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In a corner of Alaska where the Spanish Flu once orphaned a generation, a hospital executive is out of a job after downplaying the coronavirus threat to colleagues.

The message, emailed on March 16 by then-chief operating officer for the Bristol Bay Area Health Corp. Lecia Scotford, carried the subject line “do not panic.” So far so good, local tribal leaders said. But after citing state quarantine guidelines designed to stop the spread of COVID-19, Scotford told managers at the tribal health organization she had something for them to ponder.

“In 2004 we had the SARS, in 2008 we had the Evian (sic), in 2010 we had the swine, in 2012 we had MERS, in 2014 we had Ebola, in 2016 we had Zika, in 2018 we had Ebola. And now 2020 corona!” Scotford wrote to hospital managers from her work email address. “This is not political … or is it? Since all these years have been election years.”

The fact-checking site Snopes has labeled that list of election year diseases a false, conspiratorial meme.

“Just a reminder that FLU kills many every year!” Scotford wrote.

The message soon began to circulate in the Bristol Bay region, where hundreds died when influenza swept the coastal fishing villages a century ago, drawing a blistering response from some tribal and local leaders. Scotford was at the time running daily operations for the regional tribal health organization, which serves about 6,600 people in Dillingham and 27 surrounding villages.

The heart of this health care system in southwestern Alaska, covering an area the size of Florida, is a 16-bed hospital operated by the Bristol Bay Area Health Corp. Only four beds are currently equipped for coronavirus patients. And the regional population will soon double or triple in size with the arrival of fishermen, crews and seasonal workers.

They’ll arrive in May and June on jets but also private planes and boats, residents said, many from Washington state. If they need to quarantine for two weeks, as mandated by the state, residents said it’s unclear where everyone will hunker down. Local store shelves are already bare of Clorox, Lysol and rubber gloves.

Dillingham is 320 miles from Anchorage by air. As of earlier this month the hospital had a few dozen coronavirus tests for the entire region, tribal leaders said.

“It’s not a time to make jokes or make light,” said health corporation president Robert Clark. “We are it for health care out here.”

Thomas Tilden, first chief for the Dillingham-based Curyung Tribal Council, accused the hospital executive of “absolute ignorance and blatant arrogance.” Norman Van Vactor, president of the Bristol Bay Economic Development Corp., wrote: “This is beyond stupidity and rational behavior.”

Scotford did not respond to emails, phone calls and Facebook messages requesting comment. Her email to lists of “division managers” and “department managers” within the regional health organization also emphasized the need for calm, common sense and good hygiene, and for the hospital to be prepared to serve the public.

“That (email) was very concerning to me because that kind of lets people’s guard down,” Van Vactor said in a phone interview. “The people who are taking care of our patients, our tribal members at Kanakanak hospital, for a message to go out like that is just not safe.”

The tribal official and economic development president said they were also concerned that Scotford had traveled recently to Dillingham from out of state and was present in the hospital this month instead of home on quarantine. Gov. Mike Dunleavy on March 23 issued a health mandate saying that people arriving from outside Alaska self-quarantine for two weeks beginning March 25, but with exceptions for people whose work supports critical infrastructure.

Clark, the BBAHC chief executive, said that he does not believe Scotford violated any quarantine requirements and praised her contributions to the health organization over the past decade. He did not defend her email.

“Just a little bit too controversial,” he said. “It’s just one of many things (and) we decided just to separate.”

The nonprofit employed 470 people and reported a revenue of $76.7 million in 2017, according to a tax form that Scotford submitted with the IRS. That year the health corporation paid Scotford $394,179 in salary and benefits as executive vice president and chief operating officer.

For many in Bristol Bay the global pandemic recalls family histories of widespread deaths during the Spanish Flu.

“We are the survivors of the survivors of the orphans of the Spanish Flu,” said Gayla Hoseth, second chief for the Dillingham-based Curyung Tribal Council. The tribe declared a state of emergency due to the coronavirus on Tuesday.