Terlaje gets to the bottom of Public Health deficiencies in COVID-19 fight



The following is news from the Office of Senator Therese Terlaje:


As the community continues to learn how to adapt to life with COVID-19, Senator Therese Terlaje, the Oversight Chair on Health, continues to monitor progress with the Department of Public Health and Social Services (DPHSS) to get a clearer picture of the trajectory of the reopening of Guam businesses, tourism as well as restoring some semblance of normalcy for residents.

The third in a series of Oversight Hearings took place on the first day of FY2021 via Zoom with members of the 35th Guam Legislature and administrators from DPHSS to get an update on the progress of COVID-19 response measures including the Contact Tracing and Investigations capacity, implementation and results of COVID-19 tracing apps, public disclosure protocol for case investigations and contact tracing information, status of the CARES Act funding request and other federal funding, and Public Health Authority Powers under Chapter 19, Title 10, Guam Code Annotated.

“Since the first oversight on contact tracing held in May through today, these hearings have been essential to getting information to the public when there has been so much uncertainty.  Hearing that there is progress is encouraging and lets everyone in our community know that DPHSS is working hard to keep them safe, while also considering their need to get back to work,” said the Oversight Chair.

The DPHSS Workflow has been streamlined for contact tracing and containment, and they can now contact a positive case, close contacts, plan isolation, and instruct on quarantine for family members within 5-8 hours of test results.  According to Dr. Chima Mbakwem, Projects Coordinator for the Office of HealthCare Associated Infections Epidemiology, the new strategy is a time-saving mechanism where the containment team identifies family members and close contacts and immediately hands the data to the contact tracing investigation team who completes their investigation within 1-2 days while those identified are already under quarantine and are being monitored for 14 days.

Annette Aguon, COVID-19 Epidemiology/Surveillance Branch Lead, also updated the Oversight Chair on contact tracing investigation resources stating that there are currently 22 investigators, 25 contact tracers, plus 3 contact tracers with Dr. Mbakwem’s team.  Also assisting in this effort are approximately 42 DOE nurses, 38 existing Public Health staff, among others. In addition to public and private partners, a pilot project has started at UOG which will augment the investigation team at a separate site.  Santos and Mbakwem attributed the increased staffing, household contacts in multigenerational homes already under quarantine, and the current lockdown in assisting them to complete investigations sustainably until Guam starts reopening and shifting gears.

Although the Guam COVID Alert App has only seen a 19.6% adoption rate, short of the recommended 60% gold standard, efforts are still ongoing to increase the levels through various outreach and incentive programs.   Public Health also launched the SARA Alert technology which will eventually replace most of the manual monitoring, allowing a more robust way for patients and close contacts to report their symptoms daily via telephone, email, smartphone, or text messaging.

Though much progress has been made regarding containment and contact tracing, Dr. Ann Pobutsky, Guam’s Territorial Epidemiologist, advised that they are behind on data management and migration, stating that it will be at least another month until we get more robust weekly surveillance reports, which will break down community spread by activity categories.  The categories are a work in progress but could contain the information that the community has been pressing for, to make well-informed decisions about what activities could be riskier for them and their families and to help the government determine what businesses could be classified as lower or higher risk.

Senator Terlaje stated, “I continue to urge the Department to provide more data to the public to help them understand what information is driving the decisions so that they have confidence in this process going forward.”

Acting Director Art San Agustin updated the Chair on the latest changes to quarantine protocols, noting that those who wish to test on day 6 and test negative, can opt to fulfill the remainder of their 14-day quarantine at home.  Dr. Mbakwem clarified that these individuals are on restricted movement, which means they can go to the store for essential items and exercise because they have a lower probability of testing positive.  This is different from quarantine for close contacts who have been exposed to COVID-19.

Although the ongoing community positivity rate averages approximately 8% according to the JIC, Aguon advised that DPHSS is still confident in their ability to adequately trace contacts and control the spread of infection, especially with the recent adjustments made with the isolation and quarantine team and updated internal protocols with the trace investigation team.

“I am optimistic about the progress made in just the past few months regarding containment and contact tracing, however, I cannot stress enough about the importance of transparency in the process and data-driven decisions being the key to public participation,” stated Senator Terlaje.
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