Anchorage COVID-19 Health Risk Metrics

Date: May 28, 2021 To: Acting Mayor Austin Quinn-Davidson Thru: Heather Harris, Anchorage Health Department Director From: Janet Johnston, Anchorage Health Department Epidemiologist Subject: May 28, 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 20, 2021 – May 26, 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 public health 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 has moved to 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 decreased below five cases per day per 100,000 residents, moving us to the middle of the Considerable Risk Level for this metric. With just over 51% 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 infection equivalent to an average daily new case count of approximately 9 per 100,000 residents. In contrast, their vaccinated counterparts experience a risk equivalent to just under 1 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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May 28, 2021 Report, Page 2 of 10

Cases

Case Counts, Hospitalizations, and Deaths • Daily new cases. The current 14-day rolling daily average of 4.94 cases per 100,000 is a 33% decrease from last week. • New cases this week. There were 82 new resident cases this week, 54 less than last week. • Racial distribution. The weekly case rate for Native Hawaiian and Other Pacific Islander (NHOPI) people was 7.6 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 26% of the cases last week. See Table 1 for breakdown by race and ethnicity. • Age distribution: The highest weekly case rate continues to occur in the 20- to 29-year-old age group. See Table 2 for breakdown by age. • Cumulative cases. As of May 26, there are 30,773 confirmed cases in the MOA. This includes 30,169 Anchorage residents in- and out-of-state and 604 nonresidents testing positive in Anchorage. • Current hospitalizations. As of May 25, there were 11 hospitalized COVID-19 cases. The number of hospitalized cases ranged from 7 to 11 this week. As of May 25, there were 2 hospitalized Persons Under Investigation (PUI). Hospitalizations are slightly lower than last week. • Deaths. There have been 179 Anchorage deaths, 177 among Anchorage residents, and two nonresidents. This is the same as last week’s report.

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Table 1: COVID-19 Cases by Race and Ethnicity (excluding cases with missing race or ethnicity data, 26% 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 10 16% 39 4,039 19% 15,805 151 21% 3.7 48 27% 1.2 Native Asian 6 10% 23 1,476 7% 5,682 83 11% 5.6 26 15% 1.8 Black or African American 4 7% 26 1,013 5% 6,661 40 6% 3.9 9 5% 0.9 Native Hawaiian or Other 8 13% 99 1,163 5% 14,463 1 0% 0.1 19 11% 1.6 Pacific Islander White 23 38% 13 8,032 38% 4,453 239 33% 3.0 70 40% 0.9 Other Race 5 8% 77 3,280 15% 50,539 44 6% 1.3 - 0% - Two or More Races 5 8% 19 2,201 10% 8,356 166 23% 7.5 5 3% 0.2 All Cases (race known) 61 100% 21 21,204 100% 7,363 724 100% 3.4 177 100% 0.8 Ethnicity Cases Percent Rate* Cases Percent Rate* Cases Percent Rate Cases Percent Rate Hispanic 2 6% 7 1,500 13% 5,557 45 8% 3.0 14 8% 0.9 Non-Hispanic 32 94% 12 10,495 87% 4,021 518 92% 4.9 160 92% 1.5 All Cases (ethnicity 34 100% 12 11,995 1 4,165 563 1 4.7 174 100% 1.5 known) * Per 100,000

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May 28, 2021 Report, Page 4 of 10

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 10 12% 26 2,042 7% 5,254 6 1% 0.3 - 0% - 10 to 19 5 6% 13 3,683 12% 9,688 7 1% 0.2 - 0% - 20 to 29 21 26% 48 6,484 22% 14,954 39 5% 0.6 3 2% 0.0 30 to 39 14 17% 30 5,910 20% 12,741 73 9% 1.2 2 1% 0.0 40 to 49 9 11% 26 4,097 14% 11,891 91 11% 2.2 11 6% 0.3 50 to 59 13 16% 37 3,764 12% 10,713 136 17% 3.6 13 7% 0.3 60 to 69 8 10% 26 2,627 9% 8,384 167 21% 6.4 33 19% 1.3 70 to 79 2 2% 13 1,060 4% 6,957 178 22% 16.8 60 34% 5.7 80+ - 0% - 479 2% 7,745 112 14% 23.4 55 31% 11.5 All Cases 82 100% 28 30,146 100% 10,432 809 100% 2.7 177 100% 0.6 Sex Cases Percent Rate* Cases Percent Rate* Cases Percent Rate Cases Percent Rate Female 40 49% 28 14,734 49% 10,249 366 45% 2.5 69 39% 0.5 Male 42 51% 29 15,404 51% 10,609 443 55% 2.9 108 61% 0.7 All Cases (sex known) 82 100% 28 30,138 100% 10,429 809 100% 2.7 177 100% 0.6 * Per 100,000

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Health Care Capacity

• ICU beds. On average, between May 19 and May 25, 15.1% of staffed adult ICU beds at the three acute care hospitals in Anchorage were available. This is higher than the 8.3% available on average the week before and moves us back to the high end of the Lower Risk category for the Anchorage COVID-19 Health Risk Metrics. Between May 19 and May 25, the number of staffed adult ICU beds ranged from 66 to 70, and the number of available staffed adult ICU beds ranged from 4 to 15.

Infection Rate

• The consensus Rt of 0.77 is slightly lower than last week’s consensus estimate of 0.81 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 13 May 13 (updated) May 20

Anchorage, COVID ActNow 0.82 0.81 0.82

Anchorage, SOA model, (in-state residents only) 0.82 0.81 0.73

Alaska, COVID ActNow 0.81 0.80 0.82

Alaska, SOA model, (in-state residents only) 0.81 0.8 0.79

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May 28, 2021 Report, Page 6 of 10

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 20 and May 26, 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.

• Test volume: o As shown in Table 4, the testing volume has decreased slightly from last week but remains well above the White House task force's target level. Test volume is calculated using a seven-day lag to allow for sample processing time. Because some tests take more than five days to process, the average daily counts for more recent weeks will increase as more test results are received.

Table 4: Weekly Test Volume Indicators

April 30 – May 7 – May 14 – White House Target Indicator May 6 May 13 May 20 (>2,000 per week)

Tests in the week 16,227 14,560 13,619 5779.4 Average daily tests per 100,000 802 720 673 >285

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Additional Community Factors

Risk associated with additional contributing factors continues to drop and is now 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: • Variants of Concern: an increasing proportion of more transmissible B.1.1.7 variants • Continued light demand for new vaccinations. • No additional Johnson & Johnson vaccine shipments again this week.

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 58 Anchorage cases entered into CommCare with specimen collection dates between May 15 and May 21, 53 (91%) completed interviews, which is the same percentage as last week. Of cases with a completed interview, 51 (96%) 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 two Anchorage cases opened in CommCare during the past week, May 20 through May 26, that were identified as part of a cluster, compared to one the week before. One case was associated with a skilled nursing facility and the other with a different residential healthcare facility.

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Vaccination

• According to VacTrAK, 135,648 first COVID-19 vaccine doses have been administered to residents within Anchorage, and 117,354 vaccine series have been completed as of May 27. VacTrAK does not include data regarding vaccine doses administered by the VA or 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. • Vaccination rates vary by age, race, and ethnicity, as shown in Table 6. Only 42% of people aged 20 to 29 have received a first dose, compared to 58% of the general population 16 and older. This analysis is limited to vaccine doses reported to VacTrAK. • Joint Base Elmendorf-Richardson (JBER) provides vaccine dose counts directly to the MOA. As of our most recent update on May 19, 9,570 first doses have been administered at JBER, and 8,266 vaccine series have been completed. • Combining VacTrAK and JBER data, 145,218 first vaccine doses have been administered in Anchorage to residents aged 12 or older. This is an increase of 6,242 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 145,218 125,620 288,970 12+ Percent Vaccinated 59.5% 51.5% 243,890 16+ Percent Vaccinated 62.4% 54.9% 228,217 65+ Percent Vaccinated 78.1% 73.9% 35,455 Total Population Percent Vaccinated 50.3% 43.5% 288,970

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Table 6: Vaccinations by Race, Ethnicity, Gender and Age as reported to VacTrAK (ethnicity and gender not available this week)

Cases Vaccinations** Anchorage Population Cases per Vax per Percent 100, Percent of 100, Age Percent of Race Cases of cases 15+ Vax vaccinations 15+ Pop 15+ pop American 4,039 19% 20.8 13,681 12% 70.4 19,431 8% Indian or Alaska Native Asian 1,476 7% 6.8 8,652 7% 40.1 21,564 9% Black or 1,013 5% 8.2 2,991 3% 24.1 12,417 5% African American Native 1,163 5% 22.7 1,385 1% 27.1 5,114 2% Hawaiian or Other Pacific Islander White 8,032 38% 5.3 43,136 37% 28.7 150,315 65% Other Race 3,280 15% 60.7 11,386 10% 210.5 5,408 2% Two or More 2,201 10% 13.6 35,567 30% 219.0 16,243 7% Races Per Ethnicity Cases Percent 100 Vax Percent Rate Pop 15+ Percent Hispanic 1,500 13% 7.9 Ethnicity data not currently 18,894 8% Non-Hispanic 10,495 87% 5.0 available 211,598 92% Gender Cases Percent Per Vax Percent Rate Pop 15+ Percent 100 Female 14,734 49% 12.8 Gender data is not currently 115,269 50% Male 15,404 51% 13.4 available 115,046 50% Per Age Cases Percent 100 Vax Percent Rate Pop Percent 0 to 9 2,042 7% 5.0 - 0% - 40,630 14% 10 to 19 3,683 12% 10.0 6,792 5% 18.5 36,798 13% 20 to 29 6,484 22% 14.4 18,751 14% 41.8 44,884 16% 30 to 39 5,910 20% 13.0 24,382 18% 53.8 45,361 16% 40 to 49 4,097 14% 12.4 21,367 16% 64.4 33,156 12% 50 to 59 3,764 12% 10.3 23,624 18% 64.4 36,662 13% 60 to 69 2,627 9% 9.2 23,246 17% 81.0 28,701 10% 70 to 79 1,060 4% 6.5 12,141 9% 74.8 16,226 6% 80+ 479 2% 8.6 4,335 3% 77.7 5,582 2% Total 30,146 100% 10.5 134,638 100% 46.7 288,000 100% * Total number of vaccinations is undercounted by 1,010 due to rounding and inconsistencies in the data. Efforts are underway to address these inconsistencies. ** With at least one dose.

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Public Health Messages The Anchorage Health Department advises all Anchorage residents to follow CDC guidance based on your 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.

825 L Street, Anchorage, AK, 99501 | (907) 343-6718 | www.muni.org/health | @ancpublichealth