Gov. Lou Leon Guerrero today reported two more deaths related to Covid-19, bringing the total number to nine as Guam's cases continue to mount.
The first patient was 61 years old, who had existing comorbidities, which was further complicated because of this virus. On Aug. 14, he was transferred from Guam Regional Medical City to Guam Memorial Hospital after testing positive for Covid-19.
The second patient was 62-year-old nurse, who worked at ICU and ER at GMH. On July 10, she had multiple comorbidities.
"Reporting deaths is never easy, and these recent passings, which happened only five minutes apart, have been especially difficult. These two people were more than just Covid patients—they had families, friends, and loved ones. I know words are not always enough, but to the people they loved, Jeff, Lt. Governor Josh, and I extend our condolences and our sympathies," the governor said.
"Throughout this pandemic, our frontline workers have put their lives at risk for the health and safety of our island. As we see our COVID numbers increase drastically by the day, our frontliners, and by extension, their loved ones, are at even higher risk. The families who have suffered immense loss know just how painful this virus can be," she said.
"This is why I am strongly adamant that the Stay at Home Order remains in effect. If we do not do anything now, if we do not commit to the Stay at Home Order, I am afraid we will have more rough days ahead of us."
Guam has reported four Covid-19 related deaths since last week.
As of Tuesday night, Guam had 984 confirmed cases, 27 hospitalization with six in ICU. Of those cases, 823 are classified as civilians and 161 are military service members. The Joint Information Center has yet to release the latest results.
The governor appealed to the people of Guam to stay home. " As a nurse, a mother, and a grandmother, I am appealing to your sense of love and compassion for family and our island. I cannot protect them alone—I need your help. Wear your mask, social distance at least 6 feet, and more importantly, please stay home," she said
The Port Authority of Guam, meanwhile, said another employee, who is not connected to previous cases, has tested positive for Covid-19.
“Our Port Contact Tracing Team began work immediately to identify the employees who had been in contact with our latest case and testing for the additional three potentially exposed employees was completed this morning at the Department of Public Health and Social Services. We also had the area where the employee works deep cleaned as a precautionary measure,” PAG general manager Rory Respicio said.
Respicio said 30 port employees, who were traced through one of three previously reported infected employees, tested negative.
The surge of patients being admitted to GMH is putting more burden on the government hospital with has limited capacity.
"As it has been clearly and repeatedly articulated by Governor Lou Leon Guerrero and others, the true danger of Covid-19 is its ability to make a multitude of people just sick enough to need hospital care in a short period of time," GMH administrator Lilian Posadas said in a letter, responding to Sen. James Moylan's inquiry.
"As the hospital’s capacity reaches its limit with Covid-19 patients, those requiring admission for other serious medical conditions not due or related to Covid oftentimes find that there are very limited available beds and shortage of healthcare personnel, particularly registered nurses in the critical care/ICU," Posadas said.
Posadas disclosed the hospital's bed alignment strategy, which includes the opening of Covid Care 4 Unit, a 26-bed inpatient section on the third-floor Medical Telemetry Unit.
"As much as we’ve been planning to stand this unit up, we were challenged with the many non-Covid patients that needed Telemetry beds," Posadas said. "It is a multiple-level of care unit for Covid-19 patients who need close and constant Telemetry monitoring. It also has the capacity to accommodate patients who need Progressive Care Unit level of care and, it also has a section with six beds for Covid patients who need ICU level of care."
Posadas said other contingencies are in place to address surge capacity if the need arises such as the Medical Unit of the Guam National Guard. "They are ready and will be deploying their medical unit personnel to GMH to augment and support the nurses and the teams assigned to the Covid Care units."
Posadas said GMH received nearly $20 million in CARES Act funds to fund the hospital's Covid-19 response efforts.
Manpower is another issue that needs to be addressed.
"From the outset of this pandemic and for many decades, GMH has struggled with the same issues and problems. It is a public hospital and is perennially under-funded/under-resourced," Posadas said. "It has struggled with the continual shortage of registered nurses and other skilled health professionals and, too often, facility improvement and upgrade costs were deferred for other immediate hospital needs."
Posadas said she had a meeting this week Education Superintendent Jon Fernandez and his team of School Health Counselors/Nurses, who agreed to mobilize several of the school nurses and other support staff such as school aides to GMH.
"We’ve been in close communication and collaboration with the GRMC nursing leadership and management to accept movement and transfer of the non-Covid inpatients to their facility as a means to decompress the non-Covid inpatient units so that we can assign as many of the GMH RNs and other nursing services personnel to the Covid Care Units," Posadas said.
At the Skilled Nursing Facility, which is designated as an isolation facility, in Barrigada Heights, Posadas said the existing chiller has been repaired and is functioning and keeping the facility cool.
However, she added, the repaired chiller may not function at a level sufficient to keep the entire facility comfortably cool if nurses and patients fill the facility.
GHM is processing an RFQ for an “immediate temporary” chiller, Posadas said. "The ultimate plan is to replace the old chiller with a new one. For this project, the procurement documents/records are in the review process at the AGO."
Financial instability has always been the biggest challenge for GMH, Posadas said. "For that reason, your predecessors sought to give GMH a stable source of funding by commuting a fixed percentage of the business privilege tax to GMH with a fund-specific subsidy. That subsidy results in $16 million to $19 million a year to GMHA depending on the BPT collected," Posadas told Moylan. "By continually attempting to roll back the BPT without a replacement source of funding for GMH—the hospital will be forced to cut at a time when it cannot afford to do so."
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