People in Fairbanks, Alaska’s second-largest city, have embraced a return to normalcy. Alaska made national headlines in March as the first state to make vaccines available to any adult, and as the snow melted into a long-awaited spring, restaurants were packed, church pews were full, and schools reopened for in-person classes.

Yet signs of trouble became apparent before the trees had even budded. Demand for vaccinations swiftly plateaued; in early April, clinics could no longer fill their appointments. In the last two weeks of April, COVID-19 cases in the Fairbanks North Star Borough rose by 253 percent, and test positivity rates doubled to more than 10 percent. Fairbanks Memorial Hospital, which serves the entire Alaskan Interior, was