Alaska’s largest hospital announced Tuesday that a relentless coronavirus outbreak driven by the highly contagious delta virus variant has left emergency room patients waiting hours in their vehicles and forced medical teams to ration care.

Providence Alaska Medical Center in Anchorage said it was operating under “crisis standards of care” — procedures put in place to prioritize resources in a way that may leave some patients with substandard care.

Alaska is among many states with relatively low vaccination rates where the delta variant has run rampant, straining hospitals to their breaking points. Last week, Idaho announced that medical centers in the northern part of the state would move to crisis standards of care. In Alabama, all intensive care unit beds are occupied, as hospitals in Southern states run dangerously low on space in ICUs.

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In Mississippi, where only 48% of people have received at least one vaccine dose compared to 63% of all Americans, state officials tried to outsource “ICU-level-care patients” to Kentucky. And in North Dakota, an executive at the state’s largest health care system said it could use as many as 300 additional nurses to help treat COVID-19 patients.

In Anchorage, Dr. Kristen Solana Walkinshaw, a senior leader at the Providence hospital, wrote in a message to the community that the hospital did not have the necessary staff, space or beds to keep pace with demand.


“Due to this scarcity, we are unable to provide lifesaving care to everyone who needs it,” Solana Walkinshaw wrote.

The hospital said that with an emergency room overflowing, patients have to wait in their cars for hours to see a physician for emergency care. Elective surgeries continue to be postponed. Solana Walkinshaw said rationing care may include dialysis and “specialized ventilatory support.”

Providence Alaska Medical Center is a critical hub for patients from all over the state, serving as the destination for many people who need a higher level of care that can’t be provided in their home communities. Solana Walkinshaw said the hospital has been unable to accept patients from other facilities.

Alaska has been reporting record hospitalization numbers in recent days. New daily case numbers have also been on the rise, but Alaska Gov. Mike Dunleavy has resisted implementing mitigation measures — such as mask mandates — that other states have embraced.

On Tuesday, Solana Walkinshaw pleaded with members of the public to wear masks, even those who are vaccinated, and encouraged vaccinations in a state where only 48% of the population is fully vaccinated. She also encouraged people to avoid potentially dangerous activities, because people who get seriously injured may not get access to a bed at the hospital’s trauma center.

Solana Walkinshaw said the hospital expects an escalation in COVID hospitalizations in the coming weeks.

“What is already a stressful situation could rapidly progress to a catastrophe,” Solana Walkinshaw wrote.