Alaska's Doctor with Dr. Anne Zink - TAS #13

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This week we sit down with Dr. Anne Zink, emergency room physician and Alaska's Chief Medical Officer. She talks to us about how she is leading us through the Covid-19 crisis, Alaska's public health strengths, and activities she wishes Alaskans would think twice about as an emergency room physician.

Interview Notes

Dr. Anne Zink has been the Chief Medical Officer for the State of Alaska - starting July 2019. Sits under the commissioner of the DHSS.

Disaster response, disease, epidemiology are their main focus. She’s the medical voice.

Dr. Zink’s day-to-day changes a lot. They stood up their disaster response structure for the Wuhan flight. It’s been escalating since thm> She helps secure PPE. Looks at protocols around travel, tourism, large groups, and businesses. Covid is the main focus but there are other health initiatives as well. Lots of conversations and talking to the Governor and commissioners and messaging and trying to understand the data behind Covid. They do a lot of calls with frontline providers to help them understand the latest data, science, and testing. She also works with the fishing industry and various businesses.

How much do we really know about Covid-19? We have come a long way in just a month. 5-6 months ago we didn’t know this virus existed. In a short time we’ve learned a lot. There are inherent things we won’t know without time, such as immunity information. That just takes time to study. This has also highlighted uncertainty in medicine and science - and how different people adjust differently to a disease. But the genetic sequencing is already uploaded. There are over 200 vaccines in different trials. We have different antivirals working. They’re doing calls with different doctors all the time all over the world.

Dr. Zink is still working from the yurt at her house - which is a guest bedroom. That gives her kids space to homeschool in her office at home.

Dr. Zink reminds her patients that medicine is an art and it’s not perfect. She brings knowledge and education through her training and it has to sit with their personal experience. Each individual person has different needs and environment and it’s a partnership and not an exact science.

How do you decide what treatment to recommend? You analyze the benefits, the effectiveness, and the downsides. For something like masks the downside is that it’s uncomfortable and not everyone has them and it’s politicized. The upside is that the data shows the disease is translated by air through micro-droplets, and a cloth face covering could significantly decrease those droplets. A mask is covering your talking like covering a sneeze or cough. There are other social norms around what we wear like “no shirt, no shoes, no service.” A study said if 60% of us wear a mask that’s 60% effective this disease would stop. How do we use rules and regulations to address preventable disease? Dr. Zink sees a lot of Covid deaths as preventable.

Dr. Zink reminds herself that changing culture and behavior is hard. You see it in drunk driving, STIs, and drug and alcohol addiction. What’s hard about Covid for her is it’s asking us to be different than our normal human experiences. People miss having large parties and holidays and hugging their friends. Dr. Zink sees other options and treatments coming soon and knows if we can hold it off we could prevent a lot of death.

What are the bright spots of public health in Alaska? We have some of the lowest infant mortality cases in the country. We have a robust public health network. Some rates like STIs and Tuberculosis have been sore spots. The community response to public health challenges has been strong, specifically around the opioid crisis. We struggle with it but aren’t the worst in the country by far. Communities have done a great job responding on a local level.

We have some of the lowest cases in the country and highest per capita testing in the country that’s because of Alaskans.

Is Dr. Zink still seeing patients? She was until 6 weeks ago. She was doing it on weekends but this job became all consuming. Her group covered her shifts for her. She misses that part of her job a lot right now.

Does she feel removed or disconnected from patients? The highlights of her week are zoom meetings with clinicians in order to stay connected. Right before the pandemic Dr. Zink took care of a young man who coded and essentially died and came back. His friends did CPR, the EMS was ready, and the hospital system worked to save his life. Even the sadness of the job - Dr. Zink appreciates being able to grieve with people who get bad diagnoses.

She has a visceral response when she sees people riding a four wheeler with no helmet and when people party with fireworks. She has the same response when people post on social media about partying with tons of people in the time of Covid. Don’t do dumb things drunk.

Dr. Zink wishes people would test more for Covid. The data says if you get tested early on they can manage it better. She also wishes people would just ask for help more as an ER doctor. Someone with a stroke can get treated right away and get something taken care of. It’s an act of kindness to be tested early.

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