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Unalaska Mayor, City Manager, Clinic Director Discuss Local COVID-19 Mandates

Berett Wilber/KUCB

KUCB's Hope McKenney hosted a live call-in show with Unalaska's Mayor Vince Tutiakoff Sr., City Manager Erin Reinders, and Melanee Tiura, director of Iliuliuk Family and Health Services (IFHS) on Friday to discuss changes in local mandates and actions being taken to protect the community from COVID-19.

The show will re-air in its entirety on Saturday, May 30, at 4 p.m. on KUCB, 89.7 FM.

Listen below:

TRANSCRIPT:

KUCB: The Unalaska City Council adopted a new COVID-19 mandate at its meeting this week, and the local order states that everyone must follow state and CDC mandates and other guidance. Erin, can you tell us a little bit about what this new mandate requires and how it may be stricter than state mandates?

ERIN REINDERS: Sure, that's a great question. So what the process that our community has taken is taking is having City Council really reconsider the additional protective measures for the community on a regular basis. So really, every council meeting they reconsider how we might need to adjust our local protective measures, and a few of those council meetings before we tried hard to really have the resolution focus in on what is over and above the state mandates. And so what is required. So, of course, it acknowledges that there are other mandates and reiterates the importance of following those and CDC guidance. And then it focuses in on a few core things that do go above what is required throughout the state. And that's really because of where we are located and our access, you know, to health care, you know, and trying to make sure that we are able to adequately meet the needs of our community. So we're focusing on face coverings, having customers and visitors to different businesses and organizations that are open wear face coverings and again, that's a measure to not really to protect yourself but more to protect those around you. There also is a traveler quarantine for individuals that are arriving to the islands no matter where they're coming from. So throughout the state of Alaska, as well as internationally or from a different state, the expectation is that you would self-quarantine for 14 days and monitor for any signs or symptoms of COVID. And if you should discover that you have one of those symptoms to then reach out to the clinic. Obviously there are some exemptions from that, with that quarantine requirement, the critical workforce being a key part of that. Council did carve out an exemption on Tuesday, which could be a little bit confusing, but there was some rationale to it and a thought process to that. So they carved out an exemption that allows for ferry passengers that are just here for the day to go about their business and then get back onto the ferry and proceed with their travels. And primarily that decision was

acknowledging that most of those travelers are going to be those individuals from other Aleutian Island or Aleutian communities that need to come here for some critical and essential businesses to acquire some essential goods and services. So and the limit there, there's really four remaining ferry sailings scheduled. And so we're not thinking that that's going to be all that many people. And our Port Director is working very closely with the Alaska Marine Highway System, and kind of communicating to them what the expectations are once those folks do arrive.

The other requirements that we have here locally are requesting that plans be submitted…and these aren't all that much of a change from what has already been in previous Council resolutions, but just requiring that various safety protocols be submitted here locally, that have also been provided to the state. And then we're also asking all businesses that are open now and are serving members of the community to again, think through the protective measures that they are taking and the protocols that they have worked into their operations, and post those on their exits and entrances so that those that are visiting, can see that and, and it also kind of demonstrates that the businesses have kind of thought through how, and what their actions might be to help protect their employees and the visitors to their business.

KUCB: And so backing up to that travel quarantine and the exception there with ferry passengers. I've heard a bit of concern after Tuesday's council meeting about that. And we have one listener that asks, “Can you explain why day visitors coming on the ferry are getting preferential treatment compared to Unalaska residents by allowing visitors to go to local businesses without quarantine, but Unalaska residents are not allowed and must go into immediate quarantine upon arrival.” Could you talk about that a little bit? How did the city come to that decision?

REINDERS: I can touch on that. And ultimately, that was a policy decision that council made. And then, you know, perhaps the Mayor can address some of the thought process that he went through. But one way you could look at it is individuals that are coming to the community to stay, if they were to go out and about they have a larger opportunity to spread whatever virus that they might be carrying. So the I think some things to consider are just the number of individuals that we're actually talking about here and I don't think we're talking about that much. So that was a component of that thought process and it's for a limited fixed period of time. And they're going into businesses for a short period of time and then will be going. I recognize that this is a tricky wicket. And you know, there is really is no one right way to go. And it's definitely just trying to weigh out some pros and cons and it was a tricky decision, I imagine, and there's lots of different ways you can look at it. And with that, I think I'll turn it over to the mayor from kind of the more policy perspective as some of the thought process that council members might have gone through as they were considering that decision.

VINCE TUTIAKOFF: Oh, yes, thanks, Erin. This is Vince Tutiakoff. It was after much deliberation and thought process and the concerns that most the community may have is those coming from out of state. These people traveling most are on the small ferry coming into Unalaska are coming in from smaller villages. Not necessarily this year as much as last year that we see in people from King Cove, Sand Point, False Pass, even Kodiak coming out just for the ride, and maybe looking at the scenery of Unalaska. But these trips that people are making are coming primarily from Akutan. They're being informed by the Alaska Marine Highway System while traveling of all the measures that Unalaska has in place. Also the ports will be educating them as they get off of the ferry, thwy will allow only one family member to go to the store, go to clinic. Some of them are possibly going to a clinic to get medicine or traveling just to sightsee in Unalaska and not getting off the vessel. There is no that we know of…Most of these travelers have no contact or have no cases within their community, much like what's happening here in Unalaska, and we want to continue that. But there is a real need to get groceries, supplies that they ordinarily would have gotten by plane, and in some cases they're not getting it. So there was a lot of thought put into it and concern by the Council to allow the day travelers to participate in going to the store, wearing the face mask and following all of our rules and regulations coming into our community.

KUCB: So continuing with this, the quarantine requirements, and now there's this exception for people coming on the ferry… the first ferry is on June 6, so that's next weekend. One listener says, “The governor's latest updates to state mandates prohibits communities from automatically quarantining workers in the critical workforce. But the latest city resolution passed this week still requires a mandatory self-quarantine for everyone including critical infrastructure and essential service workers.” They say, “How do you explain this apparent contradiction?” Although is that still in place for critical infrastructure and essential service workers?

REINDERS: So I'll touch on that. You know, we've worked on these resolutions very closely with legal team and are confident, you know, this is obviously new territory for everyone throughout the state, but we're confident that we are aligning effectively with the governor's mandates. It is not our position that there is an automatic quarantine upon arrival. Because there are exemptions. And essential and critical members of the workforce are not automatically quarantined. They have to follow whatever plans have been submitted, you know, by their employer for safeguard measures. And this is consistent with the other safeguard measures that then they are in quarantine when they are not working. And frankly, that has been in those resolutions from the early days, a month or so ago.

KUCB: And is the city thinking about extending the mandatory 14-day quarantine beyond June 10?

REINDERS: Well, that is, as with all of this, it's a continuously changing environment and we reconsider it on a regular basis. I will say and, perhaps Melanee and the mayor might have other things to add. But, you know, what I've heard from Melanee, early on, and it continues, is that the two best protective measures for our community at this point are the

quarantine and the face coverings. I will say that as the state is opening up in the governor's is kind of reducing the quarantine requirements obviously throughout the state…and then it's being reconsidered...I believe the governor said he was going to speak to some of that today. But I think we'll know more what the governor stance is on the quarantine requirements for those coming in from out of state next Tuesday on the 2nd. But I will say that council did discuss that quarantine issue at the last council meeting. So I think that people recognize that it's a challenge, and keep weighing out the challenges that it brings and also the protections that it might be providing as well and I guess, Mr. Mayor, if you have other things to add, it's definitely a policy decision.

TUTIAKOFF: Yes, this is Vince Tutiakoff again. I believe that we have to take a look at what's going to be happening through this next couple of weeks will tell a lot about whether we keep these measures in place that we have right now. And possibly Melanee can speak to those. We need to have some kind of assurance that our communities can be kept safe, because of the larger incoming workers, due to the “B” season coming up here. I feel, and possibly most of the Council also feels, that we need to be prepared for any kind of measures and to be safe is the best option for this community and if it came down to it I would extend this continuing process that we have right now, through, possibly…what is that the 24th? The next meeting in June. So that's my feelings. And possibly Melanee can give the scientific and health reasons why this is a good process that we are doing.

MELANEE TIURA: Hi. So thank you for that. And I agree, you know, the timing of our measures, we’re timing it with “B” season, and the opening businesses….so we're trying to figure which strategies are going to be most effective for our community. And just like the state has decided to continue with quarantine measures for those coming from out of state, we've made that decision for those coming into our community even from within the state, because there are confirmed cases in the state. And we know that is how it's going to get here. So it does pose challenges. It's something that we have to keep looking at every couple of weeks, as the situation changes. If we're at a period of time where there has been no new cases in the state, I think we're going to look very differently at these guidelines. But at this point, that 14-day quarantine period is enough time for people to either show symptoms or to no longer be contagious. And we feel like that is a solid step to keeping us all safe.

KUCB: I know that you mentioned “B” season, which is quickly approaching, and I think there's a lot of anxiety right now about what will happen as more people come into the community with “B” season. So what is the plan for when we get the first case here? Is there any plan to increase restrictions in order to flatten the curve here in Unalaska?

TIURA: Erin, did you want to speak to the risk levels in the how the plan has developed?

REINDERS: Yeah, I can speak to that a little bit. I don't have it right in front of me, but I'm fairly familiar with it at this point. And then I'm wondering then Melanee, if you can touch on some of the measures that the clinic is already engaged in with those arriving for “B” season. I think that might be really helpful for people to hear. But particularly to answer your question, Hope, you know, about what are we going to do if there's a confirmed case. And a few weeks ago, you know, we've been operating under these various risk thresholds and related social distance guidance that our EOC has put together very early on. And relatively recently, we kind of took a step and we updated those based on the changes of circumstances and a little bit more information that we had and as we were working through this whole thing. And so right now, our local risk level is medium, which is because there's community spread throughout Alaska. But there's no cases here in Unalaska. And then…so your question about what happens if we get a case here and then it might not be that much changed from what we have now. If we can determine that it's travel related, and isolate that person and continue to provide the medical care, you know, to that individual and to the community…the plan at this point is just to kind of stay where we're at, obviously, continuing to reiterate the personal responsibilities of all of us, you know, social distancing. If it gets to the point where the clinic is overrun, and can't effectively meet the needs of the community for health care, or if we're not able to adequately, with the help of the Department of Public Health, adequately trace what's happening and how people are getting COVID, or if there is significant community spread, then we would go up to that high risk level, which might look more similar to where we were a month or so ago where we go down to the hunker down and closing of non-essential businesses and that sort of thing to help prevent or slow the spread of the virus.

Ultimately, at this point, you know, the focus is on really just kind of identifying as soon as we can, where those positive cases are. Identifying how they acquired the virus, and isolating those individuals. And so long as we can keep up with that, and everybody else throughout the community is doing what they can for social distancing, the possibility of it spreading community-wide will be reduced. And I can't say it enough. I feel like now it's somewhat cliche, but it's true. We really are all in this together. And it depends on the individual decisions of each and every one of us day in and day out, on the possibility of this spreading quickly, or really being able to address it quickly and keep it to a level where the clinic can still be able to provide effective service.

KUCB: And Melanee, I was wondering, can you speak a little bit to the kind of current testing capabilities at the clinic? I know, as of yesterday, I think 153 people had been tested on the island. But what will this look like as fishermen and workers begin arriving as “B” season starts in the coming weeks? Is there a conversation about routinely testing people? How will the clinic handle that?

TIURA: Yeah, so that's a great question and it's already started. So we at the clinic have been a part of the a large initiative across industry and we're working closely with industry on these types of questions. Things are going really well. So at this point, industry still has a lot of requirements regarding what they need to do regarding testing and quarantine. And those are outlined in the state mandates. Our industry partners are following those very closely, doing a really good job of it. There are several options for where testing can be done. Many are coming out of Seattle, so it can be done in Seattle with a quarantine period there, and then a safe travel practice to the community that they're heading to. And some are doing that quarantine in Anchorage and the testing that goes along with it. Others are doing a variety of testing in either their initiating port and then testing when they get here as well.

All of them that I'm aware of are 48 hours prior to release from quarantine getting their tests done here, if they've been in town, so part of that quarantine. And so that's gone really well. You'll see that reflected in the numbers. This last week has been pretty busy as those are starting to ramp up. We have a lot scheduled for the next couple of weeks as well. We have been using our Abbott ID now, and we do have the testing capacity with our Cepheids to expand that quite a bit further in this next week. So the state was able to provide us with several test kits for the Cepheid units. So that also will go very well. We're in the quality control phase. In a couple of days, we need to do that testing before we can launch the unit. But that's gone very well. So industry I think has done a really good job. We also have other types of critical infrastructure that have testing a part of their protective plan, and we're able to accommodate those requests as well. Of course we do have a schedule. We're only a small facility so at times we do need to schedule a day or two outside of what they're hoping for, but it's gone very well so far.

KUCB: Melanee, I have another question for you here that's actually about a consultation fee for non-symptomatic testing for COVID-19. A listener says, “Some arriving in town require as many as three tests while in quarantine per governor mandate. Given that this is for a test that is supposed to be free and there are no health conditions that require a visit to a physician, why charge the approximately $250 per test consultation fee just to get tested?”

TIURA: That was a great question. And so there are a couple of categories, right. So we have symptomatic patients that are obviously getting a more extensive visit, because there needs to be an evaluation in order to have an indication for having the test. In recent weeks, we've expanded that to include asymptomatic individuals but still within certain guidelines. And right now the state guidelines are that asymptomatic individuals can be tested per provider discretion, which means that there still is some level of evaluation that's needed in order to clear them for a test. At this point, we haven't had testing capabilities to extend to absolutely everybody who might want a test. There has to still be some indication. So if you're part of a post travel 14-day quarantine period, or it's in the protective plan, your critical infrastructure, those are some of the indications that we're looking for reasons why you might need a test, or that you might have some risk level. But for individuals who have been here, who haven't traveled, or haven't been exposed to anybody who may be at risk, at this point, we're still for the most part, not testing again, unless symptoms are present. So there still is a visit involved. The testing supplies themselves so far have been available to us from the state. We don't know how long that will continue, but so far so good on that. So we do not charge for the test supplies. But, of course, there's a lot that goes into a test. So we have a provider visit, we have the support of the team that's required to run the test, we have a lab team that that's actually performing the test within our lab, Personal

Protective Equipment that we need to provide to our team. And so, there are expenses for us to be able to provide the service. That's the reason for a visit. But it is a very low level visit. We've established that to be as low as is reasonably possible for the sake of the community. And it's also important to note that these visits are billable to insurance. They are eligible for a sliding fee scale for people who qualify. And then we're also working on an underinsured program with the federal government that may be able to cover some additional testing and evaluation services for those in our community who aren’t covered currently by insurance. I'll share more information when we have that ready to go.

KUCB: Did you say how many tests we currently have on-island and then that more might be coming from the state?

TIURA: Yeah, we did receive 600 from the state last week, which again will meet our needs for the time being, for several weeks to come.

KUCB: Okay. And, and I know that the state reported 13 new cases of COVID-19 on Wednesday, which is the most new cases for one day since mid-April. And Governor Dunleavy tried to allay any fears about the sudden spike in his press conference last night and I know Alaska's Chief Medical Officer, Dr. Ann Zink, said increased testing across the state may have played a role in the sudden case bump. But I think something that can't be ignored is that the state began easing health mandates on April 24, with businesses allowed to return to full capacity last Friday. Is this a concern at this point for us here in Unalaska?

TIURA: And I can speak to that. In my opinion, it doesn't pose any more concern for us based on the measures that we've put in place. We have expanded the business reopening and all of that along with the state guidance, but we don't have cases here yet. So obviously, we're not seeing a spike that they will see when they have cases in their communities. So at the point that we have cases, again, as Erin had mentioned, we may look at things a little bit differently. At this point, we believe that 14-day quarantine and masks and public places is something that's just very helpful for us, s that we can prevent what has happened in other communities.

KUCB: And we just had another question come in from Melanee. Are you looking into future serology or antigen testing?

TIURA: Another great question. Yes, we are looking into it. There are some large studies going on in the Lower 48. There’s one in the Seattle area, and I know Mayo Clinic is also working on a large study. The limitations of serology at this point is that we don't really know what to do with the results. But there's enough testing that's happening concurrently with serology testing so that it will make more sense I think going forward. I have looked into some of our vendors for equipment, they have some thoughts that they'll be getting the ability to add serology testing into some of our existing pieces of equipment. I don't know how far out that is at this point. But limitations at this point, we don't really know, if you have some antibodies, could you still have live virus? Could you still be contagious? What level is considered protective? Are the strains changing? So there are just many unknowns that don't make it as useful as we'd like it to be yet, but things are looking good. We will get there. So that serology testing will have a place in our future and will be a part of it.

KUCB: And I know we need to start wrapping things up because you all have other meetings to get to. But I have a question about this personal responsibility that Erin, I think you mentioned earlier. The state has been opening up, this week we saw an increase in the number of cases, I know the PCR and library are set to reopen on Monday. And I see people around Unalaska starting to kind of loosen up, hang out with people outside of their households, not necessarily using face masks. So what are people expected to do at this point?

REINDERS: I think the state has done a great job in providing some ideas of what that might look like. You know, and all along we've been talking about the value of staying six feet away from people, the value of wearing your mask, the importance of keeping your hands clean by washing them, or when we can't wash them to use hand sanitizer, and keeping your frequently touched surfaces cleaned. So all of that remains really important. And there's other information out there that talks about really thinking through, and remembering and documenting even, who you have come in contact with and limiting that circle. You know, I mean, this has been a long couple of months and I can certainly sympathize and understand and have experienced firsthand that desire to have those face to face conversations and maybe even give a hug every once in a while. But the fact is, we still need to be aware of who we're interacting with and you know, really try to limit that circle and limit the length of time that we're in close contact with other individuals and kind of keep being aware of the importance and the impact of those decisions.

KUCB: And do you think it's actually been somewhat harder for people here, and especially young people here, to maintain that distance and practice those good things that you were just talking about because we haven't actually had a case here yet?

REINDERS: I do. I mean, I think it is harder to recognize the importance of it when it's not right in front of your face, right? I mean, right now, it's kind of this conceptual idea that we haven't been forced to see. You know, we can watch the news, but it's not the same as really experiencing it. So it has been, I think, a challenge and a blessing, you know. It's great that we don't have any confirmed cases, but it does make it more challenging to communicate the need to remain diligent in these measures.

KUCB: Okay, well, I think we're coming up towards the end of our time here. Do any of you have anything else to add or questions that I should have asked you?

TUTIAKOFF: Yeah, this is Vince, the mayor. I would like to make a shout out to the community…same as what Erin had said earlier about we are all in this together. And I think that it's going to be the individual responsibility as we start to open our community. As you mentioned, PCR and the library's going to be opening Monday and I think it's individual responsibility that needs to be highlighted. Businesses that are opening, or have been open for awhile, need to continue to monitor their patrons regarding facemasks, self- distancing, those kinds of things, and keeping their staff and personnel safe. In regards to the “B” season, and I'm very happy with the plans that have been submitted by industry. They've worked closely with the clinic, as Melanee had mentioned, and it’s good to see that they are monitoring their people as they come in and putting them in 14-day [quarantine], and doing their testing, in-house in some cases. I'm very happy to see that. And I did a walk through PCR and the library and reviewed their plans that they've put in place and I would say that their plans are very good. I'm really happy for seeing those places opening and with the plan that they have to keep people safe, to keep their workers safe, and the community safe, I think is very good. And so I appreciate the opportunity to speak the community. And we are not through this yet. And we need to be aware of what's going on. And report it if you feel that there's infractions. Report it to that call number or call Public Safety.

KUCB: Thank you. And if people don't understand something that they're supposed to be doing, or a mandate, is there a resource? Who should they be reaching out to to get their questions answered?

REINDERS: The mayor is pointing to me. There's a number of different resources out there. And I certainly want to acknowledge that there has been a lot of mandates coming out and  they change on a regular basis. And so it's a challenge to keep up with the latest requirements and communications. Yeah, so we do issue daily, Monday through Friday, news releases with very valuable information. And those, along with any sort of other local resolutions, are all on our website. So that's all available. The state also has a website with all of their mandates and frequently asked questions. Our PIO here locally, which is also our city clerk, she's an amazing resource and you could reach out to the clerk's office and then they can direct your call accordingly, if you've got specific questions in regards to what the mandate is.

TUTIAKOFF: This is Vince again, the mayor. I know a lot of people don't have internet and don't have access to this kind of information. A phone call to me, or to the PIO, to get more information…I'm willing to help and get that information around to the community members that do not have transportation to get around. They need information, I’m more than happy to make those deliveries to them, as I've done early on this whole process and that information is available by calling City Hall.

KUCB: Well, thank you. Is there anything else you have to add?

TUTIAKOFF: No, I'm fine. And wash regularly and wear a face mask and watch the six feet distancing.

Hope McKenney is a public radio news director, reporter, producer and host based in the Aleutian Islands, Alaska.
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