Gambell suffers largest COVID-19 outbreak in region to date

The past few weeks’ COVID-19 outbreak in Gambell has been the most severe cluster of cases the region has seen since the start of the pandemic. With 31 confirmed COVID-19 positive patients and counting since September 19, the Gambell outbreak already makes up almost a third of all regional cases since March. The effort to contain the outbreak, however, has been immense, and village residents are hopeful that the outbreak is now on the decline.
The first case was a Gambell resident who tested positive on the evening of Friday, September 19. Five more members of the first case’s household tested positive the following Saturday.
The entire household went into isolation, but a few days later on Wednesday, September 23 a cascade of positive cases began turning up in the village, with 13 additional cases in the following week and another 12 the week after that.
Norton Sound Health Corporation said at one point that they were investigating around 200 possible contacts, in a community of 700 people.
The outbreak sparked an immediate response from both NSHC, which sent an emergency medical team with two rapid analyzer machines to Gambell, and the village’s leadership, which imposed a village-wide lockdown.
Charlotte Apatiki, a resident of Gambell and the city clerk, said the atmosphere during the lockdown has been tense. “Everybody is scared,” she said. “We’re staying home as much as possible.”
The lockdown requires that village residents stay away from public areas as much as possible, and those who have tested positive or are considered close contacts must go into isolation or quarantine. People can face fines of $250 for violating the lockdown.
Apatiki said the Gambell Native Store, the only store in the village, was closed to shoppers immediately after the first household tested positive. To get food and basic supplies, those who are not in isolation or quarantine can show up with a shopping list and wait outside while store employees collect their items and leave them outside the door.
For the COVID-positive and close contacts – who make up a significant portion of the village – mayor Joel James has been working with the three Village Public Safety Officers to deliver food and supplies that get airlifted in from Nome by NSHC.
The VPOs also haul water to households that don’t have access to piped water. “Between the three of them, they’re working seven days a week in eight-hour shifts, and overtime if need be,” Apatiki said.
Like many villages in the region, Gambell suffers from lack of adequate housing and thus overcrowded residences, and finding adequate quarantine space for all the COVID patients has been a challenge.
Dr. Mark Peterson, medical director of NSHC, said that if an entire household tests positive at once, they all isolate in their house together. But if one person tests positive and their household doesn’t, they need to be isolated in a separate space.
Sivuqaq Inc., Gambell’s Native Corporation, has leased out its four-plex apartments and the communal lodge to NSHC to use as isolation housing. The church building and an apartment owned by the church have also been sectioned off into isolation housing.
Apatiki said that no one has had to use the lodge for isolation or quarantine, and that she hoped it wouldn’t be necessary. So far, no one has had to be transported out of Gambell because of a lack of housing.
Apatiki mentioned that three or four patients in the first household did fly out soon after they tested positive, but NSHC’s Dr. Peterson said those patients were transported “for other reasons of a confidential nature unrelated to COVID,” and that they were done with isolation and doing well.
As far as the health situation in Gambell, Apatiki said people she knew were feeling okay. Dr. Peterson couldn’t go into detail about people’s symptoms for confidentiality reasons, but he did say that most people were asymptomatic or had mild symptoms, and that nobody had been transported to Nome for medical reasons.
Apatiki said the lockdown has still taken a toll. “It’s especially hard when you have close-knit families that are so used to spending so much time together,” she said. “And now you can’t see your brothers and sisters and your nieces and nephews.”
One plus was that subsistence is still going on, she said. When the weather is nice people go berry picking – with ample distance between households – and some have even started seal hunting.
Still, though, she said she looks forward to the end of the lockdown.
According to the state epidemiologist, that end will come when continued aggressive testing turns up no more positive cases in a two-week period.
So far, known close contacts have been tested seven days after they went into quarantine, and will be tested again seven days after that. In addition, the NSHC medical team has tested almost everyone in the entire village.
Dr. Peterson clarified that many of the later cases were not the result of ongoing community spread, but more likely had been infected earlier in the outbreak and only recently built up enough virus in their systems to experience symptoms and turn up positive on a test.
He said NSHC is expecting to detect more cases in the coming week as currently dormant infections continue to show up on tests, but that the number of new cases should slowly taper off. The current lockdown is set to expire this Friday, October 9, but that may be extended.
“It’s going to be a couple weeks before we see the results of the hard work that everybody’s been doing,” Dr. Peterson said.
In nearby Savoonga, case numbers are low, but village residents are on high alert. In the aftermath of the Gambell outbreak, Savoonga put together a strict travel mandate that explicitly prohibits travel into the village except for essential medical and infrastructure personnel, said Tribal President Ben Pungowiyi.
Savoonga had one positive case on September 25, and on the same day issued two $500 fines to people who had knowingly violated quarantine, but Pungowiyi said that case originated in Nome.
While residents of Gambell and Savoonga usually mingle at campsites around the island, Pungowiyi said people have been careful to stay apart since the Gambell outbreak. “I think the majority of the community is following the mandate and all the warnings,” he said.
To him, COVID-19 is an especially serious issue on St. Lawrence Island because of the island’s history of epidemics. In the late 1800s, a series of diseases and a resulting famine killed the majority of the island’s inhabitants.
The exact number of people who died is hard to know, but a U.S. ship that came by the island in 1880 recorded finding at least 1,000 people dead, with some villages completely wiped out.
Pungowiyi said some elders told stories of a community on the south side of the island that had 4,000 people alone. When the epidemics had run their course, only 285 inhabitants of St. Lawrence Island survived, and Gambell and Savoonga are the only villages still occupied.
“I consider myself lucky that I’m here now,” Pungowiyi said. “And I feel that both communities feel lucky.” He said that memories of past epidemics resurfaced when COVID-19 started spreading in Gambell, and that history has informed many people’s outlooks.
“I think when it shows up, people are starting to realize this is serious,” he said. “They’re taking it really seriously.”
Gambell’s Tribal President Melvin Apassingok offered his thanks to NSHC and everyone who helped with the testing and response in Gambell, as well as his support for everyone in the village who has tested positive.

 Funding for this coverage provided in part by a grant from the Alaska Center for Excellence in Journalism.