Several hotels in Tumon have been designated as quarantine facilities.
Federal funds that were initially earmarked for Guam's Covid-19 testing have been diverted to cover the cost of quarantine services, according to an official of the Department of Public Health and Social Services.
Tommy Taitague, DPHSS administrative services officer, said Gov. Lou Leon Guerrero had budgeted $313,000 from the CARES Act grant for Covid testing but the allotment was reprogrammed for quarantine services for the first two months.
During an oversight hearing held Thursday by the legislative health committee, Taitague said DPHSS has received a supplemental allotment of $397,092 from the federal aid. This fund, he added, is still available for the department’s use for immediate needs and response to the pandemic.
DPHSS also submitted a supplemental request in June to the governor for $3 million for 30 additional staff, PPE, and equipment for DPHSS divisions directly responding Covid-19.
Taitague told Sen. Therese Terlaje, committee chair, that the governor has approved department's request but the amount has not been allotted to DPHSS.
He said Public Health has received $6.1 million through an Epidemiology and Laboratory Capacity grant and $1.2 milion from a Community Health Clinic grant. To date, $1.1 million has been used from these two funding sources, and about $6.2 million is still available for use on contract tracing, testing, and investigations and the division through 2022.
According to the committee, the oversight hearing was called to determine the status of the health department's case investigations and contact tracing resources and its protocols regarding public disclosure of investigations to prevent the spread of Covid-19.
Terlaje addressed concerns about the capacity of the department to mitigate risk through contact tracing in anticipation of opening businesses and the economy.
“Our goal has always been to ensure that DPHSS has the support it needs to effectively mitigate the impact of this virus in our community and that the public has confidence in the plans and implementation of the Department’s contact tracing efforts,” Terlaje said.
Recently, DPHSS has publicly stated that with the surge in positive cases, there has been a lag with the initiation of a trace investigation from a targeted 24-hour period, aligned with CDC guidelines, to 2-3 days. The department advised that a call-out was made for help to close that gap and shared their current status and progress to address recent issues as well as short term and long-term plans for the island.
Annette Aguon, administrator for the Bureau of Communicable Disease Control, said they started out with six contact tracers and six investigators which has since increased to 20 investigators and 24 contact tracers to address the latest surge in positive cases.
DPHSS is in the process of getting 14 more tracers and investigators through an Epidemiology and Laboratory Capacity grant and assured the Committee that they will have sufficient human resources to meet the need and catch up on the backlog from last month’s surge.
They also have plans to multiply their efforts through a recent training at UOG in conjunction with UCSF which trained 85 individuals that can be utilized in the private sector and other government agencies. In addition, they are looking at a pilot project of a team of 5 contact tracers at UOG to give some relief to their personnel, with plans to expand.
Dr. Suzanne Kaneshiro, public health officer for the Division of Public Health, advised that the Department is using federal grants to open a new Bureau of Emerging Infectious Diseases, which will be fully staffed with contact tracers, nurses and microbiologists.
Acting DPHSS Director Art San Agustin is hopeful the Bureau will be fully operational next year and for the long term.
Dr. Chima Mbakwem, projects coordinator in the Office of Health Care Associated Infections Epidemiology at the Bureau of Communicable Disease Control, clarified that it is important to note the role of containment with respect to contact tracing.
He said isolating positive cases and quarantining high-risk individuals and family members helps the contact investigation team by cutting off the infection at the point of testing by giving them time to investigate community transmission.
The SARA Alert app, an open-source tool that automates the process of public health monitoring and reporting of individuals exposed to or infected with Covid-19, is currently being used as a containment and monitoring tool for DPHSS. In addition, this app allows for a second module to be deployed when Guam opens its doors to tourists. This digital platform will replace the Emocha technology that will be phased out by the end of the year.
What was originally called SafePlace, or Pathcheck was launched Thursday under the name Guam Covid Alert , which will function as another tool to help contact tracing to be more efficient and effective.
Aguon advised that she meets weekly with representatives from AAFB, USNH, and GUNG who conduct their own contact tracing.
Civilian contacts are referred to Public Health for testing if they are overwhelmed and cases or clusters are discussed at their meetings.
Aguon attributed the delay in information to capacity limitations such as the ones we see in her bureau. DPHSS receives case summaries and breakdowns of veterans, dependents, service members which will be added in the planned weekly summaries that will be issued by the department.
After months of urging by the Committee to disclose information that would be useful to the community to determine if they are at risk of exposure, DPHSS is currently reviewing a legal opinion it received from the Attorney General regarding the public disclosure and the parameters of information that can be released to the public.
San Agustin said the AG opinion recommended that disclosure of information be related to the work of contact tracing.
With plans to streamline the daily situation report and release a weekly surveillance report that provides more information, protocols are being developed based on the recent AG opinion, that will inform the release of the type of establishments or activities where there are known Covid clusters.
Terlaje emphasized the importance of disclosing information immediately regarding establishments and gatherings in order to ensure the community can take necessary precautions to keep their families safe.
“All of the businesses are clamoring for this data. They want our closures to be data-driven and risk-driven” Terlaje said.
She reiterated that the public will be supportive if it makes sense to them. “Residents want to know why certain businesses are closed and why certain ones are open and that all of our lockdowns are based on solid information.”