COVID-19


November 25, 2020

As of today, in Alaska, there is a cumulative total of 28,339 positive COVID-19 cases and 115 deaths. The total number of current active cases {physically} in the Bristol Bay Borough {BBB} is 3.

Friday, we identified 1 new positive case at the Leader Creek testing site and zero cases on Monday  and Wednesday this week. The positive individual is in isolation, close contacts have been identified and are in quarantine. The State of Alaska Department of Public Health is working with them.

As a reminder, if you have tested positive you are to immediately go into isolation for 10 days, and it is your responsibility to inform your close contacts and they are to go into self-quarantine for 14 days. Close contact is defined as anyone you have spent more than 15 minutes with for at least the last 2 days prior to your positive test result or symptoms. However, Public Health may decide that there is a need to go back further than 2 days. Every case will be determined individually.

 There have been rumors within the community that our clinic receives money based on the positive cases we identify. This is not accurate. Our clinic is an outpatient only clinic, there are inpatient clinics and hospitals that are eligible for funding if they admit a patient for treatment and they must stay in the hospital, however, that is not the type of facility we are. We do not receive any compensation for a positive test result. We test so we can identify cases in our community early and help prevent spread. We have been very successful in this endeavor and that is because of your willingness to be tested.

The new travel advisory states if you travel into our community from a road system community you must either:

  1. Test 72 hours prior to travel, or
  2. Quarantine/Strict social distance for 14 days after arrival into Bristol Bay Borough {BBB}, or
  3. Quarantine/Strict social distance for 5 days and test. If you test negative, you may leave quarantine.

We do not have the testing supplies available to test the day you arrive back into BBB and then again at day 5. Therefore, we advise anyone traveling into BBB to quarantine/strict social distance for 5 days and then test. Our policy of eligibility still applies to those who travel: you may test, at our testing site, once every 10 days. That means if you test on the day of your return you will not be able to test for 10 days and will have to remain in quarantine until you are eligible to test again in 10 days. Please keep this in mind when you decide what day to test on.

Next week we will announce our plan for a 5 days of Christmas photography event. Be on the look out for details!

All of us at Camai Community Health Center would like to wish you and your family a Happy Thanksgiving. We are blessed to live in Bristol Bay Borough and to know you all.

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

November 18, 2020

As of today, in Alaska, there is a cumulative total of 23,874 positive COVID-19 cases and 99 deaths. The total number of current active cases {physically} in the Bristol Bay Borough {BBB} is 8.

Monday, we identified 2 new positive cases at the Leader Creek testing site and zero cases on Wednesday. The positive individuals are in isolation, close contacts have been identified and are in quarantine. The State of Alaska Department of Public Health is working with both cases and contacts.

Because the state of Alaska is recording over 500 cases a day, it can take several days for public health to call and do their investigation. Therefore, your first call you will receive, when you test positive at our sites, will be from a Camai employee. They have been trained to answer limited questions and they will tell you what steps you are required to take until a public health employee calls you. The steps are as follows:

  1. You must immediately go into isolation
  2. You are required to inform anyone you have been around in the 48 hours prior to your positive test result and advise them you have tested positive and that they need to go into quarantine for 14 days. {Once public health speaks with you, they may determine to go back further than 48 hours based on your symptoms and individual situation}
  3. If you become ill, please call Camai Community Health Center, or your local Health Aide, whichever you prefer.

**If your minor child is being tested, it is imperative you provide an adult contact name and phone number so our staff can contact you with their results, will can only call who is listed on our form.

Camai CHC has received many inquires regarding people who are in quarantine and isolation that are not adhering to the rules. Every time we hear of these, we contact Public Health however, Camai does not have any enforcement authority.

Due to the recent uptick in cases in Alaska as well as locally, Camai CHC would like to caution everyone regarding large gatherings. We know this is a time for holiday parties, large dinners with family and friends, and other social gatherings but, we are concerned these activities can cause spread of virus.

I have attached a flyer from the CDC for recommendations regarding Thanksgiving gatherings.

We are committed to providing COVID-19 testing to anyone in the community and encourage everyone to continue to practice precautionary measures to help prevent the spread of the disease. Camai staff strongly recommends limiting the amount of non‐essential activities and day‐to‐day social interactions.

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

Camai Community Health Center, INC

Naknek, Alaska

FOR IMMEDIATE RELEASE: NOVEMBER 13, 2020

COVID-19 | 5 NEW POSITIVE CASES IN BRISTOL BAY BOROUGH

Today, Camai Community Health Center has identified 5 persons positive for COVID-19 in Bristol Bay Borough and will be reported by the state as residents. Many of the individuals are/were symptomatic, meaning they are/were exhibiting symptoms of COVID-19. All are in isolation and are contacts of a previously identified positive case.

Camai Community Health Center has contacted the individuals and Alaska Public Health officials will contact them soon. Public Health will notify and isolate additional persons as appropriate however, due to the backlog at public health, if you are contacted by a person who has tested positive you MUST quarantine for 14 days from the day of the positive test. Quarantine means you are not to go into any public place. This may include work, depending on where you work, and the restrictions set by your employer.

Travel is a high-risk activity and the cause of our recent cases. It is imperative that you take safety measures after traveling. Please quarantine for a week and get tested before returning to normal activities.

It is crucial to the safety of our community that everyone practices protective measures:

  • Wear a mask when you are in public
  • Wash your hands often and for 20 seconds
  • Keep your social bubble small
  • Keep physically distant {more than 6 feet} from anyone who does not reside in your household
  • Avoid non-essential travel
  • Frequently disinfect high-touch surfaces in your home and workplace

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 to speak with a health care provider. Symptoms include a fever, chills, shortness of breath, cough, diarrhea, loss of sense of smell or taste.

Rapid testing is available to community members Monday, Wednesday, and Friday 1pm-3pm at the Camai CHC Leader Creek Clinic. You are eligible test once every 10-14 days.

# # #

November 9, 2020

As of today, in Alaska, there is a cumulative total of 19,187 positive COVID-19 cases, 6,512 recovered, and 84 deaths. The total number of current active cases {physically} in the Bristol Bay Borough (BBB) is 2.

Today, we identified 1 positive case in the clinic. This person is an employee of Camai however, no clinic patients are at risk of being a close contact. The employee is in isolation and all close contacts have been identified and are in quarantine. On Saturday, I was made aware of an additional positive case in our community. This person was not tested in Bristol Bay Borough and is considered travel related. Although the person is physically in our community, they will be reported as a resident of Lake and Peninsula Borough. This person is in isolation, close contacts have been identified and are in quarantine. The State of Alaska Department of Public Health is working with both cases and contacts.

Travel is a high-risk activity and although there are not mandates in place by the State of Alaska or Bristol Bay Borough for those traveling in state, we have identified positive cases due to in state travel. We cannot suggest strongly enough that if you travel, you should quarantine when you return. For those who travel out of state, the current mandate states you must adhere to strict social distancing and either test after day 5 of your return or quarantine for 14 days. You are to go to your quarantine place and not make stops around town before doing so. Ask a friend or neighbor to pick up your mail, get your groceries, or take your trash to the landfill. Bristol Bay Borough is a great community and there are many people who will help if you need it.

What if you were in contact with a known positive?

If you are being tested because of symptoms or a close contact:

· Stay at home for fourteen (14) days (except to get medical care).

· Avoid all public places and transportation.

· Keep at least 6 feet from people and animals, including those in your household.

· Avoid sharing personal household items, wash your hands and high touch surfaces regularly.

· Inform your work, (or your child’s school) that you are awaiting results.

What if your result is negative?

· If you are a close contact to a person who is positive and you have tested negative, please follow the health department’s instructions and remain quarantined for at least 14 days since your last contact to the positive case, because you could still become positive.

What if your result is positive?

Most people do well, but it is important to take care of your health and protect those around you.

· Stay at home and avoid all public places and transportation until cleared by public health from isolation (except to get medical care).

· Keep at least 6 feet from people and animals, including those in your household.

· Avoid sharing personal household items (including the restroom), wash your hands and high touch surfaces regularly.

• Inform your work (or your child’s school) that you are positive.

· Wear a face covering if your symptoms allow, even in the house when not in a separate bedroom.

· Designate one household member to bring you food and other necessities.

· Notify your close contacts (i.e., anyone who was within 6 feet of you for 15 minutes or longer during the two days prior to when your symptoms started, or when you were tested, whichever is earlier) that they need to quarantine for 14 days from the time you were last together.

We are committed to providing COVID-19 testing to anyone in the community and encourage everyone to continue to practice precautionary measures to help prevent the spread of the disease. Camai staff strongly recommends limiting the amount of non‐essential activities and day‐to‐day social interactions.

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

November 2, 2020

As of today, in Alaska, there is a cumulative total of 15,972 positive COVID-19 cases, 6,463 recovered, and 84 deaths. The total number of current active cases {physically} in the Bristol Bay Borough (BBB) is 5. Two will be released from isolation this week and will be traveling out of the Borough.

Friday, we identified 1 positive case at our Leader Creek testing site, they are in isolation. The State of Alaska Department of Public Health is working with them. This new case is considered travel related.

All our recent cases have been identified as travel related cases. This is an important reminder that travel is considered a high-risk activity. Although there are not any mandates for residents traveling within the state it is in the best interest of your family, friends, and the community to self-quarantine upon returning home and test AFTER 5 days of being home.

We are excited to announce the two, grant funded, rapid testing machines we purchased have arrived and were installed today. This has more than doubled the capacity of rapid test processing we can do in an hour. Prior to the arrival of the new machines we had committed to processing all tests in a single day. This has meant long hours and overtime for some staff. Now we will be able to process them quicker and you will have your results within hours.

As we enter November, we have been under the stress related to COVID-19 for more than 8 months and everyone is becoming COVID fatigue. Camai Community Health Center has a very robust Behavioral/Mental Health team and I have asked Pete Tallman, the head of our team to write to all of you today. Below is his letter. Please do not hesitate to contact us if you need someone to talk to. No one will be turned away based on inability to pay for services. Pete can be reached at (907) 469-1111.

COVID Fatigue is Real and We All Have It

I do not know about you, but a “global pandemic” was not on my radar. Wars, earthquakes, meteors, fires, floods, bears- yes, but a global pandemic- no. Maybe I was naïve, maybe you were too- or maybe not- but here we are. Now after 8 months of having this unexpected and unwelcome virus disrupt our lives, WE. ARE. DONE. Done hearing about COVID-19, done talking about COVID-19, done planning, done worrying, done arguing, done with homeschooling, done with swabs up our noses, done with video everything, done with work changes, done with distance between friends, done with nagging our kids, done isolating, done with handwashing, and done with masks. We are tired and we are done- who could blame us? This “doneness” is the root of COVID-19 Fatigue. COVID-19 Fatigue is real, and it is understandable given the circumstances we find ourselves in.

Just as COVID-19 Fatigue is real and understandable, it is also potentially dangerous. Dangerous because it tempts us to abandon the individual and collective actions that will ultimately end this pandemic. Dangerous because it seeps into the resolve needed to continue the precautions that have kept us and the community safe thus far. Dangerous because it can cause us to believe things are true- that precautions are no longer necessary, for example- even if all evidence suggests the opposite- just because we need it to be true to alleviate our fatigue. Our fatigue makes us vulnerable to promises of relief even if that relief actually increases our risk.

Fortunately, there is an alternative. We can acknowledge our COVID-10 Fatigue, give ourselves permission to be having the experience that we are having, and actively work to process and manage our reaction to it.  By managing our response to COVID-19 Fatigue in healthy ways, we prevent ourselves from falling prey to the temptation of fatigue relief.

Here are some concrete ideas that are tried and true for managing our mental health during a crisis. 

  1. Treat your mental health as if it were as important as your physical health- because it is!
  2. Take a walk, go for a jog, lift some weights, do push-ups. Even 5 minutes is better than none.
  3. Extend grace and compassion towards others. No one has done this before; we are doing the best we can.
  4. Extend grace and compassion towards yourself. You have never done this before; you are doing the best you can.
  5. Look inward and ask yourself how you are doing. What emotions has COVID-19 stirred up?
  6. Communicate. Tell someone how you are feeling. No one to tell? Come to Camai, we have trained mental health professionals ready to listen.
  7. Express yourself. Not a talker? That is ok, you can paint, write poetry, sew, carve…
  8. Practice mindfulness. Notice your breathing and current physical sensations. Go to the beach, feel the breeze, smell the bay, connect with where you are.
  9. Eat well, stay hydrated, avoid numbing substances or behaviors
  10. Be a good listener to someone else. Listen to someone else’s experience without trying to fix it! Listen unconditionally and avoid offering your perspective on their feelings.
  11. Find gratitude. Find something you are thankful for. Even when we are suffering, we benefit from finding gratitude- not as a way to discount our suffering- but to acknowledge that even while suffering we have much to be thankful for.
  12. Do something random and kind for someone else.
  13. Remind yourself that this is just one chapter in a long book. “This too shall pass”.
  14. Focus on the things you can control, put any remaining energy into letting go of the rest.
  15. I am normal- it is the “global pandemic” that is not normal. Trying saying that out loud!
  16. Look for signs of hope. We tend to find what we are looking for.
  17. Practice acceptance with yourself. Create a mantra to say to yourself “ I just need to survive today” “I’m doing the best I can” “from uncertainty comes growth” “I can only control me”
  18. Find purpose in the sacrifices you are making, remember that we are literally all- as in the entire planet-in this together.

Our fatigue is real and understandable but the best thing we can do is acknowledge it and manage it in healthy ways. We can do this. It will get better. We will all learn a lot about ourselves along the way.

Pete Tallman, LCSW

We are committed to providing COVID-19 testing to anyone in the community and encourage everyone to continue to practice precautionary measures to help prevent the spread of the disease. Camai staff strongly recommends limiting the amount of non‐essential activities and day‐to‐day social interactions.

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

October 28, 2020

As of today, in Alaska, there is a cumulative total of 14,097 positive COVID-19 cases, 6,422 recovered, and 71 deaths. The total number of current active cases {physically} in the Bristol Bay Borough (BBB) is 4.

Today, we have identified 1 positive case at our Leader Creek testing site, and one was reported to us by a positive individual who tested at the Anchorage airport several days ago; all are in isolation. The State of Alaska Department of Public Health is working with them. We are testing all contacts as they are identified. Both new cases are considered probable travel related cases.

Camai Community Health Center’s medical staff strongly recommends that the community participates in the COVID-19 testing program. Rapid PCR testing is available to anyone at our Leader Creek site Monday, Wednesday, and Friday between 1 – 3. This location will accommodate testing with no out of pocket costs and may be repeated every 10 days. Individuals experiencing symptoms should call the clinic prior to testing so we can schedule a time for your testing to avoid contact with others. Please call 907-246-6155 to schedule.

We are committed to providing COVID-19 testing to anyone in the community and encourage everyone to continue to practice precautionary measures to help prevent the spread of the disease. Camai staff strongly recommends limiting the amount of non‐essential activities and day‐to‐day social interactions.

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

October 26, 2020

As of today, in Alaska, there is a cumulative total of 13,360 positive COVID-19 cases, 6,302 recovered, and 68 deaths. Last week Camai Conducted 64 tests and identified no new cases. As of Friday, October 23, we have administered 91 flu vaccines. The total number of current active cases {physically} in the Bristol Bay Borough (BBB) is 2. They will be reported as none residents.

Today, we have identified 2 positive cases; they are in isolation. The State of Alaska Department of Public Health has been notified and is working with them. We have tested all contacts and all were negative.

The circumstance surrounding these cases is unique. They were part of a working group located elsewhere in the state they are the only ones in the community and the others tested positive once they returned home and the reason we tested them and the contacts. All contacts are in quarantine. We have a testing strategy in place for all contacts but testing will not shorten the time they are to be in quarantine.

As you may know, the State of Alaska has seen a sharp uptick in the number of cases. I urge everyone to take precautions.

  • Isolate yourself if you feel any cold-like symptoms and get tested for COVID-19 as soon as possible.
  • Avoid crowded places and gatherings with anyone outside your immediate household, especially indoor gatherings; keep social circles very small.
  • Stay at least 6 feet away from people outside of your household.
  • Always have a mask on when you are around people outside of your household — even if you can maintain a 6-foot distance from others.
  • Wash your hands often and disinfect commonly touched surfaces and objects.

Tomorrow there should be a press conference by the Governor. I am not sure what will be covered but if any mandates change or are implemented, I will update our website and Facebook page.

Moving forward, I will do a planned update every Monday. If we identify a case during the week, I will put out either a press release or another update.

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

October 19, 2020

As of today, in Alaska, there is a cumulative total of 11,182 positive COVID-19 cases, 5,880 recovered, and 67 deaths. The total number of current active cases {physically} in the Bristol Bay Borough (BBB) is 1. This person will be out of isolation on Wednesday, October 21st. Last week Camai CHC processed 95 tests.

Over the past week, several cases have been reported by the state of Alaska to be in the Bristol Bay & Lake and Peninsula combined Borough. None of these cases have been in the Bristol Bay Borough except for the one we reported on October 12th.

As you may know travel protocols for the state of Alaska have changed. Alaska residents may still test for free at the Anchorage Airport upon arrival into the state or may opt to self-quarantine for 14 days. All travelers into AK are REQUIRED to strict social distance for 5 days. 5 days is the median incubation period for the COVID-19 virus.  Strict social distance allows for outdoor public places, but 6 feet away from others not in your immediate household, wear a face covering and you may NOT enter restaurants, bars, gyms, community centers, sporting facilities, office buildings, and school or daycare facilities. Do NOT participate in any group activities, including sporting events and practices, weddings, funerals, or other gatherings. A second test is optional and can be done 5-14 days after arrival. However, keep in mind if you are testing at the Camai site, you may only receive 1 {one} rapid PCR test every 10 days.

Testing is still available Monday, Wednesday, and Friday at our Leader Creek Clinic between 1pm and 3pm. Anyone can be tested at our site but due to limited supplies each person is eligible once every other week {minimum of 10 days between tests}. We are becoming extremely strict of this rule as to make sure we have enough supplies to last through the end of the year. Plan ahead if you will be traveling and need to have a test prior to leaving. Please be kind to our employees if they tell you are not able to have a rapid test because of the timing between them. We are doing our best to make sure we can test everyone who needs it.

Moving forward, I will do a planned update every Monday. If we identify a case during the week, I will put out either a press release or another update.

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

October 12, 2020

As of today, in Alaska, there is a cumulative total of 9,877 positive COVID-19 cases, 5,177 recovered, and 60 deaths. The total number of current active cases {physically} in the Bristol Bay Borough (BBB) is 1.

Today, we have identified 1 positive case they are now in isolation. The State of Alaska Department of Public Health has been notified and is working to identify all contacts. We are working to test close contacts as they become known to us.

Over the weekend Bristol Bay Area Health Corporation issued a press release for a positive case in the combined Lake and Pen & Bristol Bay Borough. We do not believe this case is in Bristol Bay Borough and is in the Lake and Pen Borough. The case we are reporting today is not that case.

We have gone a couple weeks without a positive test result but this one emphasizes the importance of following recommendations of social distancing and safe hygiene practices. Camai CHC strongly recommends residents to limit the amount of non‐essential activities and day‐to‐day social interactions. Additionally, anyone who must leave their home, is encouraged to wear a facemask in public.

Testing is still available Monday, Wednesday, and Friday at our Leader Creek Clinic between 1pm and 3pm. Anyone can be tested at our site but due to limited supplies each person is eligible once every other week {minimum of 10 days between tests}.

This is a good time to review what quarantine and isolation mean and which one may pertain to you and your situation. This is from a document that Dr. Zink, Medical Director for the State of Alaska, published last week.

Quarantine is for someone who was exposed – it is for 14 days and there are no test-based way to make that shorter {because it can take up to 14 days after exposure for the virus to grow enough to detect}. We do recommend a test near the end of quarantine to make sure you don’t have it, as even people with no or mild symptoms can spread COVID-19.

Isolation is for people who test positive for COVID-19. It is usually for 10 days since their test or onset of symptoms – but for some people who get sick or have compromised immune symptoms, it can be for much longer. Isolation is usually shorter than quarantine because the time has already passed to grow enough virus to detect.

It is important to understand that staff as Camai CHC can NOT determine the quarantine or isolation timelines and who will be mandated to them. The State of Alaska Department of Public Health is the one to make that determination. Our staff works very closely with Public Health and if you have questions, we can pass them along or get answers if you are not able to but we can not shorten a mandated quarantine or isolation.

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

October 7, 2020

As of today, in Alaska, there is a cumulative total of 8,878 positive COVID-19 cases, 5,003 recovered, and 59 deaths. The total number of current active cases {physically} in the Bristol Bay Borough (BBB) is 0.

Last week Camai CHC processed 114 total tests and no positive case was identified.

As you maybe hearing in the news, the state of Alaska is experiencing a surge of COVID-19 positive cases. Alaska is in alert level high currently. There is a prediction that we may see over 300 positive cases in a day in the next twenty days. Fairbanks and Anchorage are experiencing the largest surges but many villages around the state are also seeing outbreaks with the cause of the outbreak to be from residents travelling out of the village and then bringing it in.

In the weekly analysis report from the Alaska Department of Health and Social Services there are some comparisons I would like to share with you:

  • Compared to other states’ case rates, Alaska’s average case rate per capita over the last 7 days (20.1 average daily cases over the last week per 100,000) has jumped from #24 up to tied for #13 with Tennessee
  • If Anchorage were its own state, its 7-day case rate (18.4) would put it at rank #6, between Utah and Idaho
  • If Fairbanks were a state, its 7-day rate of 33.6 would make it #5 in the nation
  • The North Slope Borough would be #4 with a 7-day rate of 34.9
  • The Northwest Arctic Borough’s 7-day case rate of 63.7 puts it at a higher average case rate this week than any state average in the US

When we had our last cluster of cases, we were able to contain it quickly because everyone took all precautions needed seriously. We were able to test anyone who may have been in contact and community members quarantined and isolated as needed. Thank you for your help in protecting the community. But now is not the time to let your guard down, we all need to remain vigilant.

  • Do the 3 W’s: Wear a mask, Watch your distance between others, and Wash your hands.
  • Avoid the 3 C’s: Crowded places, Close contact settings or confined spaces, keep Contacts limited and social bubble small.
  • Do not be around others if you are feeling ill, stay home, and isolate your self from others.
  • Watch for COVID-19 symptoms. Get tested, even if you only have one symptom or the symptom is mild.

Flu shots are still available at the Leader Creek Clinic during COVID testing times, no appointment necessary. Flu shots are done at the far door as to keep separation from COVID-19 testing. Fee is $15

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

September 28, 2020

As of today, in Alaska, there is a cumulative total of 7,597 positive COVID-19 cases, 3,393 recovered, and 56 deaths. The total number of current active cases {physically} in the Bristol Bay Borough (BBB) is 1.

Last week Camai CHC processed 74 total tests and identified 1 positive case. The person identified has been in quarantine since September 9th and will be in isolation until the 30th?

There have been many questions regarding what type of testing Camai is conducting at our Leader Creek clinic. We have a Cepheid Xpert Xpress 4 port machine. The SARS-CoV-2 test is a rapid, real-time RT-PCR test intended for the qualitative detection of nucleic acid from the SARS-CoV-2 in nasopharyngeal specimens collected from individuals. Meaning these tests are a high-level test. Our community is extremely fortunate to have this capability. There are very few communities that offer this type of testing and we can offer them for free. Typically, this test would cost about $100 per person per test. Turn around time is one hour from the time the test is put in the machine until we have a result. Again, this is something we are very fortunate to be able to provide to the community.

In the main Camai clinic, we offer another type of RT-PCR test that takes a total of 15 minutes from the time the test is put in the machine. However, the sensitivity of the machine is different from the Cepheid therefore we reserve this machine for patients who have symptoms in order to get a more accurate result.

Flu shots will be available at the Leader Creek Clinic during COVID testing times, no appointment necessary. Flu shots are done at the far door as to keep separation from COVID-19 testing. Fee is $15

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

September 21, 2020

As of today, in Alaska, there is a cumulative total of 6,906 positive COVID-19 cases, 2,227 recovered, and 45 deaths. The total number of current active cases {physically} in the Bristol Bay Borough (BBB) is 4.

Today we identified one positive case. This person has been in quarantine as a close contact since September 9th and we do not feel there is a threat of spread from this case. This is a reminder of why it is so important for anyone who is a close contact to remain in quarantine for the full 14 days and test at the end of it. This person has been in quarantine for 12 days, no symptoms and converted to positive late into quarantine. The only way we will be able to protect our elders and those who are vulnerable is to remain diligent and when public health deems you need to quarantine, take it seriously and stay away from others.  

The Leader Creek Clinic Testing Site is operating Monday, Wednesday, and Friday between 1-3pm for COVID-19 testing. Staff will call you with your results that evening and hard copies are available for pick up the following business day at the clinic. We will email results on the following business day as well if requested. We will NOT email results on Friday evenings or over the weekend, they will be emailed on Monday. Please keep this in mind when you are testing. Friday’s are normally a larger testing day requiring staff to stay past 7pm or 8pm and due to internet security and HIPPA laws, we are unable to email from the Leader Creek site. Thank you for your understanding.

Flu shots will be available at the Leader Creek Clinic during COVID testing times, no appointment necessary. Flu shots are done at the far door as to keep separation from COVID-19 testing. Fee is $15

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

September 14, 2020

As of today, in Alaska, there is a cumulative total of 6,353 positive COVID-19 cases, 2,168 recovered, and 44 deaths. The total number of current active cases {physically} in the Bristol Bay Borough (BBB) is 8.

Today, we have identified 2 positive cases, however 3 previous cases are considered not active as of tonight and will be out of isolation. The two positive cases are close contacts to those who tested positive last week. They had previously tested negative last week. All are symptomatic. Both are in isolation and Public Health is working on contact tracing.  

Our current situation emphasizes the importance of following recommendations of social distancing and safe hygiene practices. Camai CHC strongly recommends residents to limit the amount of non‐essential activities and day‐to‐day social interactions. Additionally, anyone who must leave their home, is encouraged to wear a facemask in public.

Testing is still available Monday, Wednesday, and Friday at our Leader Creek Clinic between 1pm and 3pm.

Camai has received flu shots, if you would like to receive one, please call the clinic for an appointment. Flu shots are $15. We will have Flu Shot Clinics later this week or next, we will advertise once we have them scheduled.

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

September 11, 2020

As of today, in Alaska, there is a cumulative total of 6,113 positive COVID-19 cases, 2,152 recovered, and 43 deaths. The total number of current active cases {physically} in the Bristol Bay Borough (BBB) is 9.

Since Friday, we have identified 10 positive cases, however only 9 are still active. Everyone is now in isolation and public health has worked with them to identify close contacts. Close contacts are required to remain in quarantine for 14 days even if you receive a test and it comes back negative prior to the 14th day.

There has been a lot of questions of Camai CHC staff regarding who is in quarantine and why some people are not in quarantine. The public health nurse/worker who is assigned the case is the only person to determine who is a contact and how long their quarantine is to last. There are multiple factors to consider and each case is determined independently. Unfortunately, there is nothing we can do except report to public health what we hear or have questions about. Neither Camai CHC or the police department receive a list of contacts, so it is an honor system between public health and the individuals. However, if Camai staff has questions/concerns we call the assigned PHN for information. Again, we can not determine who is a close contact or when quarantine or isolation begins or ends. If you do test positive for COVID-19 we urge you to be honest about all the people you have been in contact with so we can help stop the spread in our community. Please keep your social interactions to a minimum as another way to minimize the risk to the community.

There are many questions regarding why Camai uses the testing protocol we use. Camai CHC follows the State of Alaska’s recommended testing protocols. Here is an update to Camai CHC’s COVID-19 testing protocols:

  • If you are identified as a close contact to a positive person, you are to quarantine for 14 days. At day 7 or later, if you do not have symptoms, you are eligible for a COVID-19 test. This test will NOT get you out of quarantine, but will help identify if you have converted to COVID-19 positive. If you do develop symptoms prior to day 7, please contact the clinic and a medical provider will advise you as to your next steps.
  • If you have traveled into Bristol Bay Borough from outside of Alaska, you are eligible for a test at day 7 or later after arrival into Bristol Bay Borough. This also, will NOT get you out of quarantine.
  • If you would like to get a test and neither of the 2 above items pertain to you, you are eligible for a test every other week.
  • If you test positive for COVID-19 you are not eligible for a test for at least 3 months.

It is also important to understand how the virus is shed {transmitted}. The following is information from the CDC website as of September 11, 2020:

When is someone infectious?

The onset and duration of viral shedding {transmission} and the period of infectiousness for COVID-19 are not yet known with certainty. Based on current evidence, scientists believe that persons with mild to moderate COVID-19 may shed SARS-CoV-2 for up to 10 days following symptom onset, while a small fraction of persons with severe COVID-19, including immunocompromised persons, may shed virus for up to 20 days. It is possible that SARS-CoV-2 RNA {RNA, ribonucleic acid, is the DNA equivalent for the SARS-CoV-2 virus} may be detectable in the upper or lower respiratory tract for weeks after illness onset, similar to infections with MERS-CoV and SARS-CoV. However, detection of viral RNA does not necessarily mean that infectious virus is present. Based on existing literature, the incubation period (the time from exposure to development of symptoms) of SARS-CoV-2 ranges from 2–14 days.

This is a lot of information and potentially frightening to some, please if you have questions, do not hesitate to contact me.

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

Media Release September 8, 2020

September 4, 2020

As of today, in Alaska, there is a cumulative total of 5,586 positive COVID-19 cases, 2,096 recovered, and 40 deaths. The total number of current active cases {physically} in the Bristol Bay Borough (BBB) is 4.

We have identified three positive cases today. They are now in isolation and public health will be working with them to identify close contacts. We have tested several close contacts and if we have any other positives to report I will publish a media release. If you have been contacted as a potential close contact, we will have testing available Saturday, September 4, 2020 at the Leader Creek site between 11am-1pm. If you are a close contact, we ask that you remain in quarantine for 14 days even if your test comes back negative and monitor for symptoms. The reason to stay in quarantine is because you may not have enough virus in your system to be positive yet. It can take up to 12 days from your initial encounter to become positive.

My last update caused a bit of confusion. We are still testing every Monday, Wednesday, and Friday between 1-3 however you are only able to get a test every other week {once every 10-14 days} to ensure we have enough testing supplies to last into the late Fall. The maker of the cartridges we need for our machine will not have additional cartridges available for purchase until at least October, maybe November. There may be times we will have to send your test to the state lab instead of running them locally depending on the number of tests that need to be run in a given day. Priority for locally ran tests will be as follows:

  1. Close contacts to a positive case
  2. Those traveling into Anchorage for a medical procedure
  3. Those who have traveled to King Salmon/Naknek/South Naknek and are on day 7 or later of their quarantine
  4. All others

*** Remember anyone who has symptoms will need to call the clinic and talk to a provider before going to the testing site for a test.

The state of Alaska sent an update to medical providers today about a study on masks. I will include it below. However, N95 masks are recommended for health care workers only.

A small, methods-focused study from Duke used cameras and laser beam scatter light to measure respiratory droplet penetration through various masks while the wearer spoke, mimicking normal daily use. Unsurprisingly, a fit-tested n95 had the best respiratory droplet containment, followed by a surgical mask. Valved n95s performed more poorly, and knitted masks were worse than other intact fabric masks. Bandanas performed surprisingly poorly, with some trials showing more droplets were aerosolized than with no mask at all. Perhaps the most surprising result was for a fleece neck gaiter, which actually was found to aerosolize more respiratory droplets than no mask at all over the ten repetitions each mask underwent. Authors commented that this may have been because the neck gaiter broke larger droplets into smaller droplets, increasing droplet count; smaller droplets also tend to hang in the air for longer. They emphasized that this is a small study published primarily to demonstrate a method for evaluating masks, with more replication needed. 

Clinicians working in offices or hospitals that require staff, patients and/or visitors to wear masks may want to consider specifying which types of masks are acceptable. Surgical masks, non-valved n95s and multilayer cloth masks, when worn correctly, may be more effective in preventing respiratory droplet spread during normal speech than valved masks, neck gaiters, bandanas, and no mask. We can also help educate patients on the importance of wearing a mask correctly, covering nose, mouth, and chin, and not touching the mask without sanitizing hands afterwards. 

This is a lot of information and potentially frightening to some, please if you have questions, do not hesitate to contact me.

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

August 31, 2020

As of today, in Alaska, there is a cumulative total of 5,263 positive COVID-19 cases, 2,044 recovered, and 37 deaths. The total number of current active cases {physically} in the Bristol Bay Borough (BBB) is 1.

Due to the repositioning of the large COVID-19 testing machine this week, the low rate of positive cases in the community, and to ensure our supplies are adequate for the Fall, we are making a couple changes to our testing site. You will be eligible for a free asymptomatic {symptom free} test every other week unless you are returning from travel out of the area or need a test to travel for a medical procedure. All group testing will need to be arranged with Veronica Wood via email at: veronicawoodcchc@gmail.com. This will ensure we have the staff available to process the tests.

As always, if you have symptoms related to COVID-19, please call the clinic and we will arrange an appointment to see and will test you.

Over the weekend the State of Alaska Department of Health and Social Services issued a memo to Health Care Providers regarding asymptomatic testing of people during quarantine. I am including it here for your reference.

Note for Health Care Providers on Asymptomatic Testing of People During Quarantine 

You may have seen the CDC guidance stating that if you have been in close contact with someone who tested positive with COVID-19 and you’re not experiencing symptoms yourself, that you don’t necessarily need to be tested. Alaska’s current testing guidance will not change, and DHSS continues to recommend testing for all individuals who have been identified as close contacts to individuals who have tested positive for COVID-19.

“We still recommend that asymptomatic people who were in close contact to an infected person get tested during their quarantine period.  For people who were put into quarantine promptly after their exposure, we recommend testing during the second week of their 14-day quarantine period.  However, for people who were exposed a week or more before they were put into quarantine, it would be appropriate to get tested right away,” says DHSS Chief Epidemiologist Dr. Joe McLaughlin. “The main problem we want to avoid is asymptomatic people getting tested too early after their exposure to decrease the likelihood of a false-negative test for those who are infected with the virus that causes COVID-19.”

Testing asymptomatic people during their quarantine period helps to identify those who are infected with the virus, their need to be in isolation, and the need to notify and quarantine their close contacts.

It is also important that people remain in quarantine for the full 14 days even if they test negative at some point during the quarantine period. A negative test does not shorten quarantine but helps determine who else may have been exposed to the virus.

Anyone who does develop symptoms of COVID-19 should be tested as soon as possible.

Camai Community Health Center will continue to follow all guidelines issued by the State of Alaska.

Finally, Camai Community Health Center is governed by a volunteer Board of Directors. I would like to personally thank each of them for their tireless help during this pandemic and for directing our path as we go down this road of uncertainty. If you see them out and about in the community, please thank them for all their hard work. Current board members are Tanya Hansen, Anishia Elbie, Rebecca Ingalls, Stan Swetzof, Robert Lee, Jeff Swanson, Deborah Jones, and Pete Caruso {appointed by BBB}.

If you are interested in joining the board, please reach out to one of them or me and we will get an application to you. We currently have 3 seats open on the Board.

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

August 28, 2020

As of today, in Alaska, there is a cumulative total of 5,092 positive COVID-19 cases, 1,993 recovered, and 37 deaths. The total number of current active cases {physically} in the Bristol Bay Borough (BBB) is 2.

Next week our testing capacity will decrease slightly. The state of Alaska is repositioning the 16-port Cepheid machine we currently have to Kodiak and replacing it with a 4-port machine. This means we will still process tests here, but it will take us longer to process them.

As Summer turns to Fall we want to remind everyone to have your annual check-up. Camai continues to provide primary care and we have time slots reserved every day for this type of appointment so we can limit exposure in the clinic with those who are ill. Sports physicals, well child visits and vaccines, well women and well men appointments are available. Flu shots have been ordered and once we receive them, we will communicate that also.

Now is not the time to let your guard down and to remain vigilant of your surroundings. If you are in an indoor space and cannot maintain 6 feet of separation, leave, and return later if you can. Wear a mask. Wash your hands for at least 20 seconds throughout the day especially if you are around others.

Key Times to Wash Hands

You can help yourself and your loved ones stay healthy by washing your hands often, especially during these key times when you are likely to get and spread germs:

  • Before, during, and after preparing food
  • Before eating food
  • Before and after caring for someone at home who is sick with vomiting or diarrhea
  • Before and after treating a cut or wound
  • After using the toilet
  • After changing diapers or cleaning up a child who has used the toilet
  • After blowing your nose, coughing, or sneezing
  • After touching an animal, animal feed, or animal waste
  • After handling pet food or pet treats
  • After touching garbage
  • After you have been in a public place and touched an item or surface that may be frequently touched by other people, such as door handles, tables, gas pumps, shopping carts, or electronic cashier registers/screens, etc.
  • Before touching your eyes, nose, or mouth because that’s how germs enter our bodies.

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

August 26, 2020

As of today, in Alaska, there is a cumulative total of 4,895 positive COVID-19 cases, 1,899 recovered, and 37 deaths. The total number of current active cases {physically} in the Bristol Bay Borough (BBB) is 2.

I apologize for the lack of updates last week. I was taking my son to college and was unable to update regularly. Last week we identified one positive case in an Alaska resident but not a Bristol Bay Borough resident. They are in isolation and all contacts are quarantining. 

Today, we identified a positive individual. This person is a resident of BBB and now in isolation. A few close contacts have been identified and have tested negative and are in quarantine. As the State of Alaska Department of Public Health begins their investigation, more contacts may be identified and will be contacted.

There have been a lot of questions regarding quarantine requirements for BBB residents. Currently the Bristol Bay Borough does not have a mandate outside of what the state has. Here is a breakdown on the state mandate 10 in effect as of today:

Interstate/International travel

For Alaska resident travelers:

  • Test 72 hours prior to travel into Alaska.
  • If unable to test prior to traveling into Alaska – Testing at arrival into Anchorage remains available at no cost to Alaska residents.
  • A 14-day quarantine only option is still available to Alaska residents. This means you will travel to your final destination and quarantine for 14 day upon arrival. You are not permitted to “stop over” in a community without quarantining. For example: you are traveling to King Salmon from Seattle but want to stay in Anchorage for a day to grocery shopping. You will have to quarantine for 14 days in Anchorage prior to traveling to King Salmon.
  • Travelers with negative results prior to arrival in Alaska must still follow strict social distancing for 14 days after arriving into the state or until the traveler receives a second negative test result from a test taken 7-14 days after arrival.

Intrastate {instate) travel:

  • There is no State-mandated requirement for intrastate travelers to test prior to travel or to quarantine while waiting for these test results or once arriving in the community.
  • Alaska residents traveling to an Alaskan community that recommends or requires testing prior to entry is eligible to receive traveler testing.
  • The traveler must agree to comply with all local requirements, if they have them, at their final destination to mitigate the introduction of COVID-19 into remote communities.

Again, the Bristol Bay Borough does not have a mandate for quarantine or testing that is different from this state mandate. However, we encourage everyone to quarantine if they have traveled outside our community. The entire mandate can be read at: https://covid19.alaska.gov/wp-content/uploads/2020/08/08062020-COVID-MANDATE-010-REVISED.pdf

During the re-opening discussions with the school, we have identified the need to have someone with medical knowledge in the school to help with decision making. Due to the unknowns of the pandemic and the effect it will have within the school Camai decided to hire a Pediatric Nurse Practitioner to fill this role. The provider will be stationed at the school and will be able to make the determination if a student needs to be sent home, and if so for how long, or the student is safe to stay in school if they are exhibiting COVID-19 symptoms on site. Because many COVID-19 symptoms are the same as a cold or allergies it could be hard for a school staff person to determine this. If it is determined a student needs to be sent home, she will be able to work with parents on ways to protect themselves and others in the home. We are still working through all the requirements that we will need to have in place for this partnership. As we get the details worked out, we will communicate those to everyone, and any paperwork needed will be sent to the parents. Whitney Holmes, PNP will be joining us in the first week of September.

Camai is also excited to announce we have once again filled our Social Emotional Learning {SEL} Coach position. We are pleased to have Ashley Bales working with us again this year. Here are a few highlights of the position:

What is the point?

The goals of social emotional learning (SEL) are fostering student skills around self-awareness, self-management, social awareness, relationship skills, and responsible decision making; not surprisingly kids with these skills do better in school, work, and relationships! SEL has become mainstream and during COVID it has received even more attention. Kids with these skills need less therapy, less medical interventions, and less support from external community resources. The goal is to build resilience by offering kids tools they can use to manage the realities of life.

How does this position fit in with Camai’s other behavioral health services? 

We have been doing training on creating a trauma sensitive school environment and SEL for several years at the school. The teachers and staff have become increasingly invested each year but are stretched thin. Having a full-time resource in the school environment will help SEL reach more kids- many who will never experience a clinical intervention like a behavioral health consultation or psychotherapy session. 

Is Ashley a school counselor? 

No. Ashley’s job is to support the teachers and staff to incorporate SEL into their classes, not serve as a school counselor. Instead Ashley will be helping teachers by leading SEL activities with their classes, bringing behavioral health messaging into the school environment, being a resource for information on SEL and providing staff, kids, and parents information about Camai’s behavioral health offerings.

Will Ashley help kids having a hard time?

Yes! But not just kids having a hard time. All kids benefit from increased self and social awareness, relationship skills and decision making. These are core skills that all kids need so her work will be focused on helping everyone at the school- not just the kids with behaviors that have attracted attention. 

Is Ashley going to be doing therapy at the school?

No, the SELC position is not a clinical position and that is not her purpose for being there. Anyone needing clinical behavioral health services should contact Kathryn or Pete at Camai CHC.

If you have any questions, please do not hesitate to contact me.

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

August 10, 2020

As of today, in Alaska, there is a cumulative total of 3777 positive COVID-19 cases, 1153 recovered, and 26 deaths. The total number of current active cases {physically} in the Bristol Bay Borough is 1. As of Friday, August 7th Camai has performed 8,883 tests.

As many of you know Camai Community Health Center. INC is a Federal Qualified Health center and most of our funding comes to us in the form of a grant from the Bureau of Primary Care’s {BPC} Health Resources and Services Administration {HRSA}. Because of the funding we receive there are reporting requirements we must follow and report back to HRSA regarding how we spent the funds we received. There have been many questions as to why we ask for social security numbers, ethnicity, race, and if you have health insurance when you come to our testing site. All of these are requirements for the funding we get. Unfortunately, there is not a way for us to do the testing without gathering this information for our grant.

As community members begin to travel to and from our community, we ask that you please be aware of the days and times we offer testing. Currently testing is available Monday, Wednesday, and Friday between 1 pm and 3 pm. Because our providers also see patients in clinic, we can guarantee we can provide a test to you outside of these hours. As a reminder, our testing site is now in our Leader Creek Clinic. All test results are available for pick up at the main Camai clinic the following day. No results are available at the Leader Creek site.

School will begin shortly and I think it is time to discuss again how the state will determine when you are to start quarantine and can discontinue quarantine if you are in contact with someone who has tested positive. Because there is potential for families to be in a quarantine situation for a minimum of 25 days, it is important to understand how this works before it happens to you and you can put a plan in place for your family. I hope the following will help.

If you live in the same household with someone who test positive and you are not able to isolate them away from you {such as a parent to a child}:

  • The positive person must stay in isolation for 10 day from the date of their positive test and all fever, fever reducing medicine or symptoms have been resolved for at least 24 hours.
  • The household member’s 14-day quarantine BEGINS the day AFTER the positive household member’s 10-day isolation has ENDED or the last day they had contact.

2 Examples:

  • Little Suzy tests positive on the 1st of September. She needs mom to take care of her, and mom is with Suzy all 10 days of her isolation. Mom will isolate with Suzy for the entire 10 days. Suzy can go back to school on the 11th because she is out of isolation and has not had a fever, fever reducing medicine or symptoms for at least 24 hours. Mom will begin her 14-day quarantine on the 11th and will be able to leave quarantine on the 25th.  
  • Little Suzy tests positive on the 1st of September. She is able to isolate from mom for her entire 10 days. Suzy can go back to school on the 11th because she is out of isolation. Mom will be able to leave quarantine on the 15th.

If you have any questions about this, please do not hesitate to contact me.

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

August 7, 2020

As of today, in Alaska, there is a cumulative total of 3536 positive COVID-19 cases, 1062 recovered, and 25 deaths. The total number of current active cases {physically} in the Bristol Bay Borough is 4. However, on Sunday we will have only 1 positive in the community as the others will have been transferred to recovered and will travel out of Naknek.

This week we have identified 2 positive cases: one resident and one non-resident. One has since left the community the other is still here and in isolation. All close contacts have been notified and are in quarantine. Last week there was a resident of BBB & Lake and Peninsula Borough combined area reported by the state on their dashboard. We have been told by Alaska Public Health this person is not currently in the region however, they are reported in the area of residency on the dashboard.

We have moved our COVID-19 testing site to the Leader Creek Clinic. Testing is available to anyone between 1pm-3pm on Monday, Wednesday, Friday. If you have a group of 10 or more people who need tested outside of these hours, please call the clinic and we will arrange testing for your group. All results will be available for pick up at the main Camai clinic, not at the Leader Creek clinic.

As more positives are detected in the community, it is important that everyone takes precautions. We cannot tell you how to do this, but we can tell you what has been proven to help and they are simple to do. Be diligent about keeping six feet away from others, wear a cloth face covering when you are out in public, wash your hands often, isolate and call Camai or a BBAHC clinic if you’re experiencing even mild COVID-19 symptoms. When you return from travel, voluntarily quarantine for 14 days upon your return.

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

August 3, 2020

As of today, in Alaska, there is a cumulative total of 3341 positive COVID-19 cases, 946 recovered, and 25 deaths. The total number of current active cases {physically} in the Bristol Bay Borough is 3. Two of the 5 listed in Friday’s update are now recovered and can leave isolation. We have moved our COVID-19 testing site to the Leader Creek Clinic. Testing is available to anyone between 1pm-3pm on Monday, Wednesday, Friday. If you have a group of people who needs tested outside of these hours, please call the clinic and we will have someone call you back to discuss a different time for your group.

Today, the State of Alaska and I had a conversation regarding the 16 port Cepheid machine we have been using. The State will be redeploying it to Kodiak to support their fishing industry. We will receive a smaller machine, 4 port, in exchange. Although we like the convenience of being able to run 16 tests at a time, I am confident we will still be able to test everyone we need to in a timely manner.  

Last week the Bristol Bay Borough sent in a grant application to the Alaska Community Foundation for the Coronavirus Nonprofit Relief Fund {CNRF}. The State of Alaska set aside $35 million from the CARES Act into the CNRF and eligible organizations can submit a grant application to the fund. Although Camai is a 501©3, we do not have a designation of 509(a)1,2 or 3 therefore we were not eligible to apply for funding ourselves. The Borough was able to incorporate our request of two Cepheid 4 port machines into their application. We hope the application is funded so we can continue testing the way we have been. If the application is not funded, we will order one machine, it will be a tight fit in our budget. But we will make it work because our priority is protecting our community. We appreciate the Borough’s willingness to help get the funding needed for the machines.

This week I will change the update days to Monday and Friday unless something of great importance comes up before Friday. I will continue to issue media releases if we detect any positive COVID-19 cases.  

If you believe they have been exposed to COVID-19 and develop a fever and/or symptom, such as a dry cough or difficulty breathing, call Camai at 246-6155. The following symptoms may appear 2-14 days after exposure:

• Fever or chills                                                           • Cough

• Shortness of breath or difficulty breathing        • Fatigue

• Muscle pain or body aches                                   • Headache

• Sore throat                                                               • New loss of taste or smell

• Congestion or runny nose                                     • Nausea or vomiting

• Diarrhea

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

July 31, 2020

As of today, in Alaska, there is a cumulative total of 2990 positive COVID-19 cases, 898 recovered, and 23 deaths. The total number of current active cases {physically} in the Bristol Bay Borough is 5. As of July 28, 2020, Camai has performed 8,619 COVID-19 Tests.

Thursday, Camai identified three positive individuals in a seafood processing plant; all are in isolation. These cases were identified while conducting testing as part of the processors Community and Workforce Protective Plan. The State of Alaska Public Health Department was contacted immediately, and contract tracing has started. We will continue to monitor their health and will keep the public informed of any information that is needed for community health and safety however, we are do not feel there is a threat of community spread from these cases.

Camai COVID-19 Testing Update:

Depending on the weather this weekend, we hope to move our testing site to our Leader Creek Clinic. There has been some concern regarding how close our clinic is to food and the overall congestion in the area. We have taken all of this into consideration and feel we can continue to provide testing to the community in a safe manner. Our staff has had training by infectious disease experts and feel we can do the testing safely in this area. Testing will be done outside as this is the safest way to test. We will have the swabbing area on the side opposite of the doors. The little side road is currently blocked on one side, and we will block the other side to ensure there is not excess traffic there. We will be offering testing Monday, Aug. 3rd, Wednesday, Aug. 5th, and Friday, Aug. 7th 1-3. We will decide what the permanent hours will be next week; please keep an eye out for that announcement. We will have a signs to help direct you where to go.

Today the State of Alaska Department of Public Health today sent me an updated outline regarding isolation and quarantine. This information should answer any questions I may have missed in my last update.

Isolation: Separates people who are infected with the virus that causes COVID-19 from others.

People in isolation should:

  • Stay home except to get medical care
  • Monitor symptoms and seek emergency medical care if they develop difficulty breathing persistent pain or pressure in the chest, new onset confusion, inability to wake or stay awake, bluish lips or face

Isolation lasts until:

  • At least 10 days since symptoms first appeared AND
  • At least 24 hours with no fever without fever-reducing medication AND
  • Symptoms have improved

If a person had a positive COVID-19 test but never had any symptoms, isolation lasts until 10 days have passed since the date the specimen was collected that tested positive.

Isolate if you are sick or have had a positive COVID-19 test even if you do not feel sick.

Quarantine: Keeps someone who might have been exposed to COVID-19 away from others. Quarantine helps prevent spread of disease that can occur before a person knows they are sick or if they are infected with the virus without feeling symptoms.

People in quarantine should:

  • Stay home for 14 days after the last contact with a person who has COVID-19, and stay away from others as much as possible, especially people who are at higher risk of getting very sick from COVID-19
  • Watch for symptoms of COVID-19, which can include fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea
  • Get tested if they have symptoms.

Quarantine if you were in close contact with someone who has COVID-19.

Close Contact:

  • Within 6 feet of someone who has COVID-19 for at least 15 minutes
  • Provided care at home for someone who is sick with COVID-19
  • Had direct physical contact with a person who has COVID-19 (touched, hugged, or kissed them)
  • Shared eating or drinking utensils with someone who has COVID-19
  • Someone with COVID-19 sneezed, coughed, or somehow got respiratory droplets on you

Case investigation: Public health staff will work with a person who has tested positive for COVID-19 to help them recall everyone they have had close contact with during the time they may have been infectious.

Contact tracing: Public health staff will notify exposed people (contacts) of their potential exposure and ask them to self-quarantine for 14 days after the date of the exposure to prevent them from spreading the virus to others if they did become infected by their exposure.

Infectious Period:

  • Symptomatic: A person who has COVID-19 is considered to be infectious starting two days before symptoms start until 10 days after symptoms start as long as they no longer have a fever and symptoms are improving.
  • Asymptomatic: A person who tested positive for COVID-19 but never has symptoms is considered to be infectious starting two days before the specimen was collected that tested positive until 10 days after that specimen was collected.

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

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

July 27, 2020

As of today, in Alaska, there is a cumulative total of 2622 positive COVID-19 cases, 817 recovered, and 21 deaths. The total number of current active cases {physically} in the Bristol Bay Borough is 0, that we know of.

Both positive cases that were in Bristol Bay Borough have been cleared from isolation. On Friday, July 24th Camai identified 2 positive cases that are not inside Bristol Bay Borough and have been recorded as non-residents by the State of Alaska {SOA} Department of Public Health.

There have been several questions regarding close contacts. Here are some answers to questions I have vetted over the last few weeks. Disclaimer: this is for our community, Bristol Bay Borough, as of today; because we do not have an active outbreak in our community, our public health nurse is able to contact those who need to be contacted. This is subject to change if we have an outbreak or Camai is notified of a change. If that happens, I will include the new information in an update. This information may not be true for other areas of Alaska.

Question: Will I be contacted if I am a close contact?

Answer: Yes, however, it may take a couple of days to call everyone. The SOA requests anyone that has tested positive to contact their immediately known contact to inform them they may have been exposed and should take precautions.

Question: What do I do if a “contact” of mine tells me I may have been exposed but I do not get a call from the SOA?

Answer: Either you were not identified by the positive person during the interview or the SOA does not consider you to be a close contact based on the interview they conduct with the positive person. Please follow up with your contact and ask them if they identified you. If not, they can contact the Public Health Nurse {PHN} in charge of their case and tell them about you. You may then be contacted and asked about your exposure, if it is warranted, based on the explanation given to the PHN and review of the interaction. If you are still unsure of your exposure, please contact me, I will contact the PHN and explain the situation and either the PHN or I will respond, as appropriate.

Question: I work with a person who has a family member that has tested positive or is a close contact, what does that mean for me?

Answer: Normal social distancing and monitor for symptoms would be in order. An entire family may not be considered a close contact and may not need to quarantine. Again, if the SOA has not contacted you, you are not considered a close contact. However, if you are still unsure of your risk, please contact me, I will contact the PHN and explain the situation and either the PHN or I will respond, as appropriate.

Question: What do I do if I have been contacted by public health that I am a close contact?

Answer: Self-Quarantine and monitor of symptoms for 14 days. You cannot “test” out of quarantine as a close contact. If there are additional members in your family you will need to limit your interactions, staying 6 feet away from them. When interacting with others in your household, you should wear a cloth face covering over your nose and mouth to help protect others in case you’re infected but don’t have symptoms. There are a number of preventive measures that you can put in place to protect your family and other household members, such as: washing your hands often for at least 20 seconds, wiping down shared spaces with appropriate cleaning products, keeping a separate set of dishes, silverware, and glasses available for your use. It may be important to identify other people to assist you with daily life activities during self-quarantine. You will need to stay at home and therefore you may need others to support you in grocery shopping, picking up medications, and caring for children and other family members during this time. If you develop symptoms, please contact Camai CHC at (907) 246-6155.

At the end of the week, we will be moving our testing site out of the pool and into the Leader Creek Clinic. We will decide on hours later this week and will have that information in our next update.

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

July 22, 2020

As of today, in Alaska, there is a cumulative total of 2132 positive COVID-19 cases, 753 recovered, and 19 deaths. The total number of current active cases {physically} in the Bristol Bay Borough is 2, that we know of.

As the commercial fishing season winds down, we would like to thank all the processors, support industries, and fisherman for everything you did to help protect our community from COVID-19. Because of the precautions you took, Bristol Bay Borough and our region has been able to have the fishing season we needed. We are grateful beyond measure for your help with our response to the COVID-19 pandemic. We have all learned a lot and this is a season many of us will remember for our lifetime.

Our work is not done, we have sports fishing, tourism, and summertime travel beginning. We must remain diligent and continue to do all the safety measures we have learned. Physically distance yourself from others, keep your social “bubble” small, wear a mask when around others, wash your hands and wash them often, and respect others if they are hesitant to come to near to you. Bristol Bay Borough is a very social community and we will get back to the way we have always been, but for now, let us all help protect the elders and vulnerable.

Due to a known resident case in the community, we encourage everyone in Bristol Bay Borough to get tested, especially if you are in a job with a lot of contact with the public, such as restaurants, bars, gas stations, and grocery stores. Free COVID-19 testing for asymptomatic persons is available Monday – Friday 1pm-3pm at the swimming pool area by the clinic, follow the signs, and no appointment necessary. The tests are available at no cost and may be repeated every seven (7) days.

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

July 20, 2020

As of today, in Alaska, there is a cumulative total of 1949 positive COVID-19 cases, 712 recovered, and 18 deaths. The total number of current active cases {physically} in the Bristol Bay Borough is 2, that we know of. Camai CHC has processed 8,444 tests as of today.

Over the last few days, we have identified two positive cases in the community. One is a resident of Bristol Bay Borough, is now in isolation, and all close contacts have been notified. The other case is an employee of Camai CHC, in isolation, close contacts notified, and we have placed additional staff in quarantine as a precaution.

There have been many rumors surrounding these cases. I want to take this opportunity to dispel a couple of them.

  • We went over EVERY visit in detail for July 14 – July 16 and identified every interaction between every employee and persons who visited the clinic. We left no stone unturned. We know who entered every room because we have hallway cameras {there is no camera in any patient room} and could easily identify all interactions.
  • I called all community members that had ANY interaction with our positive employee or in-clinic close contacts. If you did not receive a call from me, you had no interaction with any of these employees and are therefore not considered at risk for exposure.
  • I apologize I could not call every person who was in the clinic, but I had to prioritize those who we were the highest risk.
  • All close contacts of the resident case have been contacted, many have been tested, and are quarantining.
  • The clinic case did not cause the resident case.
  • The clinic did not close because of our positive case. Since the beginning of the pandemic, protocols have been in place to allow the clinic to remain staffed in the event of a positive case in our workforce. These protocols have proven to be effective.

There was an article published in the New York Times and on KTUU stating that Bristol Bay Borough has the “highest number of recent cases per resident.” The information is very misleading. When the article was published, BBB did not have a resident case. They were using all cases identified in the Borough without considering the influx of seasonal people into the Borough or the fact all the cases were identified in that population. There have been a couple of articles issued since that one explaining how modeling does use assumptions, unfortunately, the NY Times article did not clearly explain this. The assumption in this model is we only have 800 people currently in BBB.

Due to a known resident case in the community, we encourage everyone in Bristol Bay Borough to get tested, especially if you are in a job with a lot of contact with the public, such as restaurants, bars, gas stations, and grocery stores. Free COVID-19 testing for asymptomatic persons is available Monday – Friday 1pm-3pm at the swimming pool area by the clinic, follow the signs, and no appointment necessary. The tests are available at no cost and may be repeated every seven (7) days.

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

July 13, 2020

As of today, in Alaska, there is a cumulative total of 1539 positive COVID-19 cases, 620 recovered, and 17 deaths. The total number of current active cases {physically} in the Bristol Bay Borough is 7. Between Friday and today, we have had 4 positive cases in seafood workers.

 The state of Alaska has reported 2 resident cases in the Bristol Bay Borough plus Lake and Peninsula combined region however, neither of those cases are in Bristol Bay Borough; to date, we have not had a resident case.

The number of cases in the state has increased exceptionally in the last week. Although we do not know the exact reason Camai staff is increasingly concerned for our community. The increase of visitors to BBB that does not have the same quarantine mandates as the commercial seafood industry is the main cause of our concern. We are working to find ways to help support the tourism industry in the community and region while keeping everyone safe.

As the fishing season comes to an end, and residents decide to go on vacation, the potential for a community spread increases. Now is the time to be hyper-vigilant of your surroundings. If you are in an indoor space and cannot maintain 6 feet of separation, leave, and return later if you can. Wear a mask. Wash your hands for at least 20 seconds throughout the day especially if you are around others. When you return from travel, voluntarily quarantine for 14 days upon your return.

Key Times to Wash Hands

You can help yourself and your loved ones stay healthy by washing your hands often, especially during these key times when you are likely to get and spread germs:

  • Before, during, and after preparing food
  • Before eating food
  • Before and after caring for someone at home who is sick with vomiting or diarrhea
  • Before and after treating a cut or wound
  • After using the toilet
  • After changing diapers or cleaning up a child who has used the toilet
  • After blowing your nose, coughing, or sneezing
  • After touching an animal, animal feed, or animal waste
  • After handling pet food or pet treats
  • After touching garbage
  • After you have been in a public place and touched an item or surface that may be frequently touched by other people, such as door handles, tables, gas pumps, shopping carts, or electronic cashier registers/screens, etc.
  • Before touching your eyes, nose, or mouth because that’s how germs enter our bodies.

Follow Five Steps to Wash Your Hands the Right Way

Washing your hands is easy, and it is one of the most effective ways to prevent the spread of germs. Clean hands can stop germs from spreading from one person to another and throughout an entire community—from your home and workplace to childcare facilities and hospitals.

Follow these five steps every time.

  • Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
  • Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.
  • Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
  • Rinse your hands well under clean, running water.
  • Dry your hands using a clean towel or air dry them.

Free testing is still available to the community and anyone who would like a test in Bristol Bay Borough. If you are experiencing any symptoms, please call Camai at (907) 246-6155. If you do not have symptoms but still want to get tested, walk-in testing is available at our testing site located at the BBB Pool; Monday – Friday from 1pm-3pm.

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

July 8, 2020

As of today, in Alaska, there is a cumulative total of 1226 positive COVID-19 cases, 563 recovered, and 17 deaths. The total number of current active cases {physically} in the Bristol Bay Borough is 7.

Between Monday and today, we have had 4 positive cases in seafood workers. They have all been in quarantine since arriving in Bristol Bay Borough and are now in isolation. As you can tell from the number of cases physically in the Borough, many have left the community. The recent 4 cases are included in the 7 still in BBB. All our current cases have had negative results prior to the positive one so we are confident we are catching positive cases early.

Last week Camai CHC performed 1,302 tests for a combined total of 7,566. This week should be the last of large amounts of processor testing. We will still have smaller groups after this and will do contract testing as needed. All staff at Camai is tested weekly to ensure the safety of our patients, co-workers, and family members.

Camai CHC is taking any precaution we can to ensure the community is protected. With help from everyone in the community we can keep any case from becoming a situation where we have spread of COVID-19 within the community. I am sure everyone is tired of wearing masks, washing our hands as often as we have been, and not being able to do the many things we are used to doing in the summer, like bonfires. However, we feel the reason we have been able to keep community spread from happening is because everyone is being diligent. As the fishing season winds down, in the next couple weeks, we cannot let our guard down, we must stay vigilant so we can keep our elders and those with underlying medical conditions safe. Everyone in the Borough is doing a great job and I know that we will get through this together.

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

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

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.

————————

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.

—-

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}

—-

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}

—-

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.