One village of Alaska Natives knew exactly what to do in order to stop COVID-19. They set up a gate at the entrance to the village and kept it guarded round-the-clock. The same idea was used in isolated Indigenous villages over a century ago to guard against outsiders during another deadly pandemic, the Spanish flu.

It worked in large part. One person was not killed by COVID-19, and twenty people were hospitalized in Tanacross (an Athabascan village with 140 residents). The rustic wood cabins and other homes can be found between the Alaska Highway & Tanana River.

The battle against coronavirus continues. The highly contagious delta variant of the coronavirus is rapidly spreading throughout Alaska, causing one of the sharpest increases in infection rates in the country and creating risks for remote areas like Tanacross, where there is only a few hours’ drive to the nearest hospital.

The COVID-19 crisis is made worse by Alaska’s poor health care system, which mainly relies on Anchorage hospitals. Providence Alaska Medical Center is the largest hospital in the state. It has been overwhelmed by patients since the beginning of the crisis-of-care protocol. This means that doctors sometimes prioritize care based upon who has the highest chance of survival.

Since then, 19 additional Alaskan health care facilities, including Anchorage’s two other hospitals, Fairbanks Memorial and Fairbanks Memorial have entered crisis care mode. This is something that other overtaxed facilities have had to do in other states, such as Idaho and Wyoming.

Alfred Jonathan, an elder Tanacross, said, “Even though our family lives here, we are concerned about Anchorage, Fairbanks.” “If someone gets sick there, there’s nowhere to take them.”

Alaska has contracted nearly 500 medical professionals to assist over the next few weeks. However, rural Alaskans will be affected if they require higher levels of care (for COVID-19 or other) but there are no beds.

Sometimes, these patients are lucky enough to be transferred to Fairbanks and Anchorage. Sometimes, the health care staff is on the phone for hours looking for specialty treatment options like dialysis.

Mikal Canfield, a hospital spokesperson, said that one patient died because she couldn’t access dialysis at Providence. Chief of staff at the hospital, Dr. Kristen Solana Walkinshaw said that she had a patient from an outlying area who required cardiac catheterization. She died while waiting.

Overloaded options in Seattle and Portland, Oregon are also a problem. One rural clinic found a place for an interior Alaskan patient in Colorado.

Officials blame the hospital crunch on a shortage of staff, rising COVID-19 infection rates, and low vaccination rates in Alaska. Only 61% of Alaska’s eligible residents are fully vaccinated. Johns Hopkins University data shows that one in 84 Alaskans was diagnosed with COVID-19 between Sept. 22 and Sept. 29. This is the highest rate of recent national diagnosis.

Officials claim that medical personnel are frustrated and exhausted by what seems like an insurmountable task to counter misinformation about COVID-19 and vaccine safety. Others believe it could have long-term consequences, further reducing confidence in vaccines and treatment for other diseases and making recruiting health care workers from remote states more difficult.

Jared Kosin (president and CEO, Alaska State Hospital and Nursing Home Association) said that medical workers “describe the emotions: ‘You hear an code is occurring, someone is dying.’ It is quite devastating. It is never your intention to lose a patient. You don’t want to lose a patient. It is heart-wrenching.

Elders in Tanacross encourage people to get vaccinated even though facilities are limited. The village is located in an area of eastern Alaska that is sparsely populated and has a vaccination rate below 50%.

Jonathan, 78 tells the village that COVID-19 has arrived and, like the delta variant of COVID-19, will continue to evolve in other ways.

Who were those who didn’t get vaccinated Jonathan said, “Gosh, they’re afraid for them.” He recently led a team clearing dead and dying trees to provide wood for heat homes and reduce wildfire fuel.

Mildred, his wife, was responsible for guarding the gate to the community this year. These restrictions were lifted this summer, as the pandemic was improving. She says that she is tired of people calling Tanacross friends to scare them and claiming there are vaccine problems.

She said, “I got both of my shots, and I’m alive and everything’s right with me,” before packing bags of sanitizer and masks into her Prius and driving around town.

According to Centers for Disease Control and Prevention data, Alaska was 25th in the United States for the percentage of its population that had been inoculated.

Hospital care has “shifted,” according to Dr. Anne Zink (Alaska’s chief medical officer).

She stated that “the same level of care that was once available is not possible to be provided on a regular basis.” This has been going on for several weeks.”

Six Indigenous villages in rural Alaska, including Tanacross, depend on the Upper Tanana Health Center, located in Tok, which is about two hours from the Canadian border. Jacoline Bergstrom is the executive director of health services at the Tanana Chiefs Conference. This group includes 42 Athabascan villages that are spread across an area of interior Alaska almost as large as Texas.

Joni Young, clinic director, said that emergency plans can be put in place to accommodate people over night if they aren’t able to get hospital beds right away. It takes three hours to drive from Tok, Alaska to Fairbanks, and seven to Anchorage.

Young stated that if medevac cannot be sent, Young explained that they have been prepared since the beginning to assist their patients. Young said that cots have been stored in the building and that another building is available for lease to help COVID patients.

Staff are working overtime and nurses answering COVID-19 questions. Two urgent care registered nurses are needed, but very few people have applied.

Joyce Johnson-Albert was lying on a hospital bed with an IV in one arm. Although she was fully vaccinated, she developed a breakthrough infection that she believes came from a hunting camp.

Johnson-Albert stated that she hoped to feel better in the coming days after receiving a monoclonal antibody injection. This was given as a treatment for COVID-19 symptoms. It’s hard to know. It’s possible to go either direction.”

Angie Cleary, a registered nurse, is grateful that the clinic offers infusion therapy.

Cleary stated that she is worried about not getting enough on certain days. Cleary said that we are currently down to five doses. We could get more tomorrow, or not until next week. One of our concerns is, “When are we going to receive our next shipment?”

They are also fighting misinformation about the pandemic. Mike Dunleavy has been criticised for not mandating the use of masks or recommending vaccines as much as others would like. Dunleavy has encouraged people to get shots, but said that it was a personal decision. Others accuse him of selling fear and pushing vaccines.

Solana Walkershaw stated that Providence hospital employees are struggling to cope with harsh rhetoric. The chief of staff stated that one staff member was spit on when he left work.

She said, “We still have COVID-denying people as they’re being intubated or family members who’re COVID denying as they say on an iPad goodbye to their loved ones.”

Daisy Northway, a member of the Tok Native Association, knows just how difficult it can be to promote vaccinations. She says she has “talked till my face is blue” trying to persuade one of her sons.

According to the Athabascan elder, she encourages people not only to get the shots, but also to lower the political passion.

She said, “We must say, Get vaccinated’ so that it’s helpful” and not be critical of people’s beliefs.