Two years after COVID-19 reached Alaska, many are ready to move on. But the pandemic persists.

Mar. 13—Two years ago, Alaska identified its first COVID-19 case.

Now, as the pandemic enters its third year, many Alaskans are eager to shake off the long pall of anxiety, illness and shutdowns and get back to whatever passes for normal.

Most government mandates are gone. Vaccines are widely available for those who want them. Case counts and COVID-linked hospitalizations are down.

For the first time, the state's top disease detective feels like he can catch his breath and maybe even start thinking about what the path to normalcy looks like.

"This moment definitely feels different," said Dr. Joe McLaughlin, Alaska's chief epidemiologist.

But the pandemic isn't over yet.

The possibility of new and more dangerous variants threatens on the horizon. The state's vaccination rate has stalled, though many more Alaskans became infected and acquired some level of immunity with the virus during the last surge linked to the omicron variant.

People are still dying from COVID-19 while others suffer the debilitating effects of long COVID. Immunocompromised people and some parents with children under 5 who can't yet be vaccinated say they're continuing to exercise extreme caution.

And Alaska is nowhere near recovered from its loss of 27,000 jobs as the pandemic clobbered the economy in 2020 — only about 7,000 have returned, though federal infrastructure spending is expected to help significantly.

Alaskans are learning to live with the virus. For many, it's time to shift into a new reality that's not truly post-pandemic and not the dark times of 2020 either.

Call it ... continuing pandemic, says Kevin Berry, an associate professor in the University of Alaska Anchorage economics department who's studied the economics of emerging diseases and pandemics for a decade.

Berry puts Alaskans in three general camps at this moment: A small group still in hunker-down mode, staying home for two years, maybe immunocompromised people who can't risk getting the virus. A larger group protecting themselves from COVID-19 with a range of masking or socializing decisions based on personal risk calculations performed on an individual basis in the absence of regulations.

And a group who never changed their behavior to begin with, Berry said. "They never wore a mask. They may have had COVID a couple times. For them, it's been over since March 2020."

Lingering anxieties

Looking ahead, the biggest cause of anxiety for public health officials is out of their hands: the potential for more or more new highly infectious or more deadly variants not stopped by prior infection or vaccine immunity.

The rise of future variants is inevitable, said the state's public health director, Heidi Hedberg.

"We're in this constant cycle of prepare, respond, recover, mitigate, so that we're always improving and we're more resilient for the next scenario that presents itself," Hedberg said.

The number of reported deaths has ebbed and flowed as COVID-19 surges and recedes. Since the start of the pandemic, 1,168 Alaskans and 33 nonresidents in the state have died from the virus.

Alaska's health and economy observers say it's possible that in the absence of mandates — and barring an extremely severe new variant — several strategies could help keep future surges in check. That includes vaccination; widely available free KN95 masks and at-home COVID-19 tests; effective indoor ventilation systems; and paid sick days to limit workplace infection.

The state's billion-dollar tourist industry could come back fairly strong this year, especially if cruise ships continue to require vaccinations and testing, and communities and local businesses apply COVID-smart protocols, Berry said.

"The next big question: Is there going to be another wave that scares people off, or can we do things in a way that makes it safe for communities?" he said. "I think the answer is yes — if we make the right choices."

[How will COVID end? Experts look to past epidemics for clues]

'It hurts'

Initially, Alaska's isolation and strict travel policies staved off the dire death tolls and overflowing hospitals emerging on chilling news reports around the Lower 48.

But then COVID came calling in the country's only Arctic state. Case counts and deaths rose. Hospitals around the state filled, overtopping some rural facilities and eventually even the state's largest.

In rural Alaska, the specter of COVID-19 raised particular alarm due to a combination of limited health care options, families living in close proximity of multigenerational homes and, in some places, no running water or sewage facilities.

Some communities put up gates or sentries to block outsiders — the same tactic used a century ago during the deadly Spanish flu pandemic.

Still, outbreaks whipped through some villages like wildfire, especially in the Yukon-Kuskokwim region.

"Thankfully, it didn't turn out catastrophic," said Christina McDonogh, a former Perryville resident who now lives in Anchorage and runs the Rural Alaska COVID-19 Alliance Facebook page.

But the virus has hit Alaska Native communities disproportionately hard: American Indian or Alaska Native people, about 16% of the state's population, account for 26% of its COVID-19 deaths.

"That's terrifying. It hurts — it really hurts," McDonogh said. "The Alaska Native community is so interconnected that when someone in a village dies, everyone in a village and everybody connected to a village hurts."

Change came after vaccines arrived in December 2020. A concerted, coordinated vaccination push by the state's tribal health system — in the Y-K, the initiative was dubbed "Operation Togo" — coupled with an eager senior population made Alaska the most vaccinated state in the country for a few months of 2021.

Now rural people are reacting to this pandemic phase "just like the rest of the world," McDonogh said.

Rural Alaskans ready to shed restrictions are riding snowmachines to crowded regional basketball tournaments while others continue to hole up at home. Some villages are almost entirely vaccinated against COVID-19, while in others just one young child is immunized.

"With me personally, I'm just still watching," she said when asked how her family is handling this phase. "Some people are optimistic. I've seen things go up and down so many times that I'm just still watching."

Health toll

The state's vaccination push slowed last year amid hesitancy prompted by concerns over side effects but also misinformation campaigns pushing unproven treatments like the anti-parisitic ivermectin.

Battles over personal freedom culminated in angry mask mandate hearings before the Anchorage Assembly in fall 2021 that included arrests, frequent disruptions and the widely condemned use of yellow Stars of David by mask opponents, which Mayor Dave Bronson defended and later apologized for.

The state's hospital employees bore the brunt of the conflict over COVID-19, caring for sick or dying people who were largely unvaccinated as patients berated them over a virus they contended wasn't real.

The pandemic took a deep emotional and physical toll on health care workers, said Dr. Anusiyanthan Mariampillai, an oncologist with the Alaska Native Medical Center.

"2020 and 2021 were very rough years for a lot of us," Mariampillai said.

Many of his colleagues retired or left the health care field altogether, he said.

Some medical patients continue to pay a price for the pandemic and now say they're struggling as much as ever.

Many of Mariampillai's cancer patients are high-risk for severe illness from COVID-19 even if they're vaccinated and boosted. For their families and them, continuing to follow mitigation measures like masking in public, avoiding crowds and avoiding others when sick remains as crucial as ever.

Aubrey Virgin, a 13-year-old from Palmer, has Kawasaki disease — a relatively rare illness that causes body rashes, high fever and swelling — along with asthma, juvenile arthritis and an autoinflammatory disease.

Since the beginning of the pandemic, her family has worried that if she were to get COVID-19, it might knock her down more than the average person.

Her mother, Shannon Virgin, said now that Aubrey has received the added protection of four vaccine doses, her family is trying to find ways to find some semblance of normalcy. Aubrey still wears a mask at school, and her family continues to mask up in public, but she sees her friends, travels and plays sports.

"We're still toeing that line of just trying to keep her safe, but also mentally and emotionally stable as well," Shannon Virgin said.

Pandemic primal scream therapy

Many parents — especially mothers of very young children — are continuing to juggle school and day care closures with work and fewer supports than they may have had before the pandemic.

Holly Brooks, a two-time Olympic skier and an Anchorage mother of 4-year-old twins, points to statistics that show that women do about twice as much of the "unpaid work" within a family with kids as their traditional male partner does.

The pandemic only widened that divide, Brooks said.

"So the moms — even the working moms — are the ones trying to manage virtual school, or trying to manage the incessant day care closures," she said.

Brooks recently helped organize a pandemic release valve.

She joined a group of about a dozen mothers who gathered in the Service High School parking lot in Anchorage to let out a primal scream.

They were so loud that police responded to an apparent noise complaint, but officers left quickly when they spotted the row of minivans, Brooks said.

"It was really therapeutic for us to get together and just express our frustrations," she said.

For Alaska's top health officials, who devoted the last two years to beating back a pandemic, this feels like a cautiously hopeful moment — even though the possibility of a more dangerous variant looms on the horizon.

"As far as the preparedness level, we're better than we were before," said Brian Ritchie, manager for the state's health emergency response. "But we're always preparing."