By Troy Torres
Dr. Vince Akimoto and his son, Kai Akimoto, are on an important mission. They're trying to find a homeless woman in Tumon, whom public health officials believe transmitted the Coronavirus to the Airman, who began the Andersen Air Force Base cluster a couple weeks ago.
Guam Police Department officers from the Tumon precinct escorted the Akimotos into the parking lot remains of the now-demolished Royal Palm hotel across from San Vitores Church late Saturday night. The duo canvassed the homeless people living there. One of the three, who were there, said public health officials had questioned them earlier in the week, contact tracing to find this woman, who may be exposing other homeless people to the virus.
"The homeless population is a vector we need to be concerned about, especially if they live in close quarters and associate in close proximity to each other," Dr. Akimoto said about 20 yards from the next dilapidated structure he wants to canvass - a multi-unit abandoned apartment complex behind the Acanta Mall, where scores of homeless people are known to reside.
The Leon Guerrero administration recently did a sweep of the grounds of the Paseo de Susana to remove homeless people. Dr. Akimoto and others fear that when the government does this, they end up driving homeless people to live in close quarters in abandoned buildings.
According to national news reports, major city governments throughout the country are sweeping public areas of tent encampments, where the homeless largely keep to themselves in individual tents. The U.S. Centers for Disease Control has warned against the sweeping of these areas because of the probability that homeless populations will gather and will lead to Covid-19 spikes and unsanitary conditions leading to diseases like Hepatitis A.
Dr. Akimoto had friendly exchanges with the three people at the abandoned parking lot. They allowed him to take their temperatures using handheld thermal scanners. He asked if any of them felt sick, or if they've lost their senses of smell and taste. One man coughed as he answered, and the man next to him scooted himself over a few inches away.
The contact tracing for the Airmen who tested positive for Covid-19 is leading investigators to the first Airman who presented symptoms. But Dr. Akimoto believes that Airman was infectious for days prior to showing symptoms, and that makes tracing difficult, especially with the possibility that the Airman wasn't 'Patient Zero' for this cluster - it was community spread from an existing homeless cluster.
"That makes contact tracing all the more difficult," Dr. Akimoto said. "If we can get this under control then we'll be fine, but I don't know that there's a plan in place with protocols to address the homeless situation in terms of it being a vector."
At the beginning of the pandemic response on Guam, Gov. Lou Leon Guerrero did form a Strategic Planning Committee to address the homeless situation through the pandemic. The group, which included leaders from the government of Guam and non-profit homeless advocacy groups, began spending resources to retrofit the Paseo Stadium for what was supposed to be the Safe Haven tent city.
According to documents Kandit received from Guam Homeland Security from a Freedom of Information Act request for information, on May 1 the Guam Homeless Coalition wrote to Homeland Security Advisor Tim Aguon informing him GHC could no longer support Operation Safe Haven, as it was planned during that time.
"Input from Homeland Security Staff provides that homeless will be assigned 4 to 5 per tent by gender without regard to the main objective - separate spaces for self quarantine at a stationary site," wrote GHC chairwoman Angelina-Marie Lape to Mr. Aguon.
She informed him of advice GHC received from the U.S. Departments of Housing and Urban Development, and Health and Human Services, and from the U.S. CDC against building the type of homeless communities the Leon Guerrero administration planned at Paseo.
On April 27, Celestin Babauta, a planning committee member and interim manager of the Guam Regional Transit Authority, emailed officials and suggested the homeless, who were identified through the GHC, should be set up in the hotels the government already was spending money on.
"The hotel's environment [provides] for a more secure and conducive environment," Mr. Babauta said. He provided several other advantages of moving the homeless to the quarantine hotels, including cost savings from the retrofitting of Paseo.
Other documents on the subject that were disclosed showed the total number of people expected to be identified from the homeless population was between 120 to 180. The Pacific Star Hotel alone had more than enough rooms for the entire target population. The government had already paid for those rooms at the time - as the empty rooms also came at the same cost as the occupied rooms.
Alas, the government ignored Mr. Babauta's recommendations and to this day has not produced a viable solution to what is now a problem - the probability that an entire cluster of infections started from an undetected and growing vector: the homeless population.
Police officers understood the urgency Dr. Akimoto was pressing Saturday, when they planned for the canvass of the known homeless area in Tumon.
2 cops from Dededo precinct test positive
The cooperation Guam police officers gave the Akimotos is part of GPD's commitment to fighting the public health threat, but it's also something that hits home.
According to Dr. Akimoto, last week two Guam police officers from the Dededo precinct tested positive for Covid-19. Now, public health officials are scrambling to contact trace everyone they've been around, and police officials are trying to figure out how to remain a force in the island's two most populous and crime-ridden villages in case more officers are taken off the beat.
Despite the sudden uptick in cases and the reemergence of clusters and community spread, Dr. Akimoto believes that, if done right, this so-called wave of Coronavirus infections and community spread can be mitigated.
According to the government's tally over the past couple weeks, the infection rate (the number of people who test positive divided by the number of people tested) has remained low - below one percent. The problem will be if the island's hospitals become strained of resources to help those who get sick, according to Dr. Akimoto.
"There's just one, maybe two now who are hospitalized, so it isn't that big of a problem right now," the doctor said. "But if we don't do this right, we can get overwhelmed."
Dr. Akimoto believes there's a smart way to continue reopening the island. "We can't stay closed forever," he said, referring mainly to the economic strain from the lack of tourists to Guam.
What we should want, he says, is for a way to manage community spread. The ideal situation is for more people to be exposed, but not become too sick, developing a so-called herd immunity so that we are not so affected economically and socially by the virus anymore.