The Southeast Alaska community of Angoon in 2017 (Emily Russell/KCAW).

Angoon has extended its emergency travel order until further notice, in an effort to stop the spread of COVID-19 in the small, remote community. Angoon’s mayor originally issued the order two weeks ago, following the first confirmed cases of COVID-19 in the community and believes it’s important to keep it in place.

Angoon’s travel order requires visitors or residents arriving in Angoon to fill out a travel declaration form and to practice “extreme social distancing measures” for two weeks. That includes staying 12-feet away from anyone outside of their household, wearing a mask at all times outside of their home or lodging, and avoiding businesses and public places. The order excludes those traveling for critical personal needs or for critical infrastructure.

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The Admiralty Island village of around 450 people has reported 11 total cases–four of which are active–according to a nurse practitioner at Angoon’s SEARHC clinic, Sara Lang. At a recent special city council meeting (9-9-20), she said all of the cases are part of the same cluster.

“Hopefully everyone understands what a cluster is,” she said. “They’re all related to one another in some way.”

Some members of the Angoon City Council opposed extending the order, citing concerns for residents who have to travel frequently for work or health care, or for employees that don’t have leave and may lose their jobs if they have to stay home. The council discussed possibly using CARES Act funds to help.

Mayor Joshua Bowen said he understood the economic pressure but also urged everyone to remember the health and safety concerns.

“We gotta think more of what can we do to help prevent this COVID-19 from affecting more people in our community than it already has,” Bowen said.

How to manage outbreaks of the coronavirus in small, remote communities like Angoon was discussed at the weekly meeting between reporters and top Department of Health and Social Services officials. Epidemiologist Louisa Castrodale said that smaller communities may have fewer cases than cities because of smaller populations, but that doesn’t mean there aren’t challenges.

“Because there’s sort of smaller units or smaller family units and opportunities for interact, it could be really difficult to keep things…to preserve somebody’s confidentiality and to not generate a lot of real concern with one individual,” Castrodale said.

Alaska’s Chief Medical Officer Dr. Anne Zink said another challenge is that national guidelines don’t always translate to small communities. Instead, they often have to come up with their own models for managing the coronavirus.

“We are being asked more and more on a national basis to be sharing what many of our small and rural communities have been doing to protect themselves,” Zink said. “Because they’ve just been doing amazing work.”

She pointed to examples like rigorous airport testing and culturally relevant guidelines that take things like lack of running water and overcrowded households into account.

“You know, isolation and quarantine are hard enough to understand when we’re talking and reading CDC guidance all the time. But it means something totally different when you live in a family of 14 people in a house,” she said. “And so I think making sure that you’re finding really culturally, meaningful relevant ways to translate the guidance as well as the recommendations.”

Angoon’s order is in effect until public health officials mark all of the town’s cases as recovered. Public health officials are asking community members to continue testing at least every other week. Free asymptomatic testing is available through the town’s clinic three days a week.

Erin McKinstry is a Report for America corps member.