The New York Times reports:

There was one bed coming available in the intensive care unit in Alaska’s largest hospital.

It was the middle of the night, and the hospital, Providence Alaska Medical Center in Anchorage, had been hit with a deluge of coronavirus patients. Doctors now had a choice to make: Several more patients at the hospital, most of them with Covid-19, were in line to take that last I.C.U. spot. But there was also someone from one of the state’s isolated rural communities who needed to be flown in for emergency surgery.

Who should get the final bed?

Dr. ​​Steven Floerchinger gathered with his colleagues for an agonizing discussion. They had a better chance of saving one of the patients in the emergency room, they determined. The other person would have to wait.

That patient died.

“This is gut-wrenching, and I never thought I’d see it,” said Dr. ​​Floerchinger, who has been in practice for 30 years. “We are taxed to a point of making decisions of who will and who will not live.”

Since that night, more grim choices have had to be made as Alaska confronts what is currently the nation’s worst coronavirus outbreak. Nearly two years after the virus began circulating in the United States, some of the scenes here on the country’s northern frontier echo the darkest early days of the pandemic: testing supplies are depleted, patients are being treated in hallways and doctors are rationing oxygen. With emergency rooms overwhelmed, the governor has asked hundreds of medical workers to fly in from around the country to help.

Through much of the pandemic, Alaska’s natural isolation had shielded the state, with the early months defined by strict testing protocols for people arriving from the outside. Many villages locked down. When vaccines arrived, there was a legion of planes, ferries and sleds to bring doses to far-flung communities. The state has maintained some of the lowest death numbers in the country.

But with some pockets of the state wary of taking vaccines — only about half the state’s residents are fully vaccinated — and Gov. Mike Dunleavy resisting restrictions to curtail the virus, the state’s isolation has become a growing liability as the Delta variant sweeps through. The state’s surge has continued even as the virus has receded nationwide, with new daily cases down by about a third and hospitalizations by about a quarter since Sept. 1. [Continue reading…]