This article was produced in partnership with ProPublica.

Later this spring, Alaska’s Bristol Bay will blossom into one of the largest annual salmon fisheries in the world.

The regional population of about 6,700 will triple with the arrival of fishermen, crews and seasonal workers on jets but also private planes and small boats, many traveling from out of state.

And yet the heart of the health care system in southwestern Alaska, where the Spanish flu once decimated entire communities, is a 16-bed hospital in Dillingham operated by the Bristol Bay Area Health Corp. Only four beds are currently equipped for coronavirus patients. There are no intensive-care unit rooms. As of Wednesday the hospital had a few dozen coronavirus tests for the entire Florida-sized region.

Chief nursing officer Lee Yale said in an email that the Kanakanak Hospital has four negative pressure rooms to treat COVID-19 patients without infecting others and two ventilators.

“We have staffing but if they get ill we will be in a tight spot,” she wrote in an email. “(The) fishing industry will devastate our surge plan and we can not support and cover our villages if this season opens.”

We're making coronavirus coverage available without a subscription as a public service. But we depend on reader support to do this work. Please consider joining others in supporting local journalism in Alaska for just $3.23 a week. SUBSCRIBE NOW

The state of Alaska has declared the fishing industry to be a critical workforce, meaning employees can report for work but should make every effort to observe travel quarantine mandates. If the newly arrived fishermen, crews, cannery workers and others need to quarantine for two weeks, it’s unclear where everyone will hunker down. Local store shelves are already bare of Clorox, Lysol and rubber gloves, residents said.

Dillingham, the largest community in the Bristol Bay region with a population of 2,300, is 320 miles from Anchorage by air. Compounding matters, the hospital executive who ran daily operations for the health care system is out of a job after downplaying the coronavirus threat to colleagues.

“We’re scared. … People come from all over the world for Bristol Bay fishing,” said Gayla Hoseth, second chief for the Dillingham-based Curyung Tribal Council. “There’s 7,000 of us who live here, and this hospital cannot handle the 7,000 of us if we get sick. Imagine (when) our population triples and quadruples in the summertime.”

Bristol Bay is a magnet for people in the summer, with a seasonal migration of about 13,000 workers for the lucrative fishing season. The commercial salmon fishery here is the largest in the state, but as of 2010, about 60% of earnings went to out-of-state permit holders.

Almost all the major Bristol Bay seafood processing companies are based in Seattle, an early hot spot for coronavirus, and two-thirds of Bristol Bay processing workers live in West Coast states at other times of the year, according to the Institute of Social and Economic Research at the University of Alaska Anchorage.

The Alaska Department of Fish and Game forecasts some 34.6 million sockeye salmon will be harvested there this year.

“When it comes to wild salmon, we are over half the world’s sockeye and over half of the Alaska salmon value,” said Andy Wink, executive director for the Bristol Bay Regional Seafood Development Association.

The nonprofit industry group on Thursday issued an advisory urging the fleet to delay travel to Bristol Bay until May 1.

“Keep in mind, it is possible to carry this virus without symptoms and unknowingly infect others leading to overtaxed medical capacity and/or death(s),” the advisory said. “You do NOT want to be the outsider photographed or seen around town in public spaces if this situation turns for the worst,” the group warned its fishermen.

Wink said his nonprofit is working with local governments on a plan to avoid overcrowding Bristol Bay Area Health Corp. clinics and the Dillingham hospital with sick fishermen, processors and support workers.

“We are taking the stance that we don’t want to rely on the local clinics or if we do, they need to be bolstered substantially,” Wink said.

As the health care provider for the region, Bristol Bay Area Health Corp. operates the only regional hospital and the clinics in 21 surrounding villages. Clark, the health corporation chief executive, said the Dillingham hospital is seeking more equipment to meet the potential for coronavirus patients among the local and visiting fishing industry patients.

Chief nursing officer Yale said the hospital had 37 tests on hand as of Wednesday, and that all tests performed had returned negative.

Meantime, for many in Bristol Bay, the looming COVID-19 threat recalls family histories of death and loss in the face of past epidemics.

“The fact that all of our contemporary families are descendants of those children and few adults that survived 1919 is one of (the) major reasons why we are so passionate about protecting ourselves from this pandemic,” said Courtenay Carty, tribal administrator of the Dillingham based Curyung Tribal Council, which has declared a state of emergency and sought to restrict travel to the city.

Carty’s great-grandmother was orphaned in Dillingham by the 1919 flu and raised by family members, and her grandfather was orphaned by tuberculosis in the 1940s.

“What is history to others is our tribal and familial identities," she said.

Update on today’s story:

local Bristol Bay orgs are calling for strict requirements on any fishery worker heading to the region.

Among them: Workers would need to be tested and found negative for COVID-19. Then quarantined in Bristol Bay, then tested AGAIN. ... pic.twitter.com/0djzo9t4mB — Hunker Down Hopkins (@kylehopkinsAK) April 3, 2020