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An influx of tourists and a lack of safety precautions are some reasons for Alaska’s high COVID-19 transmission rate. FREDERIC J. BROWN/AFP via Getty Images
  • Alaska has the highest COVID-19 per capita case rate in the country despite having more than 50 percent of its residents fully vaccinated.
  • Experts say Alaska’s relatively low rate of transmission during the initial year of the pandemic may have produced a false sense of security.
  • They add that the return of tourists may also have played a role.
  • Experts say the solution for Alaska is to continue to get people vaccinated as well as instituting safety precautions such as physical distancing and mask mandates.

In Alaska, COVID-19 is surging and hospitals are quickly running out of capacity to handle medical emergencies.

The state’s percentage of fully vaccinated people is 51 percent. That’s nowhere near the lowest vaccinated state in the country, although it’s still far from the number believed to be required to achieve herd immunity.

So why does Alaska currently lead the nation in per capita COVID-19 cases with 829 per 100,000 residents?

One reason is COVID-19 may not have affected the state as much the first time around, leaving more room for the more infectious Delta variant to surge once it arrived, said Dr. Joe McLaughlin, MPH, Alaska state epidemiologist and a member of the American College of Preventive Medicine.

“So the proportion of people susceptible to infection might have been larger as we went into the COVID-19 Delta variant surge,” McLaughlin explained to Healthline.

And while Alaska is similar to other rural states in terms of vaccine uptake and strained hospital systems, its relative isolation likely plays a significant part in how its experience with COVID-19 has been different.

“The vaccination rate hides differences between places and populations who have higher concentrations of unvaccinated people,” said Elizabeth Beatriz, PhD, an epidemiologist at the Massachusetts Department of Public Health in the bureau of community health and prevention as well as a public health and COVID-19 adviser at Parenting Pod.

“We have seen in places that have a good number of vaccinated people, but not vaccination saturation, and where there have been fairly few COVID-19 cases up until that point, that the people are less likely to take precautions, including those who are unvaccinated,” she said.

“I think that is what we are seeing in Alaska. There may have been a sense that risk wasn’t high and that things could just return to normal. When the Delta variant is introduced in these areas, it can spread like wildfire,” Beatriz told Healthline.

She also said that per capita rates of infection are more sensitive to variation because of the state’s relatively low population.

“While this doesn’t dismiss that the surge is real, I mention it to let folks know that they shouldn’t be surprised if they see larger changes week to week than might be seen in more populous states,” Beatriz noted.

Alaska has also seen a slightly different pattern of COVID-19 cases than the rest of the United States.

“Last year, COVID-19 cases in Alaska surged and peaked before much of the U.S., leading to some speculation that colder weather earlier in the fall compared to what’s typical for the rest of the U.S. was playing a role in Alaska’s COVID-19 transmission dynamics,” McLaughlin said.

But with the summer comes tourists and a time of year when local hospitals tend to be busiest.

That, combined with the Delta variant, produced something of a triple whammy.

“Alaska had many tourists visiting this summer with very few state or local COVID-19 restrictions in place. In Alaska, we don’t have a lot of surge capacity for hospital beds,” McLaughlin said.

“As such, during the summer months, when our hospitalization rates tend to be highest, it is not uncommon for some of our hospitals to occasionally go on divert [directing ambulances away from one hospital to one with more capacity] in a normal year,” he said.

With COVID-19 overwhelming major hospital systems, that can mean turning people away entirely and triaging patients.

But the way forward for Alaska looks much the same as everywhere else, McLaughlin said.

“We have two overarching tools to curb COVID-19 transmission rates: vaccination and nonpharmaceutical interventions (NPIs) such as masking, social distancing, avoiding crowds, contact tracing, isolation, and quarantine,” he said.

“Communities with the highest vaccination rates and the highest rates of compliance with NPIs have the lowest COVID-19 incidence rates,” McLaughlin said.