SUMMARY AND RESOURCES:
We urge anyone with any COVID-19 symptoms to seek testing. If you experience symptoms, contact your health care provider.
To find available testing sites, view the Testing Sites Locator at: https://alaska-dhss.maps.arcgis.com/apps/webappviewer/index.html?id=2d92b77bc8044329a1ee3954b063bd8c
AMHS COVID-19 protocols for passengers are available at http://dot.alaska.gov/amhs/covid19.shtml
Citizens are encouraged to submit questions related to COVID-19 : firstname.lastname@example.org
Information on the State of Alaska's response to COVID-19 is available at www.covid19.alaska.gov.
Health ADVISORY #3 – Intrastate Travel - As of: 04.26.2021
The State of Alaska DOES NOT restrict or limit travel within the state.
Individual communities, acting through their local leaders and government bodies, may wish to withdraw or enact laws related to protection of communities from COVID-19. While intrastate travel restrictions are not advised, they should be limited to small communities off the Road System and the Alaska Marine Highway System.
I. Exemptions for Fully-Vaccinated Individuals:
State of Alaska and Centers for Disease Control and Prevention (CDC) guidance says the following about fully vaccinated travelers:
a. Fully-vaccinated travelers do not need to get tested before or after travel.
b. Fully-vaccinated travelers do not need to self-quarantine after travel.
c. Fully-vaccinated is defined as more than two weeks following receipt of the second dose in a two-dose series, or more than two weeks following receipt of one dose of a singledose vaccine.
II. Prior confirmed positive results within 90 days of departure:
a. Asymptomatic travelers, that had a positive viral test for SARS-CoV-2 within 90 days of travel departure, are not recommended to pre-travel test nor test upon arrival.
a. Communities that have enacted or are continuing local ordinances on travel restrictions should take into account the vaccination rates of their residents. COVID-19 vaccines have proven to be highly effective at preventing severe illness and hospitalizations. If your local population has high vaccination rates and are protected, then travel restrictions may not be necessary or useful. Information on vaccination rates for local areas can be found on the COVID-19 vaccine dashboard at:
b. Symptomatic persons are not recommended to travel.
IV. Community Restrictions and Critical Infrastructure Access
a. Local communities should not prevent individuals traveling for a Critical Personal Need or the conduct of an Essential Service/Critical Infrastructure installation, maintenance, or repair. Other considerations for communities and/or Local Emergency Ordinances are as follows:
i. Communities should not enact protective measures that prevent, delay, or limit emergency travel by Law Enforcement Officers, healthcare workers, or personnel from the Office of Children’s Services.
ii. Communities should not prevent local residents from returning home.
iii. Communities should not prevent travel for a Critical Personal Need.
iv. Communities should not prevent Critical Infrastructure Workers (CI) from traveling or commencing work immediately upon arrival.
i. Critical Infrastructure Workers traveling to small communities in support of emergency requirements should coordinate access with the municipal or tribal government representatives of the community if the situation does not allow time for pre-travel testing, such as a power outage, communications failure, damage to infrastructure, or other situation that requires emergency travel.
v. Communities should not prevent the travel of work crews engaged in nonessential construction or repair projects, and are encouraged to negotiate access requirements with both the company involved in construction and the business or agency that is sponsoring or contracting the construction.
vi. Communities should not prevent individuals from traveling to conduct subsistence hunting or fishing.
V. Possible Protective Measures
a. Travel restrictions or protective measures are at the discretion of the local government and the following items are presented as optional suggestions for protective measures as well as limitations on any restrictions.
i. Non-vaccinated residents returning home, possible protective measures:
1. encouraging a pre-travel test, a period of social distancing after arrival, or bracketed testing before and after that period.
2. Non-vaccinated residents returning home who choose not to test are recommended to conduct a full 10-day self-quarantine in their home upon their return, along with all other family members sharing the home.
ii. Critical Infrastructure Workers (CI), possible protective measures:
1. encouraging a pre-travel test, asking CI workers to follow community mask guidelines, or to be socially distant from community residents.
a. Road System: is defined as any community connected by a road to the Steese, Elliot, Dalton, Seward, Parks, Klondike, Richardson, Sterling, Glenn, Haines, or Top of the World Highways.
b. Alaska Marine Highway: is defined as any community served by the Alaska Marine Highway System (AMHS) or the Inter-Island Ferry System.
a. All travelers on Alaska Marine Highway System vessels should research and know of any testing guidelines that are specific to AMHS.
c. Critical Personal Needs: those needs that are critical to meeting a person’s individual or family needs. Those needs include buying, selling, or delivering groceries and home goods; obtaining fuel for vehicles or residential needs; transporting family members for out-of-home care, essential health needs, or for purposes of child custody exchanges (to include child travelers); receiving essential health care; providing essential health care to a family member; obtaining other important goods; engaging in subsistence activities; pursuing formal (primary, secondary, or collegiate) education or educational research; applying for a job; traveling for voting; and the inspection and maintenance of personal property.
d. Critical Infrastructure Workforce: is defined in the Cyber and Infrastructure Security Agency (CISA) “Guidance on the Essential Critical Infrastructure Workforce.” https://www.cisa.gov/sites/default/files/publications/ECIW_4.0_Guidance_on_Essential_ Critical_Infrastructure_Workers_Final3_508_0.pdf
e. Fully vaccinated is defined as more than two weeks following receipt of the second dose in a two-dose series, or more than two weeks following receipt of one dose of a singledose vaccine.
VII. Other Info
c. Cyber and Infrastructure Security Agency (CISA) “Guidance on the Essential Critical Infrastructure Workforce.” https://www.cisa.gov/sites/default/files/publications/ECIW_4.0_Guidance_on_Essent ial_Critical_Infrastructure_Workers_Final3_508_0.pdf
Q: I have tested positive for COVID-19. What should I do?
A: Follow the directions given to you by Public Health. To protect your health and that of those around you:
- Notify your close contacts (that is, anyone who was within 6 feet of you for 15 minutes or longer during the two days before your symptoms started or when you were tested) and let them know that they need to quarantine for 14 days from the time you were last together.
- Inform your work (or your child’s school) that you are positive.
- Stay at home and avoid public places and transportation until you are cleared by Public Health.
- Keep at least 6 feet away from people and animals, including those in your household.
- Avoid sharing personal household items (including the restroom), if at all possible.
- Wear a face covering if your symptoms allow, even in the house.
- Sick individuals should keep to a separate bedroom and a separate bathroom if possible.
- If a separate bathroom is not possible, then all surfaces that could have been touched must be disinfected after the sick family member uses it: handles, light switches, soap dispenser top, etc.
- Wear reusable or disposable gloves for routine cleaning and disinfection.
- Clean surfaces using soap and water, then use disinfectant.
- Clean or launder items according to the manufacturer’s instructions.
- Wash your hands often with soap and water for 20 seconds.
- Limit interactions with the sick individual. Only one person should deliver food, take away used items, and that person should be masked. Everything should be disinfected immediately.
Q: I’ve been informed by Public Health or someone who has tested positive that I am a close contact. I am not fully vaccinated. What should I do?
A: As a close contact who is not fully vaccinated, you must quarantine for 14 days from your last contact with the person who has tested positive. While in quarantine:
- Monitor yourself for symptoms and if you notice even mild symptoms, isolate yourself and get tested.
- If you do not develop symptoms, consider getting tested around day 7 of your quarantine.
- Inform your work and your child’s school that you are in quarantine for 14 days.
- Stay at home and avoid public places and transportation.
- Keep at least 6 feet away from people and animals, including those in your household.
- Avoid sharing personal household items, and wash your hands and frequently touched surfaces regularly.
- Wear reusable or disposable gloves for routine cleaning and disinfection.
- Clean surfaces using soap and water, then use disinfectant.
- Clean or launder items according to the manufacturer’s instructions.
- For non-medical help, call 2-1-1.
Q: I have been within 6 feet of a person who was identified as a close contact of a positive case. What should I do?
Monitor yourself for symptoms and if you notice even mild symptoms, get tested.
Q: Does being asymptomatic mean that I am not contagious?
No. If you test positive for COVID-19 but do not have symptoms, you may still be highly contagious and must isolate and follow the directions of Public Health.
QUARANTINE / ISOLATION / STRICT SOCIAL DISTANCING
When to Quarantine
Stay home if you might have been exposed to COVID-19, and are not fully vaccinated.
Quarantine is used to keep someone who might have been exposed to COVID-19 and is not fully vaccinated 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, separate themselves from others, monitor their health, and follow directions from their state or local health department. This is 14 days from the last contact from the known positive case.
Quarantine or isolation: What's the difference?
Quarantine keeps someone who might have been exposed to the virus and is not fully vaccinated away from others for at least 14 days from their last contact with a known positive case.
Isolation keeps someone who is infected with the virus away from others, even in their home.
Who needs to quarantine?
People who have been in close with someone who has COVID-19—excluding people who have had COVID-19 within the past 3 months or who are fully vaccinated.
People who have tested positive for COVID-19 do not need to quarantine or get tested again for up to 3 months as long as they do not develop symptoms again. People who develop symptoms again within 3 months of their first bout of COVID-19 may need to be tested again if there is no other cause identified for their symptoms.
What counts as close contact?
- You were within 6 feet of someone who has COVID-19 for a total of 15 minutes or more
- You provided care at home to someone who is sick with COVID-19
- You had direct physical contact with the person (hugged or kissed them)
- You shared eating or drinking utensils
- They sneezed, coughed, or somehow got respiratory droplets on you
What is Strict Social Distancing?
Strict Social Distancing is limiting your social contacts by remaining 6 feet away from anyone not in your immediate household and wearing a face covering. You should not enter restaurants, bars, community centers, sporting facilities (gyms or recreation centers), office buildings, school or daycare facilities; or participate in any group activities, including sporting events and practices, weddings, funerals or other gatherings.
When do we follow Strict Social Distancing?
Anyone who is not fully vaccinated and has recently traveled (within the past 5 days) and has received a negative COVID-19 test result should follow strict social distancing.
Additionally, the EOC recommends everyone who is not fully vaccinated to follow strict social distancing when the community's risk level is at Level 3 - High or above.
More and more people in Ketchikan are getting the COVID-19 vaccine. Will this change how Ketchikan determines its community risk level?
The Ketchikan EOC has updated its community risk indicators to account for the increasing number of Ketchikan residents who have gotten vaccinated. Starting Thursday, May 27, we will begin using these new indicators to set the community risk level.
The new indicators are available in the VRA – Community Risk Dashboard page.
As the percentage increases of local residents who have gotten vaccinated, the risk level indicators will be periodically adjusted. To compare incremental adjustments to the risk indicators, visit the VRA – Adjusted Risk Indicator Metrics Compared page.
The new risk levels take the following into consideration:
- Fully vaccinated individuals do not need to test or quarantine following a close contact with a positive.
- Lower prevalence of COVID in the community leads to fewer people being tested.
- Even though a positive case may increase our positivity rate due to lower testing numbers, the overall community risk lessens with the significantly increased number of vaccinated individuals.
These adjustments represent relatively small incremental changes that should help keep us in the right place without risking overestimating--or underestimating--our current risk.
Please explain how the Case Count Dashboard for both the state and Ketchikan works.
The Ketchikan EOC has updated its COVID-19 Testing and Case Count Dashboard to provide more insight on non-resident/resident testing results. The Ketchikan Testing and Case Count Dashboard includes numbers for tests administered, tests pending, cumulative positive cases, resident and non-resident cases, close contact/travel related/non-travel related cases, recovered cases, and hospitalizations.
The State of Alaska’s has its own COVID-19 Testing and Case Count Dashboard. It is used to display data as well as feed raw data into local dashboards and national dashboards. The State’s dashboard operates on a 14-day rolling average of percent positivity of COVID-19 cases, to assess the ongoing risk in each geographical area.
Why do we see different numbers reflected on the State’s Case Count Dashboard versus the local Dashboard?
Ketchikan’s Dashboard is most current because we receive numbers each day from health providers and then confirm these with local Public Health officials. The State data, in contrast, can lag behind a day or two because they receive information from multiple sources and have a deadline for receiving information each day. We work with the State to verify the numbers provided, but our local Ketchikan website is the most current.
When does an active case become a recovered case?
A case is taken out of the active case count and classified as recovered when the case has completed their recommended isolation.
According to the CDC, most symptomatic people with COVID-19 can discontinue isolation and precautions after:
- At least 10 days after symptoms first appeared, AND
- At least 24 hours have passed with no fever, without the use of fever-reducing medications, AND
- Symptoms have improved.
A limited number of persons with severe illness or who are severely immunocompromised may need to isolate for up to 20 days after symptom onset - this is determined in conjunction with a healthcare provider.
For people who have never developed symptoms (asymptomatic cases), isolation and other precautions can be discontinued after 10 days after the date of the first positive case.
What is the timeframe for testing positive to a virus, and why can there be different results depending on when the test is taken?
A Nasal PCR Test, which is the most common test administered in the State of Alaska, picks up pieces of the virus from your nose to run through a testing machine. Different machines require different concentrations of the virus to provide a positive result. Instances such as improper specimen collection, an abnormal medium or swab for the specimen, and length of time before it reaches the testing operator can all have a deteriorating effect on the sample – which can affect the results. Depending on where you are in the time frame of the disease can also impact your test results. If you are tested later or earlier on during your infection, you may not have enough of a viral load to test positive.
I’ve heard that those nasal swabs hurt. Is there an alternative way to do the testing that isn’t painful?
Many people have different reactions to the nasopharyngeal swab, a common swab administered through the nose, used for COVID-19 testing. The swab is not supposed to hurt, but it may be uncomfortable. In order to collect enough cells and fluids, the swab must be inserted along the entire passageway that connects the base of the nose to the back of the throat to get a good specimen. As the body is not used to having an object in that area, it creates a lot of very odd sensations.
If I test positive and test again a couple days later with a negative result does that mean the first test was a false positive?
No. There are many reasons that a second COVID-19 test could be negative. Foremost, the first test could have been taken during the end of the course of the virus, leading to the second test being taken after the disease had run its course and would no longer be present in the body. It is also possible that a second test did not pick up enough of a sample to test positive, even if the virus is still present. Testing results as well as a patient’s clinical history are both used to understand where a patient is within the disease process.
Unless someone takes a rapid COVID-19 test, it is unlikely that a person will receive their test results in less than 3 days. How can someone that is not symptomatic get tested?
Communities are providing a wide range of testing options. Ketchikan is operating a Drive-up Testing Site at Berth 3 that is available to:
- Those who have symptoms of COVID-19
- Those who have had close contact (within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period) with someone with confirmed COVID-19
- Those who have taken part in activities that put them at higher risk for COVID-19 because they cannot socially distance as needed, such as travel, attending large social or mass gatherings, or being in crowded indoor settings
- Those who have been asked or referred to get testing by their healthcare provider, local Public Health Office or state health department.
The State of Alaska has made testing guidelines for individual communities incredibly broad to allow for asymptomatic testing.
What testing options are currently available in Ketchikan?
Although the Ketchikan EOC has discontinued its Berth 3 Drive Up Testing Site as of June 25, 2021, many local clinics are offering COVID testing. For a list, go to the Borough’s COVID-19 Testing Information site: https://www.kgbak.us/969/COVID-19-Testing-Information
The State of Alaska Dept. of Health and Social Services is planning to offer free COVID testing in Ketchikan—the place and times have not yet been announced. There is also a testing facility at the Ketchikan International Airport.
Ketchikan International Airport Test Facility is for:
The Ketchikan International Airport Test Facility is for travelers arriving on interstate and intrastate flights, and voucher retesting 7-14 days after arrival. Airport testing is operated by Capstone Clinic.
This site offers nasal swab PCR test. With a voucher, travelers can return to the Ketchikan Airport for the follow-up test or contact another health care provider in Ketchikan to see if the provider will accept the voucher. Follow-up voucher testing (bring the voucher) at the airport does not require an appointment. Airport testing hours are generally 8am to 8pm daily.
Testing is also available from local health care providers such as Creekside Clinic and Peace Health Medical Center.
What criteria does a person doing contract tracing use to determine if someone has been in close contact with a person who has tested positive for the virus?
If you’ve been identified as a "close contact" of an infected person, you will receive a call from a public health nurse, or the infected person. "Close contact" is defined as having been within 6 feet of an infected individual for 10-15 minutes or longer during the two days before their symptoms started, or before they were tested), or if you’ve been coughed or sneezed on by that person.
If you are not fully vaccinated and think you have been exposed and have not received a call, consider taking the following measures:
- Hunker down if you are able to do so
- Limit your social contacts for 14 days
- Stay at least 6 feet away from others
- Wear a cloth covering when in public
- Monitor for symptoms and if you start feeling sick, no matter how mild, isolate yourself and call your provider to get tested.
When someone coming in from the Lower 48 tests positive, shouldn’t everyone who was on the plane with them be contacted to quarantine or be tested?
“Close contact” has been defined federally as being within 6 feet of an identified positive case for a set duration of time. As the state does not have access to a commercial airline’s manifest, they work closely with their federal partners to access that information to identify and contact the people who were sitting in close contact with the identified positive case. Not everyone on the plane will be contacted by public health, just those sitting within close parameters of the infected person.
AMHS TRAVEL PROTOCOLS
Go to the Alaska Marine Highway System website for the latest information about AMHS COVID-19 protocols: http://dot.alaska.gov/amhs/covid19.shtml
KETCHIKAN TRAVELER TESTING SITE
Please describe how the process works for out of state travelers to be greeted, screened, and tested when they arrive at the Ketchikan airport.
All travelers to Alaska must create an account in the Alaska Travel Portal before they arrive. It is strongly recommended for travelers to Alaska to take a PCR test within 72 hours of their departure for Alaska, and upload into the Portal the documentation that they took the test. If they have received results, they should upload the documentation of the results into the Portal. If they have not yet received their test result, they should practice strict social distancing until they receive their negative result.
The traveler testing site is located at the airport terminal. There is a greeter to meet each passenger to help direct individual travelers and provide information on the testing process.
Travelers coming into Alaska (over the age of 10) who do not have documentation of a PCR test taken within 72 hours of their departure for Alaska, and are not fully vaccinated should consider testing at the airport. This test is free for all, whether or not they are an Alaska resident. Travelers who test at the airport should practice strict social distancing until they receive a negative test result, and upload that result into their Alaska Travel Portal account.
If a traveler has had a previous positive test result of a PCR test for SARS-CoV2 within 90 days of departure for Alaska and is currently asymptomatic, they do not need to consider testing on arrival.
Fully vaccinated travelers should follow pre-travel testing recommendations, but do not need to practice strict social distancing while they wait for test results. (Fully vaccinated is defined as more than two weeks following receipt of the second dose in a two-dose series, or more than two weeks following receipt of one dose of a single-dose vaccine.)
STATE OF ALASKA HEALTH ADVISORIES FOR TRAVELERS
Per the interstate travel protocols, why are flight passengers provided a voucher for a second test? Why take a second test 5-14 days after the first, even if the first was negative?
Testing strategies by the state of Alaska are based around time frames of symptom onset and virus detection. At 5 days, only 50% of those infected will be showing symptoms, while at 10 days 90%-95% will be showing symptoms. Travelers can be exposed to the virus during transit, so by testing 5-14 days after arrival, there will be a higher percentage of positive cases.
If someone is traveling to Seattle for a medical procedure and will be there for less than 24 hours, when should they be tested? Before or after they travel, considering as both are within 24 hours?
As described in Health Advisory #2, Alaska residents leaving the state for less than 72 hours should obtain a test on their return to Alaska, and monitor for symptoms, even mild ones, for 14 days after their arrival.
Why doesn’t the state of Alaska implement and strictly enforce a 14-day quarantine for all arriving travelers, like what is being done in New Zealand and Western Australia?
As Alaska is a state and not a country, there are restrictions on what a state government can require of US travelers. Due to the commerce clause in the US Constitution, the state of Alaska is prohibited from violating a US citizens’ right to privacy. Instead, the state government has shifted to test-based travel recommendations to help curb the spread of the virus from travelers arriving in our state.
For Health Advisories #2 and #3, what are the recommendations for interstate and intrastate travel? Why are there differing restrictions for travel within the state?
At this time, the state is in support of local governments establishing their own travel restrictions, allowing them to impose stricter restrictions based on their community needs. Many communities continue to have a 14-day quarantine required upon arrival for all intrastate and interstate travelers. Ketchikan does not have any additional restrictions for travelers but has expanded their testing parameters to include asymptomatic individuals who have recently traveled.
GENERAL INFORMATION ON COVID-19
Does mask wearing decrease the need for social distancing when indoors?
Dr. Zink relates mask wearing to wearing a seatbelt, although it might not prevent someone’s death, it will reduce their chances of dying. Seatbelts are part of a much bigger set of tools that include speed limits, separate highways, and airbags. Masks and social distancing are much like airbags and seatbelts, where your chances are better if you use both. Masks along with keeping 6 feet apart from others, hand washing, and increased hygiene practices are used to minimize the risk of exposure to the disease.
What is the concept behind herd immunity and is this a viable option for our community to deal with COVID-19?
Herd immunity applies when enough people have been infected and recovered from the disease, so that the virus can no longer spread from person to person. Most times herd immunity in humans can be attributed to the use of vaccines.
There are many diseases to which humans have never developed herd immunity to, such as small pox. The key factor in herd immunity is that the immunity needs to last. One of the major concerns with the Coronavirus is that with common cold viruses like COVID-19, the immunity only lasts 8 months to a year and half. Because of these factors, rapid herd immunity is not being considered a viable option to combat the coronavirus.
Combined with what little research we have on the long term effects of the disease, the amount of deaths it would cause, and the overwhelming of our healthcare system – rapid herd immunity is not a viable option unless it can be done so with vaccinations. At the moment there are hundreds of different vaccines being developed, a few of which are already in phase three of development.
SCHOOL DISTRICT PLANS
What are the state-wide and local directives for schools?
The actions we all take now to combat this disease - such as minimizing social interactions, hand washing, and mask wearing will keep our kids safe. The Ketchikan Gateway Borough School District has implemented a plan that can be adapted when the community’s COVID-19 risk level changes. For more information, go to the School District’s website: https://www.kgbsd.org/
What efforts are being undertaken for business and economic recovery?
The BERG is the Business Economy Recovery Group, established by the Ketchikan Emergency Operations Center, the Ketchikan Chamber of Commerce, the Ketchikan Visitors’ Bureau and the Borough Planning Department. The BERG has developed a local webpage on the Ketchikan Chamber of Commerce website, accessible through the Ketchikan Visitor’s Bureau and Ketchikan Gateway Borough websites: https://www.ketchikanchamber.com/covid-19-updates/
The BERG can be reached at email@example.com.
The Ketchikan Chamber website has helpful information for local businesses such as links to state and local mandates, information on tax credits for small businesses, and programs administered by the Small Business Administration.
Are there criteria to determine when to shut things down in the event of another ‘wave’ of the virus?
The Ketchikan EOC has developed a Community Risk Level grid to assess what measures to take to keep Ketchikan safe:
The current risk level is determined by several statistical measures.
Churches may open and are encouraged to consult the State of Alaska’s Communities of Faith page: http://dhss.alaska.gov/dph/Epi/id/Pages/COVID-19/faith.aspx
When will the DMV reopen to the public?
Go to the State of Alaska DMV page for updated information: http://doa.alaska.gov/dmv/
The REAL ID enforcement deadline has been extended until May 3, 2023.
Where should I go to get the latest guidance for critical infrastructure?
Go to the State of Alaska – Critical Infrastructure Guidance page: http://covid19.alaska.gov/unified-command/critical-infrastructure/
I have had COVID-19 and have fully recovered. Am I now immune?
A recovered person would not transmit the virus if they were truly recovered and no longer carrying the virus. However, there is no evidence that a person who recovered from COVID-19 would be immune from catching the virus again. Essentially, no one is immune from becoming infected with COVID-19 and everyone should continue to take necessary precautions, practice personal hygiene, and social distancing.
If a seasonal worker has had COVID-19 and has recovered, what measures should they take on arrival in Ketchikan?
A traveler coming into Alaska, who has a prior confirmed positive result from a PCR-based test for SARS-CoV2 within 90 days of their departure for Alaska and is currently asymptomatic, does not need to take a test before travel or on arrival. They should monitor for symptoms, however mild, for 14 days after arrival, and seek testing if symptoms develop.
TESTS, DRUGS, OTHER THERAPIES
What is the difference between the types of tests available for COVID-19?
For more information about COVID testing, go to the Food and Drug Administration page, FAQs on Testing for SARS-CoV-2: https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/faqs-testing-sars-cov-2