The Wrangell Borough Assembly met Tuesday evening to hear from some Alaskan health experts regarding the COVID-19 pandemic. As Wrangell received its first case of the virus over the weekend, assembly members and other city officials wanted an opportunity to learn more about how the pandemic is being handled, and to ask questions about how testing works and the process behind pandemic response.
Public Health Nurse Erin Michael was given the opportunity to explain the process of what happens when a person is tested positive with COVID-19. With a positive case, she said, the lab that ran the test notifies the medical provider, and then either the medical provider or the lab will notify the patient. The state lab will also notify the Alaska Section of Epidemiology, which will then notify Public Health Nursing. After that, the case gets assigned to whichever Public Health Nurse covers that community.
"In most cases, if it's Monday through Friday then I am the person that is calling and doing the initial interview with the person that had a positive," Michael said. "This interview is very intensive, it can take several hours, and we're looking at what the person was doing and who they were around."
Michael went into more detail, explaining that they look into who the patient was around within the past two days before they started showing symptoms. If they are asymptomatic, they look two days before they get a positive test. Those people they were around, if they were within six feet of the patient for more than 10 minutes, or are otherwise thought to be high risk, are considered "close contacts" and will also be interviewed. They are advised to quarantine for two weeks, from the time they were around the patient.
Michael also said that the Public Health Nurse will also go back 14 days in the patient's history, prior to them having symptoms or being tested, to try and determine where they caught the virus. Sometimes they can determine where they got the infection, either by traveling or from contact with another sick person, but sometimes the source of the infection remains unknown.
The patient, while isolating, will be regularly monitored for signs and symptoms of COVID-19, and they may be referred to their medical provider for medical care. Close contacts are not required to get tested, Michael said, but it is recommended if they show symptoms of COVID-19. They should speak to their medical provider about testing options.
Another health expert present at the meeting was Dr. Jayme Parker, lab manager for the Alaska state virology lab in Fairbanks. Her lab, she said, handles about half of the Public Health COVID-19 tests for the state. They are testing between 300 to 1,000 specimens a day. She was invited to the meeting to help answer questions from assembly members and city officials.
Mayor Steve Prysunka asked, in general, if somebody were to test positive for COVID-19 what the protocol would be on her end. Parker answered that a positive test result is an "actionable event." This means they call the provider that patient came from, and make a report to the department of epidemiology. Any positive that they see in her lab, she said, they take very seriously.
Prysunka also wanted to know about the process of further testing of patients and validating the original positive test result. Parker explained that when they examine a test, they are looking for the RNA of the virus. However, sometimes at the end of respiratory diseases like COVID-19 there is "viral litter" that can make accurate test results a challenge at times.
"This could be RNA that's not infectious," Parker said. "It could be degraded RNA just from the ends of an infection, but we're going to pick that up as a positive intermittently, at the end of someone's infection."
Assembly Member Patty Gilbert wanted to know if Parker knew what percentage of positive tests were actually false positives. She also asked if the state labs could tell the "viral load" of a test, beyond just a positive or negative result. Parker responded that yes, they could determine the viral load of a test, whether or not it is a high positive or a low positive. There are a number of factors that can determine the strength of the sample they are testing, she said, including the quality of the specimen and when it was taken, among other factors. As to Gilbert's question about false positives, she said there was not a lot of data to go on.
"That isn't something that we've really been focused on, here in the state, or across the country, or even literature that I was looking for this morning about this topic," Parker said. "There just isn't really anything published about the rates of false positivity ... We really haven't gone very deep into the false positivity aspects of some of these tests, we're basically acting on all of them and making sure that we're protecting communities."
Jamie Roberts wanted to know how somebody could receive a positive test result and still be asymptomatic. Parker answered that viruses can be very tricky. Not giving some hosts symptoms is one way that viruses can persist undetected. She also added that COVID-19 has an incubation period of about five days, on average, and a patient is most likely to test "positive" within the first three weeks of infection. This can vary case by case, however.
Following the discussion and Q&A session on COVID-19, the assembly approved of this year's mill levy tax. The mill levy, according to the agenda packet for the meeting, is the rate at which a property in Wrangell is taxed.
The resolution that came before the assembly set the mill levy at 12.75 for property within the Wrangell Service area, and 4.0 for property outside of this area. Borough Manager Lisa Von Bargen said that this is the same rate as previous years, so there will be no property tax increase moving forward. According to the agenda packet, the assessed value of all properties in Wrangell this year, after exemptions, is a little less than $159 million. This is an increase of about $5.8 million from last year. According to a table in the meeting's agenda packet, about $143 million-worth of property is within the Wrangell Service area, and the remainder is outside of that area. With the mill rates set as they are, Wrangell can expect to collect about $1.8 million in property taxes within the service area, and $62,453 in property taxes outside of the service area.
In other items, the assembly decided to accept Ryan Howe's application to fill a vacant seat on the assembly left by the resignation of Drew Larrabee.
The assembly also heard a letter from Angie Flickinger, calling for city officials, the police department, and the wider community to be more aware of the issue of systemic racism and to collaborate to combat the issue.
The assembly approved of a bid from Spenard Hardware, in the amount of $32,250 for primary school doors and hardware procurement.
A special meeting of the assembly was scheduled for Tuesday, June 16, for a public hearing on the FY 2021 budget.
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