Alaska’s high Coast Guard official warns of rising medevac instances as he leaves command

As he handed off command of the Coast Guard in Alaska this month, Rear Adm. Nathan Moore mentioned there’s a number of good issues about residing in Alaska — together with the flexibility to observe Monday Evening Soccer at an affordable time.

However as Rear Adm. Megan Dean takes command, Moore mentioned, his service is dealing with new challenges within the state, and one of many largest is a rising — and probably unprecedented — demand for emergency medevac flights.

“It’s simply extra maritime exercise,” Moore mentioned. “This 12 months, we’re seeing the industrial cruise ship trade return to what’s the pre-2019 stage.”

“They’re truly going above the before-COVID stage by way of ships and vessels and passengers right here. And so what meaning is simply extra danger for us,” he mentioned.

In simply the primary half of this 12 months’s summer season vacationer season, from Oct. 1 via June 15, the Coast Guard in Alaska has flown 163 medical flights.

That’s already greater than the 150 that the Coast Guard flew in a full federal fiscal 12 months 4 years in the past, the final 12 months earlier than the COVID-19 pandemic.

The most important Coast Guard base in the USA is on Kodiak Island, dwelling to a serious port and air station. Sitka additionally has a Coast Guard air station, and boat crews function from giant and small cities throughout the southern coast.

Moore mentioned the Coast Guard is maintaining with the demand with folks and tools from these locations.

“However is it extra of a workload? There’s no query,” he mentioned. 

The Coast Guard’s figures embrace the form of dramatic helicopter rescues from ships at sea which are correctly known as medevacs, however additionally they embrace what are often called “non-maritime medical transports,” the place somebody must get from a distant onshore location to a hospital urgently.

The variety of requests for non-medical transports elevated greater than 50% from FY19 to FY22, and this 12 months’s quantity is on tempo to surpass final 12 months’s determine.

This information desk, offered by Jennifer Whitcomb, supervisor of the Coast Guard District 17 search and rescue program, reveals the variety of medevac flights and requests via June 15, in comparison with prior federal fiscal years. (U.S. Coast Guard information)

“The distinctive problem of small cities and villages off of the highway system with restricted medical services creates a frequent want for pressing medevacs to hospitals in larger cities. Whereas there’s a sturdy community of economic suppliers akin to Guardian, LifeMed, and Airlift NW, (plus North Slope Borough SAR within the Arctic) there are a lot of areas they can not fly into after darkish or in inclement climate. For years, the Coast Guard has helped fill that hole,” mentioned Jennifer Whitcomb, supervisor of the search and rescue program for the Coast Guard within the state.

The Coast Guard doesn’t fly to each name for assist, Whitcomb mentioned. A Coast Guard flight surgeon opinions each case and decides whether or not the urgency of the request warrants a flight.

If the affected person’s situation improves, the climate clears up or a industrial air ambulance turns into out there, the Coast Guard would possibly defer.

Even with these {qualifications}, the variety of medevacs is rising, and officers say there’s one major trigger: the rebound of Alaska’s cruise ship tourism trade.

“This isn’t solely our first full cruise ship season in a number of years, however it’s our largest. And so that’s driving nearly all of these numbers,” mentioned Erin Hardin, director of neighborhood relations at Juneau’s Bartlett Regional Hospital.

Southeast Alaska has a inhabitants of about 74,000 folks unfold throughout a California-sized stretch of islands and deep ocean channels. Bartlett is the most important hospital within the area, and plenty of Coast Guard medevacs finish there.

In 2019, 1.3 million vacationers visited Alaska by cruise ship, most of them staying in Southeast Alaska. This 12 months, 1.65 million vacationers have been anticipated to reach by cruise ship, and precise passenger counts have been near that projection.

Coast Guard Rear Adm. Nathan Moore, middle, talks with Rear Adm. Megan Dean, proper, throughout a change of command ceremony on June 9, 2023, in Juneau. Dean changed Moore as commander of Coast Guard District 17, which covers all of Alaska. At left is Vice Adm. Andrew Tiongson, commander of the Pacific Space and Protection Drive West. (Photograph by James Brooks/Alaska Beacon)

Throughout an emergency at sea in Southeast Alaska — whether or not aboard a cruise ship or not — the Coast Guard is normally the primary responder and sometimes carries the affected person to Juneau or Sitka for additional therapy or a switch to a industrial medevac flight that will take them to Seattle or Anchorage for extra superior care.

Business corporations additionally carry sufferers between communities with airstrips, however when the climate is unhealthy, the Coast Guard can fly at occasions when industrial flights can’t.

Stephen LeMay, director of enterprise growth for Airlift Northwest, the nonprofit air ambulance service affiliated with the College of Washington medical middle, mentioned his group has seen the identical development that the Coast Guard is observing. 

“We’ve form of nicknamed it ‘revenge journey’ after COVID,” mentioned Stephen LeMay, “Everybody needs to get out of the home and journey. So we’ve seen a fairly important uptick in medevacs from the cruise ships, both going north to Anchorage or south to Seattle,” he mentioned. 

However some officers say tourism isn’t solely responsible.

Near 8% of Alaska’s inhabitants is at the least 71 years outdated, the very best proportion on document, with the variety of Alaskans over 65 doubling from 2010 to 2021. That upward development is anticipated to proceed via at the least 2035, state economists have mentioned.

Most of these aged Alaskans aren’t newcomers: They’re individuals who arrived in Alaska throughout the oil growth and have stayed within the state whilst they aged. 

The SouthEast Alaska Regional Well being Consortium has been increasing its presence in Southeast Alaska to satisfy the area’s wants, and Dr. Cate Buley, its medical director of major care clinics, mentioned that higher well being care has decreased an incentive to maneuver away as residents age.

“So I feel there’s extra folks with extra extreme continual ailments residing in very distant areas than there have been up to now,” she mentioned.

In Southeast Alaska, a couple of in six residents is now at the least 65 years outdated.

Telemedicine choices have gotten higher and clinicians at the moment are in a position to assist folks in distant locations with continual circumstances, “however then you definately’re additionally in a really rural spot when one thing goes unsuitable. You may get sick, actually fairly sick, actually quick,” she mentioned.

That, coupled with adjustments in procedures which have decreased the supply of some industrial medevac firms, has elevated the burden on the Coast Guard, she mentioned.

LeMay, at Airlift Northwest, mentioned that group hasn’t seen a major change in its year-round enterprise, which might be anticipated if Alaska’s growing old inhabitants have been contributing to the demand for flights.

“The common — what we name our meat and potatoes stuff, year-round — has been fairly constant. Now we have not seen any giant uptick or any downfall on that in any respect,” he mentioned. “So our progress has been seen via the tourism this 12 months.”

For the previous two years, Buley mentioned, SEARHC has been assembly quarterly with the Coast Guard, industrial medevac providers and representatives from the cruise tourism trade to speak about demand and take steps to cut back the burden on the Coast Guard.

These have included directions to shipboard docs, letting them know in regards to the availability of clinics in several ports and the industrial medevac providers that function in Alaska.

“If someone breaks their hip, or it’s one thing that’s not life-threatening, they are often transported out that manner,” Hardin mentioned, referring to industrial providers.

She mentioned the hospital has been collaborating in conversations about medevac providers as properly, as a result of as demand rises, so does the chance that the Coast Guard can’t reply in a real emergency.

“It’s essential for people to know when it’s applicable to name the Coast Guard and when it’s not,” she mentioned.