Pacific Island governments stepping up preparedness against COVID-19

Death toll: 3,131 as of March 2. Number of confirmed cases: 92,182. Affected countries and territories: 77.

The numbers keep spiraling, including those of collateral economic damage. Airlines have cancelled more than 200,000 flights around the world as the novel coronavirus— newly named COVID-19 — continues to spread globally, prompting travel restrictions and booking cancellations.

The threat of coronavirus ignites a combination of alert, panic and paranoia, triggering rumors that spread faster than the virus. While it may be reminiscent of the SARS outbreak that killed nearly 800 people in 2002 and 2003, COVID-19 is turning out to be more malignant. The fright evokes episodes from The Walking Dead, where no one is spared from contagion unless a community is strongly fortified.

As of March 1, no confirmed cases of COVID-19 have been reported in any jurisdiction in the Pacific Islands region, where some communities are just recovering from the measles and dengue outbreaks. But island governments in the region are scaling up efforts to ensure that they are ready and equipped to rapidly detect and respond to threat of the virus, which is expected to peak between March and April.

“There is no cure for coronavirus yet and our best line of defense is to keep it out,” Dr. Janna Manglona, medical director at the Department of Public Health and Social Services, said at the Guam Visitors Bureau’s industry briefing held Feb. 18 at the Lotte Hotel Guam.

Considering the scarcity of Guam’s health care resources, Manglona said it will be hard for the island to deal with any plague. “We already know our limitations, so we just need not to go there,” she said.

COVID-19, which scientists said was caused by SARS-COv2 virus, started in December 2019 and was first identified in Wuhan, the capital city of Hubei, China.

Infection is primarily spread through human-to-human transmission via respiratory droplets produced when people exhale (such as sneezing or coughing).The incubation period is typically two to 14 days. Symptoms may include fever, cough and breathing difficulties. Complications may include pneumonia and acute respiratory distress syndrome. Research is currently in progress to develop a vaccine or any antiviral treatment. Public health officials stressed the importance of basic hygienic practices in preventing infection and issued suggested behavioral guidelines for individuals suspected of having the virus.

On March 3, Guam senators introduced a bill that would create an Emergency Pandemic Fund.

Bill 308-35 would take up to a million dollars from the Rainy Day Fund to set aside for any pandemic that the government of Guam may need to respond to, according to a press release from the Office of the Speaker.

“Pandemic response by the government of Guam that uses this fund can encompass proactive prevention efforts, purchasing of screening equipment and medical supplies, leasing of quarantine facilities, hiring of medical and emergency personnel as well as the activation of the Guam Army National Guard,” the press release states.

The bill was introduced by Speaker Tina Rose Muña Barnes, Sen. Jim Moylan and Sen. Amanda Shelton. “As we await action by our federal government, this measure would create a funding source for our local government to act immediately. Once the Trump administration and Congress approve an emergency spending measure, the government of Guam can be reimbursed to the extent that federal laws permit,” states the speaker’s office.

“The message is clear: this 35th Guam Legislature would like to ensure that our PEOPLE come first,” Muña Barnes said.

“This issue goes beyond politics, and I look forward to working with the Speaker and my colleagues on assuring that funds are readily available if needed for medical supplies or even a quarantine facility if this global pandemic does indeed reach our shores,” said Moylan.

“The legislature stands ready to support our government’s response in carrying out all means necessary to keep our public safe,” Shelton said.

Industry stakeholders speak at the Coronavirus briefing organized by the Guam Visitors Bureau at Lotte Resort Guam on Feb. 18, 2020. From left Airport Executive Manager Tom Ada, GHRA president Mary Rhodes, Customs and Quarantine chief Vince Perez and CQA director Ignacio Peredo. Photo by Mar-Vic Cagurangan

Officials assured the local community and visitors that Guam remains coronavirus free. “From day one, our pandemic response plan has worked to keep Guam safe and open to the world,” Guam Gov. Lourdes Leon Guerrero said in her state of the island address on Feb. 24. “This means that we are working with the Centers for Disease Control and public health officials to screen visitors from impacted countries before they board planes for Guam, and screen potentially symptomatic passengers before they de-plane here. It means that we take clear steps to limit the risk of transmission whenever possible.”

Suspected passengers are to be quarantined at the airport, where “isolation” is more of a concept than an actual place. “We don’t have an actual isolation room at the airport,” Tom Ada, executive manager of the Guam International Airport Authority, said at the GVB briefing. Any office space that is available will become a de facto isolation room, where a medical specialist would screen and evaluate the suspected passenger. “When the airline contacts the tower to report an ill passenger one hour prior to arrival, we can activate our response,” Ada said.

The Guam Department of Public Health and Social Services (DPHSS) continues to work with local and federal partners to address the threat of COVID-19.

Should there be a sick person arriving on an any ports of entry (incoming plane or vessel), the Guam Communicable Disease Response Plan and Protocol is as follows:

● If an ill passenger is identified, the airline calls Tower 1 prior to landing.

● Tower 1 notifies Guam Customs & Quarantine Agency (CQA).

● CQA contacts the Territorial Epidemiologist. Via phone, the Territorial Epidemiologist gathers information on the case and determines if the passenger has any suspected illness of public health concern or meets U.S. Centers for Disease Control and Prevention (CDC) criteria for a person under investigation (PUI). You can find the updated “Criteria to Guide Evaluation of PUI for COVID-19” on the CDC website here:

● If criteria is met, DPHSS Communicable Response Team [a DPHSS nurse and a DPHSS Bureau of Communicable Disease Control (BCDC) investigator] is activated to the airport or vessel.

● DPHSS Communicable Response Team conducts a clinical and an epidemiological assessment.

● Following an assessment, the DPHSS Medical Director is contacted and the passenger is directed to the hospital or a private health care provider.

Neighboring islands in the region have established their own travel restrictions, border protocols and quarantine measures to prevent the entry of any infected traveler into their jurisdictions.

“The CNMI remains coronavirus-free, but we are strengthening our ongoing efforts to screen passengers from affected countries, most especially South Korea,” CNMI Gov. Ralph Torres said. “Our administration has been working closely with the White House in implementing additional measures to safeguard our Commonwealth."

Last Friday, Torres issued an executive order extending the CNMI government's emergency protective measures for response, quarantine, and containment of the disease. "Public health is our top priority, and we will continue to keep our residents safe,” the governor said.

The Governor’s Coronavirus Task Force, led by CHCC, will continue to lead the administration’s efforts to screen and prevent the spread of the coronavirus, monitor the economic impact to the CNMI, and ensure all CNMI residents have the most accurate and updated health and travel information. The Office of the Governor will continue working with the White House and the nation’s governors on national protective measures, according to the Office of the CNMI Governor.

"CHCC is working with the US Centers for Disease Control and Prevention and the World Health Organization on prevention and quarantine guidelines, as well as on accurate public information. As cases of coronavirus continue to rise across the globe, CHCC has elevated efforts on preventative and precautionary measures with increased Airport Surveillance, and screening at our CHCC entry points (Family Care Clinic & Emergency Room) to safeguard patient intake should a case present itself on island. During a communicable disease outbreak, CHCC has the responsibility and authority to issue orders of Isolation & Quarantine to prevent the spread of a communicable disease."

The CNMI requires every inbound passenger to fill out a health declaration form, along with their usual Customs form, when they enter the CNMI. “We will continue to protect our borders, while also mobilizing our local resources for our CHCC medical team to quarantine individuals suspected of having the coronavirus,” Torres said.

In Palau, President Tommy E. Remengesau Jr. ordered a temporary suspension of all incoming flights from China, including Hong Kong and Macau, from Feb.1 to 29. He also restricts Palau government employees from traveling to these areas.

Marshall Islands President David Kabua has signed a proclamation declaring a State of Health Emergency following the World Health Organization's declaration that the new coronavirus is a "public health emergency of international concern." The proclamation imposes an indefinite ban on all international travel by government employees and elected leaders to reduce risk of importing the coronavirus.

In Federated States of Micronesia, President David Panuelo has amended his earlier Public Health Emergency declaration to extend the travel restrictions and reimpose previous restrictions and requirements as may be necessary. “As long as our nation can remain virus free, I am confident that, after a two week period, our overall capabilities to screen, assess, isolate if necessary, and treat any suspected cases will be improved to a point where the overall exposure risk can be lowered to a locally manageable level,” Panuelo said.

He acknowledged that precautionary measures are no guarantee that FSM won’t get the virus. However, he said, precautions have credible merits as part of a larger overall mitigation plan. “Carrying an umbrella with you doesn’t guarantee you won’t get wet when it rains—but it certainly helps,” Panuelo said. “If you’re going to use a raincoat, the umbrella is your best protection until the raincoat is ready.”