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Alaska regulations drop some COVID-19 reporting requirements, add requirement for RSV reports

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Alaska regulations drop some COVID-19 reporting requirements, add requirement for RSV reports

Sep 20, 2023 | 10:48 pm ET
By Yereth Rosen
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Alaska regulations drop some COVID-19 reporting requirements, add requirement for RSV reports
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A sign at the Alaska Native Tribal Health Consortium campus in Anchorage, seen on Tuesday, advises patients that a testing site that once operated there is now closed. COVID-19 is no longer considered a new disease, and health care providers are no longer required to report cases to state officials, under updated Alaska Division of Public Health regulations. But some different testing requirements have been added to the regulations. The public health reporting requirements are updated every few years, and the latest update went into effect on Sept. 3. (Photo by Yereth Rosen/Alaska Beacon)

Alaska medical providers no longer need to report patients’ COVID-19 cases to the states, but there are some new requirements for reporting other diseases and emerging health concerns, under new regulations that went into effect earlier in the month.

COVID-19 slips out of the reporting requirements for two main reasons, said Louisa Castrodale, an epidemiologist with the Alaska Division of Public Health.

While the regulations continue to have a general mandate for reporting “novel” diseases, COVID-19 no longer fits that description, she said. Additionally, much of the diagnoses are done with at-home tests by the patients themselves rather than by providers, making tracking difficult, she noted.

Mandatory reporting of COVID-19 cases remains in place for laboratories, under the new regulations. Although that information will not give accurate totals, it will provide a guide to how the disease is moving through communities, Castrodale said.

“We want to use the data in a meaningful way to tell us about trends,” she said.

A culture of Candida auris, a fungal organism discovered in 2009, is seen in 2016 on a petri dish. This fungus is resistant to multiple medicines normally used to ward off infections. (Photo by Shawn Lockhart/U.S. Centers for Disease Control and Prevention)
A culture of Candida auris, a fungal organism discovered in 2009, is seen in 2016 on a petri dish. This fungus is resistant to multiple medicines normally used to ward off infections. (Photo by Shawn Lockhart/U.S. Centers for Disease Control and Prevention)

An important addition to the requirements is reporting by laboratories of Respiratory Syncytial Virus infection cases.

Infections from the virus, called RSV, are common respiratory ailments that cause serious problems, especially for infants and young children. High hospitalization rates in rural Alaska for the RSV infections have been linked to substandard water and sanitation services and overcrowded housing conditions.

Up to now, RSV cases in Alaska have been tracked in some ways, but that has been largely outside of the routine public health reporting system, Castrodale said. Emergency responders and regional health providers have closely monitored RSV outbreaks because of the limited supply of pediatric hospital beds in affected regions, she said.

Southwest Alaska’s Yukon-Kuskokwim Delta has long had the nation’s highest or near-highest rates of infant hospitalizations for RSV infections, up to seven times the national average, according to medical researchers. Preventive measures reduced those hospital stays over the years, but infant hospitalization rates there are still more than three times the national average, according to the Yukon-Kuskokwim Health Corp., the regional Tribal health provider.

Castrodale said there are high hopes for three types of new RSV vaccines developed for both children and adults. The regular reporting, coupled with the new vaccines, should help health officials monitor future changes, she said. 

“We’re going to have a better sense of how to track that going forward,” she said.

Another notable change to the reporting requirements is an update of language about antibiotic-resistant organisms that are considered of national significance.

A digitally colorized microscopic image shows two mustard-colored, rod-shaped bacteria that are resistant to a class of antibiotics called carbapenems. The bacteria, seen ni 2014, are interacting with a green-colored human white blood cells. (Image provided by the Produced by the National Institute of Allergy and Infectious Diseases)
A digitally colorized microscopic image shows two mustard-colored, rod-shaped bacteria that are resistant to a class of antibiotics called carbapenems. The bacteria, seen ni 2014, are interacting with a green-colored human white blood cells. (Image provided by the Produced by the National Institute of Allergy and Infectious Diseases)

Those include Candida auris, a yeast that causes sometimes-fatal infections. Discovered in Asia in 2009, it is resistant to a variety of medicines normally used to treat infections, according to the U.S. Centers for Disease Control and Prevention. Cases have been rare in the United States, according to the CDC, and none have been detected in Alaska, according to state officials.

They also include infections of Carbapenem-Resistant Organisms, or CROs. Those have emerged in Alaska; six cases were documented in health facilities in 2022 and this year.

The new regulatory wording is more flexible, with a broadness that is appropriate at a time when there are more discoveries of disease-causing organisms that do not respond to medicines, Castrodale said. “These bugs are developing resistance,” she said. “We just don’t know what they are.”

Additional changes to the public health reporting requirements include wording about lead levels in blood. Rather than setting a fixed numerical threshold for reporting that may have to be adjusted in the future, the new requirements tie Alaska’s reporting to national standards, Castrodale said. National standards that define “elevated” levels of lead in blood became stricter over time; most recently, in 2021, they were tightened from 5 micrograms per deciliter to 3.5 micrograms per deciliter.

Alaska health officials previously identified a need for more screenings of children’s blood-lead levels. Screening declined substantially during the COVID-19 pandemic, according to an epidemiology bulletin issued last year.

The state’s public health reporting requirements are updated every few years, Castrodale said. The updates are accompanied by a regulation process that usually takes eight to 12 months, she said.