Date: June 4, 2021 To: Acting Mayor Austin Quinn-Davidson Thru: Heather Harris, Anchorage Health Department Director From: Janet Johnston, Anchorage Health Department Epidemiologist Subject: June 4, 2021, COVID-19 Risk Assessment Update for the Municipality of Anchorage This weekly report shares data available on the State of Alaska and Municipality of Anchorage (MOA) websites for the period May 27, 2021 – June 2, 2021, with some more recent data. Unless otherwise indicated, this data is for cases reported in the MOA. Anchorage COVID-19 Health Risk Metrics The MOA developed the Anchorage COVID-19 Health Risk Metrics tool to communicate the current level of health risks associated with COVID-19 within the Municipality. The tool includes multiple measures, which are referenced throughout this report. Each metric is assigned one of four categories each week, ranging from Very High Risk to Low Risk. Risk categories are based on authorities' standards, including the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), and the Harvard Global Health Institute.

The Overall Anchorage COVID-19 Risk Level remains on the border between the Lower Risk and Considerable Risk categories. This Overall Risk Level is a consensus metric derived from individual metrics, with appropriate weight given to the most important metrics – Cases and Health Care Capacity. Additional community-level factors that affect risks associated with COVID-19 within the Municipality are also considered. Average daily new case counts have dropped to just over 3 cases per day per 100,000 residents, moving us to the low end of the Considerable Risk Level for this metric. With just over 52% of eligible residents age 12 and older having completed a COVID-19 vaccines series, Anchorage comprises two subpopulations with very different COVID-19 risk profiles. Unvaccinated individuals currently experience a risk for COVID-19 equivalent to an average daily new case count of approximately 5.6 per 100,000 residents, while their vaccinated counterparts experience a risk equivalent to 0.6 per 100,000. With fewer mandated restrictions, individuals – especially unvaccinated individuals – need to assess their own risk and regulate their activities accordingly.

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June 4, 2021 Report, Page 2 of 9

Cases

Case Counts, Hospitalizations, and Deaths • Daily new cases. The current 14-day rolling daily average of 3.40 cases per 100,000 is a 31% decrease from last week. • New cases this week. There were 55 new resident cases this week, 27 less than last week. • Racial distribution. The weekly case rate for Native Hawaiian and Other Pacific Islander (NHOPI) people was seven times that of White people. Overall, since the beginning of the pandemic, the case rate for NHOPI people is 3.2 times that of White people. Race data was missing for 31% of the cases last week. See Table 1 for a breakdown by race and ethnicity. • Age distribution: The highest weekly case rate continues to occur in the 20- to 29-year-old age group. Forty percent of cases were in this age category, compared to 22% for the entire pandemic. There were only four cases older than 60 and no cases under the age of 10. See Table 2 for breakdown by age. • Cumulative cases. As of June 2, there are 30,837 confirmed cases in the MOA. This includes 30,226 Anchorage residents in- and out-of-state and 611 nonresidents testing positive in Anchorage. • Current hospitalizations. As of June 1, there are 15 hospitalized COVID-19 cases. The number of hospitalized cases ranged from 10 to 15 this week. As of June 1, there are 0 hospitalized Persons Under Investigation (PUI). Hospitalizations are slightly higher than last week. • Deaths. There have been 179 Anchorage deaths, 177 among Anchorage residents, and two non- residents. This is the same as the last two weeks’ reports.

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Table 1: COVID-19 Cases by Race and Ethnicity (excluding cases with missing race or ethnicity data, 31% missing)

Cases in the Last Week All Cases Hospitalizations Deaths Hosp. rate per Death rate 100 per 100 Race Cases % Rate* Cases % Rate* Cases % cases Cases % cases American Indian or Alaska 5 14% 20 4,043 19% 15,820 151 21% 3.7 48 27% 1.2 Native Asian 4 11% 15 1,481 7% 5,701 83 11% 5.6 26 15% 1.8 Black or African American 2 5% 13 1,015 5% 6,675 40 6% 3.9 9 5% 0.9 Native Hawaiian or Other 5 14% 62 1,170 6% 14,550 1 0% 0.1 19 11% 1.6 Pacific Islander White 16 43% 9 8,061 38% 4,469 240 33% 3.0 70 40% 0.9 Other Race 3 8% 46 3,281 15% 50,555 44 6% 1.3 - 0% - Two or More Races 2 5% 8 2,204 10% 8,367 166 23% 7.5 5 3% 0.2 All Cases (race known) 37 100% 13 21,255 100% 7,380 725 100% 3.4 177 100% 0.8 Ethnicity Cases Percent Rate* Cases Percent Rate* Cases Percent Rate Cases Percent Rate Hispanic 1 7% 4 1,506 13% 5,579 45 8% 3.0 14 8% 0.9 Non-Hispanic 13 93% 5 10,531 87% 4,035 519 92% 4.9 160 92% 1.5 All Cases (ethnicity 14 100% 5 12,037 1 4,180 564 1 4.7 174 100% 1.4 known) * Per 100,000

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Table 2: COVID-19 Cases by Age and Sex

Last Week Cases All Cases, All Time Hospitalizations Deaths Hosp. Death rate per rate per 100 100 Age Cases Percent Rate* Cases Percent Rate* Cases Percent cases Cases Percent cases 0 to 9 - 0% - 2,042 7% 5,254 6 1% 0.3 - 0% - 10 to 19 8 15% 21 3,690 12% 9,706 7 1% 0.2 - 0% - 20 to 29 21 40% 48 6,505 22% 15,002 39 5% 0.6 3 2% 0.0 30 to 39 9 17% 19 5,918 20% 12,758 73 9% 1.2 2 1% 0.0 40 to 49 5 9% 15 4,103 14% 11,908 91 11% 2.2 11 6% 0.3 50 to 59 6 11% 17 3,771 12% 10,733 137 17% 3.6 13 7% 0.3 60 to 69 1 2% 3 2,631 9% 8,397 167 21% 6.3 33 19% 1.3 70 to 79 2 4% 13 1,062 4% 6,970 179 22% 16.9 60 34% 5.6 80+ 1 2% 16 480 2% 7,761 111 14% 23.1 55 31% 11.5 All Cases (age known) 53 100% 18 30,202 100% 10,452 810 100% 2.7 177 100% 0.6 Sex Cases Percent Rate* Cases Percent Rate* Cases Percent Rate Cases Percent Rate Female 34 63% 24 14,772 49% 10,275 366 45% 2.5 69 39% 0.5 Male 20 37% 14 15,423 51% 10,622 444 55% 2.9 108 61% 0.7 All Cases (sex known) 54 100% 19 30,195 100% 10,449 810 100% 2.7 177 100% 0.6 * Per 100,000

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Health Care Capacity

• ICU beds. On average, between May 26 and June 1, 13.8% of staffed adult ICU beds at the three acute care hospitals in Anchorage were available. This is similar to the 15.1% available on average the week before and moves us just over the boundary into the Considerable Risk category for the Anchorage COVID-19 Health Risk Metrics. Between May 26 and June 1, the number of staffed adult ICU beds ranged from 69 to 71, and the number of available staffed adult ICU beds ranged from 7 to 13.

Infection Rate

• The consensus Rt of 0.71 is lower than last week’s consensus estimate of 0.77 and keeps us in the Lower Risk category for the Anchorage COVID-19 Health Risk Metrics (Appendix 1). See Table 3.

Table 3: Reproductive Number Estimates

Geography, Source May 20 May 20 (updated) May 27

Anchorage, COVID ActNow 0.82 0.76 0.69

Anchorage, SOA model, (in-state 0.73 0.79 0.73 residents only)

Alaska, COVID ActNow 0.82 0.79 0.78

Alaska, SOA model, (in-state 0.79 0.8 0.75 residents only)

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June 4, 2021 Report, Page 6 of 9

Testing

• Percent positivity: o The State COVID-19 Testing Dashboard has been adjusted to accommodate the ever- growing number of test results. This adjustment decreases the precision of the percent positivity estimate, but still allows us to assess test coverage. On average, between May 27 and June 2, approximately 1% of COVID-19 PCR and antigen tests had positive test results. This is similar to last week and keeps us in the lower end of the Lower Risk category for the Anchorage COVID-19 Health Risk Metrics. o COVID Act Now provides a seven-day average of test positivity reported by the CDC. On average, between May 25 and May 31, approximately 0.7% of COVID-19 PCR and antigen tests had positive test results. This is consistent with the percent positivity reported on the State COVID-19 Testing Dashboard.

• Test volume: o As shown in Table 4, the testing volume has increase slightly from last week and remains well above the White House task force's target level. o This increase is due at least partly to an unusually large number of tests reported on a single day during that period. Without that outlier, we would see a continued slow decline in test volume. Test volume is calculated using a seven-day lag to allow for sample processing time. The average daily counts for more recent weeks may increase if more test results are received.

Table 4: Weekly Test Volume Indicators

May 7 - May May 14 - May May 21 - May White House Target Indicator 13 20 27 (>2,000 per week)

Tests in the week 14,613 14,424 15,606 5779.4 Average daily tests per 100,000 722 713 772 >285

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Additional Community Factors

Risk associated with additional contributing factors remains in the middle of the Considerable Risk category. While daily case counts have dropped steadily this week in Anchorage and most other areas of the state, the following community factors continue to present considerable risk within the Municipality: • More transmissible Variants of Concern. • Continued light demand for new . • Increased numbers of travelers to Alaska for both employment and tourism.

Public Health Capacity

Track and Follow New Cases and Contacts • Positive case outreach. o MOA and State of Alaska (SOA) case interviewers aim to interview or leave a message for each new case within 24 hours of receiving the case assignment. To maximize the effectiveness of case investigations and contact tracing, cases closest to the date of specimen collection are prioritized for interviews, including source investigation for the five days prior to specimen collection. Cases are closed after two unsuccessful outreach attempts. o Of the 52 Anchorage cases entered into CommCare with specimen collection dates between May 22 and May 28, 46 (88%) completed interviews, which is slightly lower than the 91% that complete an interview last week. Of cases with a completed interview, 42 (91%) were completed within five days of specimen collection.

Transmission Trends This section summarizes trends in infection and transmission found in CommCare or through feedback from the AHD COVID-19 response team.

• Clusters. There were four Anchorage cases opened in CommCare during the past week, May 27 through June 2, that were identified as part of a cluster, compared to two the week before. Two cases were associated with the Department of Corrections, one was associated with a skilled nursing facility, and one was associated with a different residential healthcare facility.

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Vaccination

• According to VacTrAK, 137,462 first COVID-19 vaccine doses have been administered to residents aged 12 and older within Anchorage, and 118,925 vaccine series have been completed as of June 2, 2021. VacTrAK does not include data regarding vaccine doses administered by the Veterans Administration (VA) or the Department of Defense (DoD). • These numbers may be underestimated as there is often a delay between vaccine administration and reporting to VacTrAK, and some vaccines may be administered by providers who do not report to VacTrAK. We encourage all vaccine providers to report vaccine administration to VacTrAK as quickly as possible. • rates vary by age, race, and ethnicity, but these details are not available this week. • Joint Base Elmendorf-Richardson (JBER) provides vaccine dose counts directly to the MOA. As of our most recent update on June 1, 10,025 first doses have been administered at JBER, and 8,719 vaccine series have been completed. • Combining VacTrAK and JBER data, 147,487 first vaccine doses have been administered in Anchorage to residents aged 12 or older. This is an increase of 2,269 first doses since last week. See Table 5.

Table 5: Resident Vaccination by Dose and Population Percentage, Municipality of Anchorage

Anchorage Anchorage First Dose Series Complete Population Total Vaccinated Individuals 147,487 127,644 288,970 12+ Percent Vaccinated 60.5% 52.3% 243,890 16+ Percent Vaccinated 63.3% 55.8% 228,217 65+ Percent Vaccinated 78.4% 74.3% 35,455 Total Population Percent Vaccinated 51.0% 44.2% 288,970

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Public Health Messages The Anchorage Health Department encourages all Anchorage residents aged 12 years or older to get vaccinated as soon as possible. Please get vaccinated now to be fully protected when you return to indoor activities in the fall.

Getting vaccinated supports the health of the entire Anchorage community. Your vaccination protects those around you, including people with weakened immune systems, young children, and others who may not be able to get vaccinated.

The Anchorage Health Department advises all Anchorage residents to follow CDC guidance based on their vaccination status.

If you are fully vaccinated (two weeks past your second Pfizer or Moderna vaccine dose or two weeks past your single Johnson&Johnson vaccine dose): • You can resume activities that you did prior to the pandemic. • You can resume activities without wearing a mask or staying 6 feet apart, except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance. • If you travel in the United States, you do not need to get tested before or after travel or self- quarantine after travel. • If you have been around someone who has COVID-19, you do not need to stay away from others or get tested unless you have symptoms. o However, if you live or work in a correctional or detention facility or a homeless shelter and are around someone who has COVID-19, you should still get tested, even if you don’t have symptoms.

If you are not fully vaccinated, you should wear a mask when you are: • Indoors in public. • Around people you do not live with either Inside your home or inside someone else’s home. • Inside your home if someone you live with is sick with symptoms of COVID-19 or has tested positive for COVID-19. • Outdoors at large, crowded events.

Additional considerations: • Masks are required by federal mandate for all travelers while on public transportation, including buses, trains, and planes. People must also wear masks while at transportation hubs, including airports and bus terminals. • The CDC recommends vaccinated people wear masks when in health care facilities or in congregate settings such as homeless shelters.

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