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Infectious Disease

Alaska COVID-19 Alert Levels

As part of the plan to reopen long-term care facilities to visitors, the Alaska Department of Health and Social Services (DHSS) has defined three levels of community transmission. These alert levels complement additional considerations, listed below, that a facility or healthcare system could incorporate into its decision making process. In the July 28 press briefing, Governor Dunleavy highlighted PDFlocal mitigation guidance and current alert levels for boroughs/regions. Please note that policies dictated by Centers for Medicare & Medicaid Services or the State of Alaska may establish a minimum standard visitor policy, but facilities may elect to take a more conservative approach.

The levels are based on per capita incidence. Specifically, DHSS calculates the number of new cases of COVID-19 per 100,000 residents per day averaged over the past 14 days in each region.


 Explore the COVID-19 alert levels map


Note: Alaska-specific rates by region are available on the DHSS COVID-19 dashboard in the summary tables (geographic distribution of case rates).

How accurate is this system at detecting the risk of transmission?

The average daily per capita incidence is useful because it is the single measure that most directly reflects transmission in a community; however, no one measure can fully capture the complex dynamics of the COVID-19 epidemic in Alaska. For example, other factors that may be considered include the extent to which cases occurring in the community represent community transmission (i.e., the source for the person’s infection is not clearly identified), the percentage of tests that are positive in the community, and whether the trajectory of COVID-19 in Alaska is increasing or decreasing.

Additional limitations  

  • COVID incidence levels will likely differ somewhat between communities within a given region.

  • A large outbreak in a well-contained setting would increase the average daily per capita incidence, but may not pose much risk to the general population.

  • In many people, COVID-19 causes no symptoms or only very mild symptoms. While DHSS strongly encourages all people with even mild symptoms to get tested and is continually working to increase access to testing, it is likely that many cases of COVID-19 go undetected.

  • Cases are assigned to regions based on residency, which may not correspond to where the person was infected or where they spent time while infectious. Cases among non-Alaska residents are not reflected in this measure. While DHSS closely monitors the number of cases identified in non-Alaska residents, cases among residents are a more meaningful indicator of the extent of transmission in a community.

The focus is on trends, not daily case counts

Averaging the per capita incidence of COVID-19 over 14 days will reduce the influence of day-to-day fluctuations in the number of cases identified in a community. Therefore, DHSS strongly encourages focusing on trends and patterns over time, rather than the number of cases on any given day.

These community transmission levels were developed to inform decisions about allowing visitors to long-term care facilities. However average daily per capita incidence may inform decision making in other sectors as well, such as schools, institutions of higher education, and businesses. Importantly, decisions about whether to open or close an institution cannot be made solely on epidemiological grounds. These decisions inherently entail complex tradeoffs and judgements about a community’s unique vulnerability to COVID-19, such as socioeconomic factors, household composition and disability, minority status and language, housing type and transportation, and healthcare infrastructure. All of these factors may need to be considered when making such decisions.

Updated July 1, 2020