‘Living memory’ of influenza pandemic inspired both COVID-19 protection and a sense of resiliency

    A close-up view of names of influenza victims is seen on Sept. 3, 2021, at Nome’s 1918 pandemic memorial. (Photo by Yereth Rosen/Alaska Beacon)

    Fairbanks, Alaska (Alaska Beacon) - While the 1918 pandemic provided lessons for today, Alaska Natives’ COVID-19 experiences provide lessons for future pandemics, experts say

    Past pandemic trauma helped shape Alaska Native response to the modern COVID-19 pandemic, limiting the damages and providing some lessons for future health responses, said experts speaking at a health conference in Fairbanks.

    The influenza epidemic that struck Alaska in late 1918 and nearly wiped out entire Native villages is a “living memory” that inspired people to take precautions on behalf of their entire communities, said Dr. Alisa Alexander, senior medical officer for the Tanana Chiefs Conference, a Fairbanks-headquartered tribal consortium.

    “So asking people to wear a mask for other people was really easy,” Alexander said. “Walking past those cemeteries and seeing these tiny little graves with 2-year-olds who died from the flu, it’s really easy to keep other people in your mind.”

    Alexander spoke Tuesday in a panel discussion at a conference held by the University of Alaska Fairbanks’ Center for One Health Research.

    While those influenza memories underscored the gravity of COVID-19, they also helped provide some confidence in people’s ability to be resilient during the modern pandemic, said Taylor van Doren, an anthropologist and post-doctoral fellow with the Sitka Sound Science Center and another panel speaker at the One Health, One Future conference.

    Van Doren, who focuses on pandemics, reviewed her research into COVID-related risk perceptions and adaptations among Native residents in the Southeast Alaska communities of Sitka, Hoonah and Kake. Her findings, described in a study published in January, showed reliance on tradition as key to coping and effective health protection – traditional foods, cultural practices and knowledge.

    “The Tlingit people had agency over the response,” she said.

    While they took the pandemic seriously and followed precautions, residents she interviewed generally considered COVID-19 to be a problem that could be managed – and something less daunting than long-term climate change, she said. Residents told her they are more worried about things like shrinking glaciers, diminished salmon runs and ocean acidification, “the really large-scale environmental changes that are threats to their traditional ways of life,” she said.

    The COVID-19 pandemic, like others before it, placed a disproportionate burden on Alaska Native people, statistics show. In the case of COVID-19, some of the blame has been placed on inadequate water and sanitation service and overcrowded housing.

    Through 2021, COVID incidence rates were about twice for Alaska Natives as the for white Alaskans, according to the Centers for Disease Control and Prevention. As of late February, according to the Department of Health’s COVID-19 data hub, 26% of the state’s more than 1,400 COVID-19 deaths were among Alaska Natives, which is greater than the Native share of the population.

    Still, there were important successes within the Native population.

    Cultural values were demonstrated in the rapid distribution of vaccines by Native organizations, including TCC, Alexander said. That included hard work and creativity to ensure that the vaccine was distributed throughout the population, not just Native patients, she said. “It really highlights our sense of community,” she said.

    Alexander mentioned the pharmacy manager at TCC’s Chief Andrew Isaac Health Center, Daniel Nelson, who was recently honored for his service during the pandemic. That service included personally packaging vaccine doses in coolers for shipping by bush plane to far-flung villages, she said.

    There are other lessons that are important for the next pandemic, which is sure to come because of “the interconnectedness of our planet,” said Kristin Clark, public health coordinator at Iowa State University and part of the panel.

    “It’s not an if,” she said. “It’s when.”

    One lesson, the panelists said, is that providers and society need to figure out how to keep other medical services going. In Alaska and globally, there have been lapses in normal medical services and treatments, leading to problems like delayed cancer diagnoses and an upswing in active cases of tuberculosis.

    A new research project by van Doren seeks to quantify those lapses. That is a direct offshoot from her Southeast Alaska study. Participants from the Southeast communities told her directly that they were missing some of their normal medical checkups and treatments, and Dr. Eliot Bruhl, chief medical officer for the SouthEast Alaska Regional Health Consortium, has expressed his own concerns about the problem, she said.

    Alexander said some reduction in normal services stems from exhaustion of medical professionals, many of them now retired or working curtailed schedules. That results in a scramble to find bed space for needy patients, she said.

    “The hospitals are full. They’re not full from COVID cases. They’re full because we don’t have enough staff to manage the beds,” she said.

    Fixing that so that people can continue to have access to care that they need might require a continuation of some practices that became important during the pandemic, like flexible work schedules and delivery of care through telemedicine, she said.

    Alexander, von Doren and Clark all said that in retrospect, they believe it would have been better to keep schools open rather than endure the widespread closures that occurred earlier. “In terms of tamping down the transmission of the virus, it was probably a good strategy. But at what cost?” van Doren said.

    Many villages in the vast Interior TCC region were able to keep schools open by using precautions to avoid spreading infections, Alexander said.

    Yet another lesson is the need to respect Indigenous knowledge, said van Doren. “Western science cannot explain everything,” she said.

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