12 days into the 14 quarantine and was found to be positive. The company immediately isolated him, later transporting him from the community, and the other workers tested negative. However, because of the close contact they had, all the remaining workers have restarted their quarantine and will be tested again 1) if they develop symptoms or, 2) in order to end their quarantine. This case, as well as the 6 other seafood workers in Alaska that have tested positive have been in quarantine and so far, no one in close contact have tested positive. We know distancing ourselves from others works, this can lead us to believe that if quarantine is done properly, it can work as well to help fight spreading the virus.

We are still testing large and small groups of people. Next week we will begin to offer a specific time for walk-up/drive-up testing for individuals and groups of less than 10, this will take place at the pool building next door. If you have a group of more than 10 people, we ask that you contact the clinic to schedule a time for your testing. We want to refine the process and streamline our response so this is a test for how we will handle our testing site moving forward. On Friday, I will announce the times we will be open at the testing site. We have ordered signs to help guide you as you come to the site as well, but they are not here yet. Thank you for your patience as we prepare for the larger influx of workers into the community.

We know the stress of being in quarantine can make life hard, but it is the best way to protect yourself.  As the state begins to “open up”, you will have to be aware of local restrictions when you travel outside of Bristol Bay Borough. Many communities will be putting into place their own restrictions. We have not heard of any for Bristol Bay Borough, outside of the revised state issued fishing mandates, but if we do, we will include them in future updates.

Once again, I feel the need to compliment the work the clinic staff is doing. Between testing, training new staff, and seeing patients, everyone is doing a great job. We are incredibly lucky to have a clinic staffed with so many people who genuinely love being here and want to do everything they can to keep our community healthy. Thank you from the bottom of my heart.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay well,

Mary Swain

Executive Director/CEO

May 18, 2020

As of today, in Alaska, there is a cumulative total of 399 positive COVID-19 cases, 345 recovered, and 10 deaths. Although there are cases in Southwest Alaska there are NONE in Bristol Bay Borough.

As we hear about testing more and more in the news, I thought I would discuss a little about that today. There is a report circulating stating the Abbott ID Now machines are missing about 30% positives: giving a false negative. While we cannot dispute the report, we do understand how it can miss a positive. As previously reported, it takes 127 virus genomes for the Abbott test to report positive. To get to that many genomes in a sample typically means a person has symptoms. If the symptoms are early, late, or not severe, you may not have enough genomes in your nasal sample to produce a positive result. In Alaska, the state has decided, prior to this report, they would like all negative resulted Abbott tests to be sent to the state lab for verification. This is because it only takes 3 virus genomes for the type of test the state lab performs. As of Thursday, May 14, all Abbott negative resulted tests the state lab has processed have in fact been a negative. Therefore, if we test you with our Abbott ID Now machine and it is a negative, we will ask you to continue to self-quarantine/physical distance yourself from others until we receive confirmation from the state of a negative result. All positive Abbott tests that have been verified by the state lab have also been true positives; we can be confident of all positive results.

Later this week the installer for our Cepheid 16 port testing machine will be here. Once we have that installed, staff is trained and we have done a few sample groups, and our additional staff are on site, we will be ready to open our testing site. Although we will reserve some tests for symptomatic patients, we will be able to test more people at once with this machine and have the results within an hour. We have some internal processes to work on for this such as who, and when we will use the point of care machines. But rest assured, if you need a test, we will be able to test you now and in the future.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay well,

Mary Swain

Executive Director/CEO

May 15, 2020

As of today, in Alaska, there is a cumulative total of 388 positive COVID-19 cases, 343 recovered, and 10 deaths. Although there are cases in Southwest Alaska there are NONE in Bristol Bay Borough.

Yesterday we co-hosted a group of state, federal, tribal, and security officials. This meeting lasted several hours and included a tour of the King Salmon Clinic, a visit with officials from the King Salmon Tribe, a tour of Camai and the areas our testing site and quarantine/isolation facilities will be, and it ended with a call in teleconference at the Borough building. We were able to discuss our concerns and all the preparations we are doing. The officials were able to provide valuable feedback, suggestions and answered many questions. Heidi Hedberg, director of Public Health, offered to hand carry the tests we preformed that day to the lab for us and we took her up on the offer.

Dirt work has begun for our additional facilities and we made the payment for the “ER in a can” that we are purchasing. This is a 20-foot container that is equipped as a standalone ER. We will position the container behind the clinic for ease of ambulance loading and unloading, if needed. At this point we envision it being the room we treat suspected or confirmed COVID patients, however this may change as we work on protocols.

We got confirmation from the University of Alaska Medical Assisting, School of Allied Health, program that they will be able to help us with our testing site. This is great news to all of us. We have worked with their staff for a few years and this partnership continues to grow in many ways. We are grateful for the help they will be offering this summer.

Next week, if everything goes well, the installer for our 16-port point of care COVID testing machine will be here to install and train our staff. As soon as the controls for the machine come in, they will be here to set it all up.

We have put together a document that we hope you will find helpful in determining if symptoms you are experiencing are related to COVID, or other common illnesses. If you have symptoms, please do not hesitate to contact the clinic, and speak with a provider. We may ask you to come to the clinic for a visit or we may be able to do a telemedicine visit or we may do a home visit depending on your circumstances. We do not want anyone to feel they cannot be seen. Our priority is the health and safety of our patients.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay well,

Mary Swain

Executive Director/CEO

May 13, 2020

As of today, in Alaska, there is a cumulative total of 383 positive COVID-19 cases, 338 recovered, and 10 deaths. Although there are cases in Southwest Alaska there are NONE in Bristol Bay Borough. Camai has tested 295 people so far this week.

Work has begun on the land that our quarantine/isolation facilities will be put on. Today the brush is being cut down, next it will be leveled it and then gravel will be laid. We are still deciding whether a well needs to be drilled or not. We choose this place for the building because the sewer connection is close by.

Tuesday, we co-hosted a team from Samaritans Purse and Bryan Fisher, Incident Commander for the State EOC, on their visit to decide on the right place for the field hospital. They met with several community members from Lake and Peninsula Borough, Bristol Bay Borough, Naknek Native Village Council and South Naknek Village Council. Then we met with the Air Force for a walk through of the facilities they will use for their response. Today, Samaritans Purse send out a couple employees who have been part of their response teams in New York City and Italy to train our staff and EMS on proper PPE, IPE, and sanitation. They shared stories of their experiences and spent time going over our specific protocols for testing. One point they made very clear during the training was that washing your hands and not touching your face and wearing a mask are HIGHLY successful in helping to stop the spread of COVID-19. This was invaluable training and we are very appreciative of the support they are offering the clinic, staff, and community.

Tomorrow we will co-host several members of the state Emergency Operations Center to include: State Medical Director- Dr. Anne Zink, Commissioner of DHSS – Adam Crum, Director of Public Health – Heidi Hedberg, Medical Director for ANTHC – Dr. Onders, Sr. Medical Officer for US Homeland Security – Dr. Alex Eastman and his Chief of Staff – Jeff Birks, Chief of Staff to Governor Dunleavy – Ben Stevens and President of Denali Universal Service – Bob Kean. They will be here to meet with the fishing industry, walk through the site plan for the Samaritan’s Purse response, met with us on our response efforts and lastly they will hold a teleconference community update that will air on KAKN and KDLG. We look forward to meeting with them.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay well,

Mary Swain

Executive Director/CEO

May 11, 2020

As of today, in Alaska, there is a cumulative total of 381 positive COVID-19 cases, 328 recovered, and 10 deaths. Although there are cases in Southwest Alaska there are NONE in Bristol Bay Borough.

This week we will be meeting with state and other partners for our COVID-19 response. Tomorrow the team in charge of the field hospital will be here. They will meet with the Borough, Camai CHC, Airport personnel, and SAVEC, among others. Then on Thursday Homeland Security and State of Alaska Unified Command members will meet with us and the fishing industry as well as many others from the community. These meetings will allow for all the plans to be visualized and any remaining questions we or they have should be answered.

Our 16 port Cepheid testing machine and testing supplies should be shipped tomorrow or Wednesday. Training will be completed this week for those as well.

We have begun testing a new registration platform to use in the clinic and we will have a smartphone option available as well. All screening information will be done on an iPad in the office with the ability for payment/co-payments to be collected on the device at the same time.

Recently I have begun sampling communication platforms to use during the fishing season to inform people of changes as we implement them or other important information. We should have this arranged by next week. This will allow for us to send out text messages to fishermen, processors, and community members, who have cell phone capabilities, of important information. We will work the local radio stations to put out the same information as a back up for those who do not have cell phones. More information to come on that.

Today I want to take a moment to applaud the work that our lab and provider staff are doing for COVID testing. This is an overly complicated undertaking and they have developed a system and streamlined the process. The amount of paperwork that it takes to send one test out is crazy but, they are handling it like the true professionals they are.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Mary Swain

Executive Director/CEO

May 8, 2020

As of today, in Alaska, there is a cumulative total of 377 positive COVID-19 cases, 305 recovered, and 10 deaths. Although there are cases in Southwest Alaska there are NONE in Bristol Bay Borough.

This week we have been working on a lot of planning. Ordering more supplies, working with contractors, and more policy and procedures. We have inspected the quarantine/isolation facilities prior to them getting on the barge to Naknek. They will be put on a barge next week and will be in Naknek around May 31st. We are identifying the placement and hope to have work started on the site next week. We have identified the supplies we will have available to those who will be staying there and have all of that on order.

Testing has taken a turn to the better. Camai will be receiving a 16-port point of care testing machine. This will allow for 16 tests to be run at the same time and have results within 45 minutes. However, we will not be using this for testing a large group of people without symptoms unless a provider deems it necessary. Our hope is to have it within the next couple weeks. This will increase our availability for point of care testing with results available the same day. As reported previously we have begun testing groups. This has gone well. Next week we will test larger groups.

During this process we have identified a weak area that we are working to resolve. Camai must adhere to HIPPA laws. This regulates patient information and who it can be shared with. Therefore, we are unable to notify an employer of a patient’s test results. The way to remedy this is for employers to have a release from their employee to allow us to share results with them. We are still working through this issue and are optimistic we will have a solution. In a processing plant it is particularly important for plant management to have his information as soon as possible so they can begin taking the necessary actions to protect other employees and isolate those who may need to be.

Congratulations to the Senior Class of Bristol Bay Borough! Everyone at Camai is proud of your accomplishments. We look forward to celebrating with you when the time allows for us to do it in a safe manner.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Mary Swain

Executive Director/CEO

Mom of a BBBHS senior

May 6, 2020

As of today, in Alaska, there is a cumulative total of 372 positive COVID-19 cases, 284 recovered, and 10 deaths. Although there are cases in Southwest Alaska there are NONE in Bristol Bay Borough.

This week we have secured facilities for isolation and quarantine needs that would arise if/when COVID-19 comes to Bristol Bay Borough. The total capacity will be 19 beds to begin with but can be expanded by a couple more if needed. Although we know that this is not enough if we get a big outbreak, it is what we know we can manage without outside help. If we get more than this, we will be calling the state for additional help. That help will come to us as a 20-bed field hospital staffed with the medical staff needed to run it. They would be an extension of Camai and we will, and have, been working closely together on planning this.

We have been in many meetings with the State of Alaska regarding changes to quarantine and testing. Through those conversations we have been told that Mandate 10 will be amended and seafood workers that reside in a bunkhouse situation will have additional rules to comply with. One of which will require testing at least two times during their quarantine phase. We have begun practicing our testing protocols with a few processors that have staff in town currently. We want to make sure we identify any complications, risks, and details we might have missed in the planning phase. All of this is to ensure we have a process in place to do the testing that will be necessary safely and efficiently. You may notice in the next few days the number of test performed in our region jump and that is not because we suspect the virus to be here, although we may find out it is, but because we are doing some sample testing of those who are in quarantine currently.

As the state begins the process of relaxing some mandates, we would like to remind everyone they MUST call before coming into the clinic. We have many protocols in place for everyone’s safety and want to be able to direct patient traffic to the appropriate places. We are still seeing patients for primary, routine care however, we do not want to mix sick patients with healthy ones. Thank you for your understanding on this issue.

I feel I need to take a moment to compliment the work the staff is doing at Camai. This has been an incredibly stressful time for them. Between the stress of taking care of the medical needs of the community they have been instrumental in the planning for a pandemic all the while transitioning to a new electronic medical record program. This program is what they use for everything they do in the clinic. Everyone has stepped up to do more than asked or required and have done so because they care about everyone in the community. I give a big heartfelt thank you to everyone of them.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay well,

Mary Swain

Executive Director/CEO

May 1, 2020

As of today, in Alaska, there is a cumulative total of 364 positive COVID-19 cases, 254 recovered, and 9 deaths. Although there are cases in Southwest Alaska there are NONE in Bristol Bay Borough.

There is not much to report today. We continue to make plans and practice protocols. Next week we hope to have our Abbott ID Now point of care testing machines installed and training for staff. Currently all COVID testing must be sent out to the State lab, this will help our ability to have results quicker. We will also have time to be comfortable with the machines and how they work prior to the big in haul.

Tonight, we were officially notified that a grant I wrote for a portable x-ray machine has been funded. The grant is provided by Premera Blue Cross Blue Shield of Alaska and administered by the Alaska Community Foundation and Rasmuson Foundation. We are extremely grateful for this award as a portable x-ray has been a piece of needed equipment for years.

Thank you to everyone who asked questions and participated in our Facebook live event. We hope to do another one soon.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay well,

Mary Swain

Executive Director/CEO

April 29, 2020

As of today, in Alaska, there is a cumulative total of 355 positive COVID-19 cases, 240 recovered, and 9 deaths. Although there are cases in Southwest Alaska there are NONE in Bristol Bay Borough.

Testing requirements have changed again as of yesterday. As the state moves to a broader testing methodology, they have relaxed the total number of symptoms that one must have to be tested. Camai has already been testing when someone has symptoms, this allows for more testing as deemed necessary by a provider. Following are the new requirements:

  • Symptoms of COVID-19 may include any of the following: fever, cough, shortness of breath, difficulty breathing, chills, decreased appetite, diminished sense of taste or smell, diarrhea, fatigue, headache, muscle/joint aches, nausea, rash, rigors, runny nose, sore throat, or sputum production.
  • Have a low threshold to test any patient with new, unexplained symptoms that may be clinically compatible with COVID-19.

New testing guidelines for persons without symptoms have changed to the following:

Per Mandate 15

  • Upon admission to a health care facility
  • For patients undergoing urgent/emergent procedures that put health care personnel at high exposure risk (starting May 4)

Other settings where asymptomatic testing may be considered:

  • Health care workers in hospitals and congregate living settings  
  • Residents in congregate living settings (see the Alaska DPH guidance on this)
  • Other high-consequence settings (e.g., people coming into remote communities from areas where COVID-19 is circulating)  
  • People involved in discrete outbreaks (in consultation with public health)

It is important to know however that a medical provider has the ultimate say as to whom gets tested. You maybe experiencing symptoms on the list, but a provider may decide you do not need to be tested.

As the news reports more and more information on antibody {Serologic} testing it is good to know what the State says about this kind of testing based on CDC recommendations. Following is the actual guidance from the State of Alaska on serologic testing as of April 28, 2020:

Guidance on Serologic Testing

  • Please read the brief Infectious Diseases Society of America (IDSA) Primer on Antibody Testing for COVID-19. {attached at the end of this update}
  • At this time, serological tests should not be used as an alternative to molecular detection tests for the diagnosis of COVID-19 in symptomatic patients.  
  • Interpreting positive serologic test results can be particularly difficult in persons who did not have a prior clinically compatible illness and a positive RT-PCR test for COVID-19.
  • When the prevalence (or pre-test probability) of infection is <5%, a test with a specificity between 96%-98% will be more likely to give a false positive than a true positive result. The prevalence of prior SARS-CoV-2 infection is likely <1% in the general Alaska population at this point. We do not yet have a good understanding of the specificity of the various serologic assays for COVID-19.
  • Cross-reactivity with other common coronaviruses may also lead to false-positive serologic test results.
  • Even if a person does have antibodies to SARS-CoV-2, whether these antibodies confer immunity is unknown. Therefore, IDSA recommends that antibody tests not be used to make decisions about whether personal protective equipment is needed.

Lastly the State of Alaska offers this warning:

Because the sensitivity of all COVID-19 tests is <100%, a negative test result does not rule out infection.

What this means is, just because a test comes back negative does not mean you do not have the virus, it means the test that was used may not have had enough of the virus in the specimen to detect a positive test. Our providers may request you to stay in isolation for a few days, monitor your symptoms and retest to be confident you are indeed negative for COVID 19.

On Thursday, April 30th at 5pm Camai will hold a Facebook live event. This will be the first of a couple public forums we will hold. We understand there are people that do not have Facebook, so we are working on other venues for future events.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day.

Stay Well,

Mary Swain

Executive Director/CEO

https://www.idsociety.org/globalassets/idsa/public-health/covid-19/idsa-covid-19-antibody-testing-primer.pdf

April 27, 2020

As of today, in Alaska, there is a cumulative total of 345 positive COVID-19 cases, 218 recovered, and 9 deaths. Although there are cases in Southwest Alaska there are NONE in Bristol Bay Borough. On tonight’s news conference with the Governor it was reported that currently only 4 people are hospitalized in Alaska for COVID-19.

Beginning this week, many businesses can start opening in the state. We caution everyone to be careful. Dr. Zink, State of Alaska Medical Director, asks everyone to keep a log of places and people that you go to so if there you are in close contact with anyone for longer than 10 minutes. Based on how the numbers change the Governor will decide if he will continue to allow businesses to open or pull it back.

This week Camai CHC will take on the task of how best to prepare for a potential surge in medical care {surge planning}. We are identifying a space that can be used if someone is sick enough to be somewhere but not sick enough for a medevac. This would be for a short time and close to the clinic so we can monitor patients closely. This is a work in progress, and I will give updates as work to finalize items. There is a process we must follow and many “rules” if we want to meet criteria for FEMA reimbursement. We feel the only way to do it right is to make sure we cover all the bases and have a plan that takes full advantage of the money available for the project.

On Thursday, we will be doing a Facebook live event to answer questions. This will be a time to ask our staff and possibly providers {depending on their schedules} questions. We are working on the logistics so on Wednesday we will let everyone know what time we plan to do it. I know there will be people who do not have access to Facebook, we are working on other ways to do more. But we want to try this first. We may limit the answers to those who use the clinic if we get too many questions. If you have questions you want to submit prior to the event, please message the Camai Community Health Center Facebook inbox and we will print them off and try to get to all of them. We will be on the Camai page so you may need to “like” the page in order to be able to see the event as well.

Wash your hands, do not touch your face, wear a mask, and do something nice for someone every day. We will get through this together.

Stay Well,

Mary Swain

Executive Director/CEO

April 24, 2020

As of today, in Alaska, there is a cumulative total of 339 positive COVID-19 cases, 208 recovered, and 9 deaths. Although there are cases in Southwest Alaska there are NONE in Bristol Bay Borough.

The highlight today is how many recovered cases there are in Alaska right now. 208 are recovered meaning there is only 122 active cases. Physical distancing is working. It has been hard; we understand that, and we are optimistically cautious. Washing your hands, not touching your face and physical distancing is especially important.

The Governor has issued a few new mandates this week and a plan for opening the state. One of the mandates is for fishing vessels. If you have not seen it, I will post the link below so that you have it available. We have been talking with Dr. Anne Zink and her team about a couple revisions we would like to see. Specifically, when someone gets sick on a vessel, we would prefer them to call the medical facility closest to where they are and not have to make multiple calls to get help. We have seen the draft mandate for set netting and have offered some suggestions. This mandate has not been issued but it should be coming out soon.

Tonight, a new mandate will come out regarding social gathering. I have not seen the mandate but what I heard was that in some situations you will be able to gather up to 20 people with 6 feet apart from each other.

Stay well,

Mary Swain

Executive Director/CEO

https://covid19.alaska.gov/health-mandates/

https://gov.alaska.gov/wp-content/uploads/sites/2/COVID-MANDATE-017-Appendix-01-Protective-Plan-for-Independent-Commercial-Fish.pdf

April 23, 2020

As of today, in Alaska, there is a cumulative total of 337 positive COVID-19 cases, 209 recovered, and 9 deaths. Although there are cases in Southwest Alaska there are NONE in Bristol Bay Borough.

I apologize for missing yesterday’s update. I asked our Behavioral Health Director to put together today’s update. Camai CHC is committed to treating the whole person, since Pete has joined the Camai team he has been successful in incorporating behavioral health into almost all visits.

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So far, our updates have focused on COVID-19 as physical illness, but I’d like to take a moment today to speak to the mental health components of current events. Although we’ve not yet identified any positive cases of COVID-19 here in Bristol Bay every single one of us has already been affected mentally and emotionally. At Camai we know that a person’s mental health can have a significant impact on their overall wellness. During this time of increased stress, we’d like to offer some tips and ideas to bolster your mental health.

  • Try to get at least 30 minutes of outside activity every day. Walks, biking, jogging, or playing with kids and pets can help us stay active. Activity, fresh air, and sunshine help our bodies and minds.
  • It’s normal to feel fear or anxiety when facing uncertainty, or to be less productive than usual. Cut yourself some slack, you’ve never done this before!
  •  It can be helpful to put energy into things we have control of rather than things we do not. That helps us feel effective rather than powerless.
  • Take care of yourself even as you care for others. We must remember to prioritize our well-being so that we are healthy enough (mentally and physically) to continue caring for others. 
  • Structure and routine bolster our sense of safety and ability to manage stress. Little things like consistent bedtimes, predictable schedules, and daily hygiene can boost our mental health.  
  • You might try setting an hourly chime on your watch, when it goes off, take a breath, look inward and notice what sensations you are experiencing. If there’s discomfort, that’s a cue to intervene with mindfulness, exercise, self-care, or doing something that brings you joy.
  • It’s worth noticing the relative temporary nature of our present challenges, this will pass, we will grow, and life will go on despite the challenges ahead- that can be hard to remember.
  • Our personal histories and genetics impact our response to stress and fear. Previous exposure to trauma makes us vulnerable when facing future traumas. Be forgiving towards yourself, you are doing the best you can. If you are not doing the best you can, there is always tomorrow!
  • Look for meaning in the present moment. Maybe this is the year to start that garden. Maybe stripping nets is a father son activity this year. Time to build a new steam? Seagull eggs anyone?
  • Although many things are currently out of our control, there is much that we can do, we can wash our hands, do acts of kindness for elders and loved ones, sew masks, spend quality time with our kids.
  • Look for signs of safety. Notice that despite everything, people are still helping other people, good still outweighs bad, the fish still return, berries grow. We have much to feel safe about!
  • We must remind ourselves that wearing masks, social distancing and other precautions are not because the present environment is so dangerous. These precautions are a collective effort to protect one another- our sacrifices are out of concern for the most vulnerable among us.
  • Practice gratitude. Look for things to be thankful for, take time to meditate, pray, or reflect on those in your life who bring you joy.
  • Fear can hijack our brains and bring out our worst impulses. If we are self-aware and notice our fear, we can consciously choose to respond to it rather than react.
  • Did you know that taking care of your mental health boosts your immune system?
  • It can be helpful to remind ourselves that our kids will remember this moment for the rest of their lives, how do we want them to remember us and how we behaved during this moment of global challenge?
  • These days it’s easy to be overwhelmed with scary information that activates the most reactive parts of our brains. Limiting how much information we ingest can help us maintain perspective.
  • Try to “catch” other people doing nice things, look for signs of strength and consistency-they are everywhere if we are looking for them.
  •  Extend kindness and grace to those around you, remember that everyone is having their own reaction and that those reactions are informed by their personal histories and experiences that you (and maybe they) are not aware of. None of us have been through a “global pandemic” before, be forgiving!

Camai has been offering mental health services since 2014 and we are proud to be continuing that work during this time. Due to changes in federal and state regulations we have additional opportunities to utilize video for support in ways not typically available. Now is a great time to reach out for support!

If you are interested in speaking with a mental health professional or learning about services available, call our behavioral health director Pete Tallman at 469-1111 or ask your primary care provider for information at your next visit. 

Stay Well,

Mary Swain

Executive Director/CEO

April 20, 2020

As of today, in Alaska, there is a cumulative total of 321 positive COVID-19 cases, 161 recovered, and 9 deaths. Although there are cases in Southwest Alaska there are NONE in Bristol Bay Borough.

We received our testing machines today, however all the supplies for them are not here – yet. Our new concern is the ability to order more supplies {reagent} for the machines when/if we need too. We are working with the State of Alaska on this issue. Although the manufacture of the machines promises to be able to fill the need for more supplies, they have not yet. We are confident that this will happen prior to the fishing season. Camai has not released the number of testing kits we have available because we do not want to put a number out there and then create a fearful atmosphere that we don’t have enough. We have spent a lot of time on deciding how many we need, what is available and more. Working with the State, we feel we have enough for now, but will get more as the season approaches. If you feel you have symptoms and worry about our ability to test, do not hesitate to call. We will test you if our providers feel you meet the criteria to be tested.

As processors submit their plans to the State, they often say that they will work with the local medical providers/entity to help when they have an employee that is ill. I want to assure you; we are working with the industry and know what plans many of them have and have helped them develop internal processes and staffing decisions based on our discussions. It is no secret that if we get an outbreak we will be overwhelmed as a clinic, but so will the community and industry. We have been talking through scenarios and adjust as things come up. The current mandates are due to be revisited after May 1st and we know the Governors office is working on specific mandates for the fishing industry. Camai has seen some of the the draft mandates and offered suggestions to them. I believe that once these mandates are issued, plans will be revised, and we will have a better understanding of the gaps that need to be filled.

As previously stated, Camai is securing additional staffing for the season and the bumper seasons as well. People will start coming to Bristol Bay in May and will trickle in for a month and then the rush will happen. We are trying our best to stay ahead of the curve. It may not be the perfect plan, but we are committed to protecting the community and the staff at the clinic. Although we have not worked in a pandemic situation, we have worked through infectious disease outbreaks during the fishing season. We know when to call for help and have done so in the past and each time the State has helped. I am confident they will with this situation also.

Please do not hesitate to contact us if you have questions, or if there is something you would like us to update the community on as well.

Stay well,

Mary Swain

Executive Director/CEO

April 17, 2020

As of today, in Alaska, there are a total of 309 positive COVID-19 cases, 128 recovered, and 9 deaths. Although there are cases in Southwest Alaska there are NONE in Bristol Bay Borough.

As you know things change quickly. On Wednesday the FDA approved a couple of antibody tests. Although this is great information, we and most of the medical community in are hesitant about using this test to allow for back-to-work or not needing quarantine. Here is a bit of information about this kind of test:

“The test can identify both IgG and IgM antibodies. IgM typically shows up early in the immune response, but the levels quickly drop; IgG antibodies increase more slowly after an infection, but generally stick around longer. In some cases, it can take 10 to 11 days for an individual’s immune system to attack the virus and produce the antibodies. This is why the antibody tests aren’t used to diagnose patients with COVID-19 that have shown symptoms within the last two or three days”.

We have heard from the head epidemiologist of Alaska that the tests can not differentiate between COVID-19 and other SARS-CoV-2 viruses. “Serologic testing…will give us an idea of who is left in our community who is at risk of developing an infection,” said Brown University professor of medicine Angela Caliendo, MD, PhD in a recent media briefing for the Infectious Diseases Society of America. “Knowing how many people in a given community are still susceptible to the virus will be very important for us to decide what to do next winter, and how to manage both testing and whether we need to limit people’s social interactions again in a preventive way.” Currently this is how we see this test being used.

Availability of ventilators is also a hot topic right now. Camai CHC will not be in a position to use them at our clinic and may never be able to. They are used in a hospital setting in ICU with extensive nursing staff and the ability to run labs immediately and they need an advanced care setting. Our hope is that anyone that will need advanced care will be identified early and have been transported out of Bristol Bay Borough quickly. If needed, medevac crews do have the equipment needed to ventilate a patient when needed prior to transporting to Anchorage.

As our testing capability increases, we may begin testing outdoors. Supplies for this have been acquired and we will begin testing our protocols. The beginning of May we will be doing a tabletop drill with the public health department for the State of Alaska. This will allow for us to tighten up procedures and identify weaknesses that need to be fixed.

Many changes have taken place inside the clinic as well. We have put HEPA filter systems in all exam rooms and will have one in the lobby next week. We will have them in the Leader Creek clinic as well. Next week “sneeze” guards will be put up in the lobby to protect our front desk staff. Before entering the building, we require everyone to wear a mask and sanitize their hands. In the entry way there are masks; if you do not own one, please take one.

Recently, there have been news articles and media referencing that clinics in Bristol Bay are not prepared for the summer. We cannot speak for all of Bristol Bay, but we can speak for what we have done in Bristol Bay Borough. Camai has been updating the community for over a month of our preparations. We have been upfront and honest about what we can do, what we are working on, and what we need help with. We know that if we get a lot of cases here it will overwhelm us. We have been working with the State of Alaska Department of Health and have a strategy ready if that happens.

Provider staffing is a moving target. Camai is hiring more providers than we have in previous years. The Leader Creek clinic will be open for most of June and all of July. Sick call will happen in plants so that ill workers will not have to leave the area unless health care providers deem it necessary. We have the ability to for Telehealth for fishermen on their boat or in camp. In addition to all of this we will have increased testing. There will be hiccups, but we will work through them and work with the community as we always have. We have been planning and preparing since February, if there is something you would like to know more about, please reach out and let’s talk about it.

Stay well,

Mary Swain

Executive Director, CEO

References:

https://www.biospace.com/article/fda-grants-ortho-s-covid-19-antibody-test-emergency-use-authorization/

https://www.cidrap.umn.edu/news-perspective/2020/04/antibody-tests-may-hold-clues-covid-19-exposure-immunity-its-complicated

https://www.cdc.gov/coronavirus/2019-ncov/lab/serology-testing.html

April 15, 2020

As of today, in Alaska, there are a total of 293 positive COVID cases, 106 recovered, and 9 deaths. Although there is a case in Southwest Alaska there is NONE in Bristol Bay Borough.

Tonight Mandate 15- Services by Health Care Providers was issued and is for health care facilities and health care providers. This mandate requires Camai to take a few extra precautions. The first will be that all employees must wear a mask. Second, all patients will be screened for recent illness, travel, fever, or recent exposure to COVID-19. Third, if we need to provide breathing treatments, we may have to test you for COVID-19. In addition to the measures that are in the mandate we will also require all patients entering the clinic to wear a mask. If you are here for respiratory matters, we will give you a mask to wear prior to entering the lobby. Those without respiratory matters may wear a cloth mask of their own, or we will offer you a mask prior to entering the lobby.

We have noticed an increase in scams targeting our patients. We caution everyone to not give your Medicare number over the phone. Medicare will not call and ask for this information or solicit you to buy something {such as a COVID-19 test} and then ask for your Medicare number. There is NOT an at home test for COVID-19. Please do not order one online or if anyone calls and asks you to buy one. The ONLY testing allowed in the United States is at a health care facility or drive in testing facility. We have also learned of a scam from newsletters you may receive in your email. If you get an email with a newsletter you did not request, do not “unsubscribe” to the newsletter, if you do, you may receive malware or a virus that will affect your computer. Instead delete the email. Many are referencing COVID-19 updates or information.

There has been a lot of press regarding serology testing that tests for antibodies. As of today, these tests have been approved for studies but NOT for diagnosis. They are not a test that can be used to “prove” you have had it and are recovered or that you do or do not have the virus. Remember, this virus is very new. We are learning about it every day. Camai is committed to giving timely, accurate information that is backed up by science. If you have any questions about a new product or something you have read and do not understand, please do not hesitate to contact me. I will tell you what we know or understand at the time and if I do not know, I will find the answer for you with a creditable source to back up the information.

Stay well,

Mary Swain

Executive Director/CEO

April 13, 2020

As of today, in Alaska, there are a total of 277 positive COID cases, 85 recovered, and 8 deaths. Although there is a case in Southwest Alaska there is NONE in Bristol Bay Borough.

There is not much to report today. Our clinic has been busy training and ordering extra supplies. We have identified a new vendor that has been able to get us supplies we have not been able to find until now. Hopefully we will have more information on our new testing machines on Wednesday’s update.

Remember, the state is still under a Social Distancing Mandate. A comment we are getting a lot is about the grocery store. Please respect those around you and maintain 6 feet from others while in the grocery store. If someone is in a section you need, please wait until they move on and then go to that section. If you are wearing a mask, you still must practice social distancing.

Stay well, we will get through this together and be stronger on the other side.

April 10, 2020

As of today, in Alaska, there are a total of 246 positive COVID cases, 55 recovered, and 7 deaths. Although there is a case in Southwest Alaska there is NONE in Bristol Bay Borough.

Earlier this week Camai was notified we would be receiving 2 COVID testing machines allowing for us to get results within 15 minutes and we stated we would be following the states testing protocols. There is still a national shortage of testing equipment. Following is the protocol we will be following:

  1. Patients who have new onset of any one of the following: cough, shortness of breath, or difficulty breathing, OR
  2. New onset of two or more of the following: chills, diminished sense of taste or smell, diarrhea, fatigue, fever, headache, muscle/joint aches, nausea, running nose, sore throat, or sputum production AND at least one of the following:
  • Health care worker or first responder
  • Household member of a health care provider
  • Known close contact to a confirmed case of COVID-19 in the last 14 days
  • Travel in the past 14 days to a location where community transmission of COVID-19 is occurring
  • Person working in critical infrastructure occupations
  • Any other patient as determined by clinical discretion

Patients MUST have symptoms for Camai CHC to perform a test.

Beginning next week, we will start more telehealth visits. Several patients have expressed concerns about coming to the clinic and we want to be able to help everyone who needs us. The provider will speak with you about the best way to handle your case. Although we have been providing this service for a few years with our Behavioral health services, this will be the first time we have done it on a wide scale in medical care. Please be patient with us as we roll this out.

For those residents in South Naknek, this service will be available to you as well. We do not want anyone to go without the medical care they need during this uncertain time. All you have to do to schedule an appointment is call our office at 246-6155.

We can provide these services because the Centers of Medicare have relaxed rules for telehealth. However, once the declaration of emergency of Alaska or the country has ended, these services must end with them. We will be studying the response and utilization to our telehealth services so we can try and get the rules to allow it on a permanent basis.

A question has come to us regarding what the “rules” are when someone has family travel to come see them. Currently Mandate 12 states “personal travel is prohibited except as necessary to meet critical personal needs or work in critical infrastructure jobs”. This means that unless you are traveling for critical needs or job you can not travel. We have included the link to the frequently asked questions for Mandates 11 and 12. Because these mandates are in force currently and the rules may change once lifted, we will not interpret them now.

http://dhss.alaska.gov/News/Documents/press/2020/FAQs_03272020-SOA-COVID-19-Health-Mandate-011-012.pdf

April 8, 2020

As of today, in Alaska, there are a total of 226 positive COVID cases, 32 recovered, and 7 deaths. Although there is a case in Southwest Alaska there is NONE in Bristol Bay Borough.

This week testing has been in the news a lot. We have been told that our clinic will receive 2 point of care testing units however, we have not been “officially” notified. This means, not only can we test locally, we will get the results with in 15 minutes. But we will only be able to process one test at a time per machine.

The test is different than what the tests we send off to other labs. Our tests will take 127 virus genomes per milliliter to test positive; the state test only takes 3 genomes per milliliter. What that means is if someone has early onset symptoms, they may test negative today but, test positive the following day. There maybe times we decide to do another swab and send it to the State lab for confirmation of a negative result. We are working on our protocols and will have them done by the time we get the machines.

If we get a case in Bristol Bay Borough, we will begin testing outside of the clinic, as needed. We will set up an area for testing where patients do not have to leave their vehicle to be tested. We have already begun using alternate entrances when we have a patient with respiratory symptoms. Later this week we will begin using different screening questions when you call to make an appointment. We are taking all the precautions we can to make sure that everyone is protected when they visit the clinic.

We have received many calls about what self-quarantine is, so we thought it was time for a refresher. The following recommendation are according to the State of Alaska; all recommendations are for 14 days.

  • Keep your distance from others (about 6 feet).
  • You can go to work if you are able to maintain a safe distance from those around you. However, many employers have stricter rules, so please check with your employer. *The state of Alaska is currently in a state-wide social distancing mandate until at least April 11, 2020. Therefore, unless your business is on the list of the essential workers you must stay home and practice social distancing.
  • Do not go into public places. These include grocery stores, post offices, restaurants, or the Borough landfill.
  • Monitor your health.

You may order food from the grocery store or restaurants and have someone bring it to you. Ask them to leave it on your porch or put it in your car. When they leave or are at least 6 feet away you can pick it up. If no one can help you pick up your orders, you may park outside and ask them to bring it out to you if you maintain 6 feet of distance. Remember, you cannot go inside.

April 3, 2020

As of Friday, April 3, 2020 at 5:00 p.m. Alaska has reported 157 positive COVID-19 tests, 15 hospitalizations, and 3 deaths. We do not know how many are still hospitalized; that information is not reported. There have been 5,859 total negative tests. No confirmed cases in Southwest Alaska.

Today the CDC released a new regulation regarding masks being worn in public. The recommendation is: “wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies) especially in areas of significant community-based transmission”. Further, they state that surgical masks and N-95 are considered critical supplies and need to be reserved for healthcare workers and other medical first responders.

The State of Alaska has issued Health Alert 10 – Recommendations regarding the use of cloth face coverings was released this evening. They recommend that Alaskans make their own face coverings and wear them in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies) — especially in areas of significant community-based transmission.

What is a cloth face covering?

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

How well do cloth face coverings work to prevent spread of COVID-19?

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

How should I care for a cloth face covering?

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

• No longer cover the nose and mouth

• Have stretched out or damaged ties or straps

• Cannot stay on the face

• Have holes or tears in the fabric

Recent studies indicate that persons without symptoms are shedding {releasing} the virus that cause COVID-19. This means before you know you have the virus you could be infected and transmit the virus to others when in close proximity of you. Spring is starting show up and we know this is a time that people start to become more social. Please take social {physical} distancing serious. The only way that we can ensure that the virus is not spread is to stop it before it gets here. We all hope you have a good weekend. If you have any questions for our staff, please do not hesitate to contact the clinic.  

link to the CDC’s Recommendation: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html

link to the State of Alaska Health Alert 10: http://dhss.alaska.gov/dph/Epi/id/SiteAssets/Pages/HumanCoV/SOA_04032020_HealthAlert010_ClothFaceCoverings.pdf

April 1, 2020

As of 5:00pm on Wednesday, April 1, 2020 there have been 5,022 tests completed in Alaska: 143 confirmed positives, 9 hospitalizations and 3 deaths. There are no cases in South West Alaska.

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Testing protocols in Alaska have changed. Following is the current protocol of who can be tested at the State Lab. {These are considered High Risk}

Patients who have a clinically compatible illness {e.g., fever, cough, or shortness of breath} AND at least one of the following criteria:

  • Hospitalized
  • Lives in a long-term care facility
  • Health care worker or first responder
  • Known close contact to a confirmed case of COVID-19 in the last 14 days
  • Travel in the past 14 days to a location where community transmission of COVID-19 is occurring {clinical discretion is required}

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Individual not meeting any of the above criteria can be tested however, they are sent to a commercial lab where there may be costs to the patient for the testing and this is taking 1-2 weeks for results:

Patients who have a clinically compatible illness {e.g., fever, cough, or shortness of breath} AND at least one of the following criteria:

  • An outpatient who is at increased risk for serious illness {i.e., age >60 years or has one or more select chronic medical conditions, such as heart disease, lung disease, diabetes, immunocompromised} – Medium Risk
  • Any other patient as determined by clinical discretion – Low Risk

DO NOT TEST: Asymptomatic persons {These are persons with out a clinically compatible illness}

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The Alaska Department of Environmental Conservation, Division of Environment Health – Food Safety and Sanitation Program has put out a bulletin for Preventing the spread of COVID-19 Guidance for Food Establishments and we have found the information to be very informative and thought we would share some information here. The full bulletin is posted below for your reference.

Does coronavirus spread through food?

State of Alaska DEC response: It is unlikely, and there is no current evidence, that the novel virus is transmitted through food or water. History with previous outbreaks of coronavirus such as SARS and MERS suggest that people do not likely become infected with coronavirus through food. However, limited research on the new coronavirus indicates that it can be shed in stool. It is not known at this time whether the virus can make people sick after it has passed through the digestive tract.

While we don’t believe the novel virus can spread through food, we do know other germs can. We highly encourage people to practice routine food safety procedures to reduce risk:

  • Only handle food when healthy. People that are coughing, feverish, short of breath, vomiting or have diarrhea or other symptoms of illness should stay out of the kitchen.
  • Wash hands to reduce risk of illness. Always wash hands thoroughly before and during food preparation.
  • Rinse fruits and vegetables before cutting or eating. Rinse raw agricultural products, such as heads of lettuce, under running water prior to cutting or serving. Bagged lettuces that are ready-to-eat do not need additional washing.
  • Thoroughly cook whatever you can. Cooking destroys many germs, including coronavirus.
  • Clean and sanitize food contact surfaces. Wash, rinse, and sanitize cutting boards, tables, utensils, and other food contact surfaces often.

CDC’s Response: Coronaviruses are generally thought to be spread from person-to-person through respiratory droplets. Currently there is no evidence to support transmission of COVID-19 associated with food. Before preparing or eating food it is important to always wash your hands with soap and water for 20 seconds for general food safety. Throughout the day wash your hands after blowing your nose, coughing or sneezing, or going to the bathroom.

It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

In general, because of poor survivability of these coronaviruses on surfaces, there is likely very low risk of spread from food products or packaging that are shipped over a period of days or weeks at ambient, refrigerated, or frozen temperatures.

What is the role of money (cash, coins, and cards) in the spread of COVID-19?

State of AK DEC Response: According to CDC, money, like cash and coins and cards, is not likely a primary mode of transmission of coronavirus, however, it may be possible to transfer the virus by touching a contaminated surface and then touching the mouth, nose, or eyes. Customers and employees are encouraged to properly wash their hands often throughout the day, including after handling money, and always before they eat or touch their eyes, nose, and mouth.

https://www.cdc.gov/coronavirus/2019-ncov/faq.html

March 31, 2020

I apologize for not doing an update yesterday. The clinic was closed in observant of Seward’s day and there was not much change from Friday to report. On a call this morning with the State of Alaska we asked if there were any statistics around those in Alaska who have tested positive and are now “recovered”. The response was that recovery was not a reportable event in this pandemic. However, we know that there have only been 3 Alaska reported deaths and 7 hospitalizations as of today.

The CDC has issued updated information for medical providers and we think the information is timely and could help answer many questions we have received. It will also help understand information that is circulating around social media. I will put some of it here as well as a link to the entirety of the information.

What is the incubation period?

The incubation period for COVID-19 is thought to extend to 14 days, with a median time of 4-5 days from exposure to symptoms onset. One study reported that 97.5% of persons with COVID-19 who develop symptoms will do so within 11.5 days of SARS-CoV-2 infection.

What are the Symptoms?

The signs and symptoms of COVID-19 present at illness onset vary, but over the course of the disease, most persons with COVID-19 will experience the following:

Fever (83–99%)

Cough (59–82%)

Fatigue (44–70%)

Anorexia {Loss of appetite} (40–84%)

Shortness of breath (31–40%)

Sputum production (28–33%)

Myalgias {Muscle aches} (11–35%)

What should I know about medications?

CDC Response: It has been hypothesized that angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) may increase the risk of SARS-CoV-2 infection and COVID-19 severity. ACE inhibitors and ARBs increase the expression of angiotensin-converting enzyme 2 (ACE2). SARS-CoV-2 uses the ACE2 receptor to enter into the host cell. There are no data to suggest a link between ACE inhibitors or ARBs with worse COVID-19 outcomes. The American Heart Association (AHA), the Heart Failure Society of America (HFSA), and the American College of Cardiology (ACC) released a statement recommending continuation of these drugs for patients already receiving them for heart failure, hypertension, or ischemic heart disease.

It has also been hypothesized that non-steroidal anti-inflammatory drugs (NSAIDs) may worsen COVID-19. There are no data suggesting an association between COVID-19 clinical outcomes and NSAID use. 

Camai’s interpretation: Please do not stop taking your medications as prescribed without talking to your medical provider. Taking Tylenol, Ibuprofen, Motrin and Advil are okay to take as directed.

What should I know about Reinfection?

CDC Response: There are no data concerning the possibility of reinfection with SARS-CoV-2 after recovery from COVID-19. Viral RNA shedding declines with resolution of symptoms and may continue for days to weeks. However, the detection of RNA during convalescence does not necessarily indicate the presence of viable infectious virus.

Camai’s interpretation: Once symptoms are gone the infectiousness of the virus is diminished. There is no data to support the claim that someone that has had COVID – 19 is at risk to contract the virus again.

This information as well as the references for the information can be found at:

https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html#Medications

March 27, 2020

This evening the Governor of Alaska implemented 2 new health mandates. We are taking all precautions seriously and well be changing some of our processes. We have evaluated and decided, although we are considered critical essential services there are some positions within the clinic that can be done from employee’s homes. Beginning Tuesday, March 31, 2020 our billing department and some admin staff will be working from home. We have cancelled the onsite monthly services from our CFO and Behavioral Health Provider. Their services will be done via distance for the time being. The clinic is scheduled to be closed on Monday, March 30, 2020 in observance of Seward’s Day.

Beginning Tuesday, March 31, 2020 we will require more time between appointments to allow for thorough cleaning of the patient rooms and lobby. As we stated before, there may be appointments we would prefer to handle in the home. We want to protect everyone and there are situations when this will be a safer approach. We are asking all patients to not bring any extra family or friends to appointments unless medically necessary. All patients must call for an appointment as walk ins are not recommended, except for in the case of an emergency. At this point, the schedule is open, so appointments are available.

Some key points that came out of the frequently asked questions put out by the State of Alaska that we think are very important to understand and take into consideration.

Q) Should I wear a mask?

A) A mask will not necessarily prevent you from catching the virus, however, it will limit you from SPREADING the virus IF infected. There is a national shortage on masks and we, at Camai CHC, ask you to not use masks that may be needed later, if we have an outbreak here.

Q) How do I keep from getting the virus?

A) The science is definitive that maintaining six feet or more from other people will greatly diminish your risk of getting the virus. This, and washing your hands, not touching your face, and wiping down surfaces are the best public health guidance about preventing the spread of this virus. Since there are no current vaccination or antiviral treatments, the primary goal is to prevent getting the virus in the first place. Standing six feet away or more from others is the best way to do this.

Q) Can older people leave the house on essential errands?

A) The Centers for Disease Control and Prevention (CDC) recommends that older adults, age 64 and older, and those with underlying health conditions not leave home at all, even to run errands. The State of Alaska recommends that these more vulnerable populations order food or necessary items using available services from stores and restaurants, or ask for help from a relative, friend or neighbor. For the safety of everyone, stay home.

Q) Can I get groceries?

A) Yes, grocery stores remain open, but you must maintain six feet of social distancing. Take advantage of grocery delivery or pickup services. All Alaskans are encouraged to limit their number of weekly trips to the grocery store and to shop alone, do not bring the entire family into the store. If you MUST go to the grocery store, you MUST remain six feet away from anyone. Please keep at least six feet from others when you are out in public, wash your hands often and wipe down frequently touched surfaces. Do not go grocery shopping if you are ill with a respiratory infection; if you are ill, you should be isolating yourself at home, including from family members.

Q) What if I’m dating someone who lives in another household? Am I allowed to visit that person?

A) You must stay six feet away from anyone who is not a family member. Not doing so endangers the members of the dating partners’ families.

Currently, there is no case of COVID-19 in Bristol Bay Borough and it is our continued hope that these measures will help keep the virus at bay. All the staff at Camai CHC are here to help.

If you have any questions, we will help answer them. We are all in this together and together we will get through it.

Mary Swain

Executive Director/CEO

March 25, 2020

We have been asked several times, what will happen if I get sick and can not travel on a commercial flight out of Bristol Bay. Although we can not answer for the airlines, we do know if a situation is life threating, we are able to medevac a patient to Anchorage. We have been in contact with our medivac providers and they have begun taken extra precautions in cleaning their aircraft and decontamination. The providers are protecting themselves as well based on CDC guidelines.

Medevac insurance is a tool that can help you have peace of mind and not worry about a large medical bill for the flight. The 2 companies we work with are Guardian and Life Med. Guardian is $125 a year for your family and has a 15-day waiting period prior to utilizing. Therefore, you must have it in place prior to being ill or injured. LifeMed is $49 and you must have other insurance to apply for this one. It can be used instantly but other insurance is a requirement.

As a reminder, we are still in flu season and we have flu vaccine available for all age groups.

You may have heard in the news lately that the FDA is working on a new “rapid” test for COVID-19. Unfortunately, this is not a test Camai CHC will be able to do when it is approved. The test will require a lab to process it and our lab is not certified to do this kind of testing. We do not predict a test that can be used in our lab for months, if at all.

Please know that Camai CHC is working very hard to prepare for this virus. Staff has spent hours working on several contingency plans and training. If you have any questions, please do not hesitate to contact us.

March 23, 2020

Patient confidentiality is as important to us as safety. Safeguarding patients’ rights regarding personal health information is an ethical and legal obligation for the clinic and everyone who works at Camai CHC. This can be challenging at times in everyday situations, but when we are in a crisis it is even harder. All patient information is protected by HIPPA, Health Insurance Portability and Accountability Act, legislation that assures every patient’s health information is protected. We are not able to disclose who has been at the clinic, what they are here for or if any test was done for a patient. Privacy is a right of patients to keep information about themselves from being disclosed. Deciding who, when, and where to share their information is the right of patients. As staff at Camai we are obligated to treat patient information confidentially.

You may hear in the news that HIPPA rules have been waived. This does not mean they have been suspended. Certain information may need to be shared to assist a nationwide public emergency. The Secretary of the U.S. Department of Health and Human Services (HHS) Alex M. Azar exercised his right to waive certain aspects of the HIPPA Privacy Rule. These include:

  • the requirements to obtain a patient’s agreement to speak with family members or friends involved in the patient’s care. See 45 CFR 164.510(b).
  • the requirement to honor a request to opt out of the facility directory. See 45 CFR 164.510(a).
  • the requirement to distribute a notice of privacy practices. See 45 CFR 164.520.
  • the patient’s right to request privacy restrictions. See 45 CFR 164.522(a).
  • the patient’s right to request confidential communications. See 45 CFR 164.522(b)”

This means a health care provider /clinic/hospital will not be fined if we do not give you all the privacy information we normally would if you were coming to the clinic for a regular visit. However, it does not allow us to disclose patient information to any member of the public that the patient has not approved in writing.

March 20, 2020

Beginning the week of March 23rd, we will offer a new schedule for the benefit of our patients who might be more susceptible to infection {Elders, Pregnant women, and patients with chronic health issues}. Tuesday and Thursday mornings from 9-11am will be reserved for these patients.

We have also begun to ask patients who have a fever, cough, or shortness of breath to wait in the outer entryway of the clinic so a staff member can come out to them with a mask or other necessity prior to entering the clinic. It may become necessary to use the back entrance for patients if we have concerns for patient safety. If this happens you will be told in advance of your appointment which entrance we would like you to use. Patient safety is our number one concern so please be patient with us as we work through all the changes.

Camai CHC has been contacted a couple times regarding self-quarantine procedures after travel and what we would recommend. Here are our recommendations based on the current recommendations by the State of Alaska; all the recommendations are for 14 days.

Although the current guidelines issued March 17th do not specifically address in State travel we would recommend the following:

  • Keep your distance from others (about 6 feet).
  • You can go to work if you are able to maintain a safe distance from those around you. However, many employers have stricter rules, so please check with your employer.
  • Avoid crowded places and limit public activities.
  • Monitor your health.

If you are traveling from out of state, you MUST:

  • Keep your distance from others (about 6 feet).
  • You can go to work if you are able to maintain a safe distance from those around you. However, many employers have put in stricter rules, please check with your employer.
  • Avoid crowded places and limit public activities.
  • Monitor your health.

If you are traveling from out of country, you MUST:

  • Stay home and avoid contact with other household members .
  • Contact your employer and do not go to work or school for 14 days after you return home.
  • Monitor your health.

See the blank monitoring sheets for an example of what to monitor and record that we posted yesterday.

March 19, 2020

Due to requests from those traveling, we decided to share this tool to help you monitor yourself during self-quarantining. We hope you find it helpful.
Don’t forget to wash your hands.
Don’t touch your face.
If you feel sick, please do not go to work.

March 18, 2020 Update

Camai Community Health Center staff is part of an ongoing task force with processors and industry leaders from the Bristol Bay area. Yesterday we discussed at length what preparation everyone is taking, questions about supplies needed and other general ideas and questions. Everyone on the call has been preparing for quite some time. Many fishing communities are already doing things because they are currently actively fishing. We are building our preparations around what is working and what is not working. We are lucky to have them for support.  Most are internal processes and business decisions but here are a few highlights that I hope will help everyone.

  • Processors are requiring employees returning from Level 2 or 3 countries to self-isolate for 14 days to ensure they are symptom free before coming to work.
  • Some industry and processors have already hired companies to do health and temperature screens at airports, so employees are screened prior to coming to King Salmon in addition to the screening or quarantines they are requiring prior to travel to Alaska.
  • Visitors will be limited or not allowed in plants and surrounding areas.
  • Temperature checks before and after shifts and breaks.
  • All processors are developing contingency plans.

One thing we must keep in mind is that this is a very fluid situation. One day can be drastically different from the next. During our staff meeting this morning we went over new ideas and how we would handle some scenarios.

Please know that everyone at Camai Community Health Center is taking this very seriously. This is new for everyone and, one thing we do not want is panic. If there are questions you have that we have not addressed, please let me know. If I do not know the answer, I will find out for you.

Mary Swain

Executive Director/CEO

March 17, 2020

In our continuing effort to keep everyone up to date with the latest information regarding the COVID-19 virus we thought sharing how tests are treated would be helpful to everyone. Here is the latest as of today, March 17, 2020.

In order to have a test performed you must meet the criteria set by the State of Alaska/CDC. The criteria changes rapidly so these can change at any time. Following is a list of criteria:

  1. Had close contact to a laboratory-confirmed case of COVID-19
  2. Travelled (not airport transit) within the last 14 days to a location where community transmission of COVID-19 is occurring {this list is on the CDC website and is rapidly changing}
  3. Hospitalized
  4. Lives in a long-term care facility
  5. Health Care worker (negative influenza test)

Once a patient has had their nose swabbed by a health care provider they need to self-quarantine until they have the results.

The swabs are sent to the state lab in Anchorage. Tests are run 7 days a week by the State of Alaska. Specimens need to be tested within 72 hours from the time they are taken. Currently, specimens are gathered at the Anchorage lab and sent to Fairbanks for testing. They send the tests to Fairbanks at 2pm every day and they are tested the following morning. Fairbanks can process 100 at a time. On Sundays, the lab in Anchorage does the tests; their capacity is 24 tests at a time and does take a bit longer to process. At this time America does not have a test available for testing for antibodies, this means we cannot test to see if someone thinks they had the virus, only active cases with symptoms.

Prior to today, states had to have their first 5 cases confirmed by the CDC; this is no longer the case. If the state lab comes back with a positive then it will no longer be presumptive, it will be positive. You will then move into self-isolation. This means you need to separate yourself from other people in your home and limit your contact with pets and animals. You will be instructed to self-monitor. This means taking your temperature twice daily and monitoring for a cough or respiratory issue. Instruction will be given to you at the time of your confirmation call.

Once you have tested positive an epidemiology investigation will begin. You will be contacted by an investigator. They will ask for information regarding who you have had contact with beginning 48 hours prior to symptoms. They will then talk with the contacts and recommend that they to go into self-quarantine and self-monitoring. They will also decide if the contacts will need to be tested as well. They may decide a test is not warranted. This will be handled privately and on a case by case basis.

Because this information is rapidly changing, we cannot guarantee that it will always be handled this way. Protocols within the state/nation can change without our knowledge.

We hope this information will help you with the unknown. Camai Community Health staff are here to help you during this time of unsettling times. As we learn more, we will update everyone. Please, if you have any questions, do not hesitate to call us.

March 16, 2020

Camai Community Health Center is committed to taking precautions and preparing for the potential that the COVID 19 virus may come to Bristol Bay Borough. We have begun reviewing and updating our protocols. In the next few days, we will have processes in place that may change what patients have come to expect when making an appointment. We will have specific screening questions prior to making an appointment. We may also ask you not to come to the clinic and ask you to allow us to come to you for treatment. However, these are all items in the works and may change as we review and test our processes.

We will have the ability to test for the virus but there are protocols in place as to who gets tested. Each case will be handled individually and privately.

We have also been in contact with most of our industry partners in the community. Tomorrow, March 18, 2020 we will participate in a newly formed task force with key leaders and experts in the field and community. Our goal is to have the most up to date information and ensure that everyone is on the same page with procedures and processes.

This is an ever-changing situation and we will update our website/facebook at least every other day {Monday, Wednesday and Friday} and at other times as the situation warrants an update. Our priority is to keep everyone informed and protected as much as we can.