By Eric Rosario
Dr. Felix Cabrera is crossing his fingers residents will exercise personal responsibility on Thanksgiving.
Dr. Cabrera, a member of the Governor's Physicians Advisory Group that has guided the government's COVID-19 response, told Kandit that while the COVID Area Risk (CAR) Score has been going down, complacency on Thanksgiving may turn things for the worst.
The CAR Score is a simplified look at how the virus is spreading on the island. It is derived through a seven-day rolling average of daily new cases per 100,000 people, multiplied by the square root of the test positivity rate, then adjusted for the momentum of spread retransmission value. As of last night, Guam's CAR Score is 9.0, down from a high of 41.5 two weeks ago.
Gov. Lou Leon Guerrero has said she is inclined to ease restrictions if the CAR Score can be maintained at or below 5.0. Dr. Cabrera said the time frame for maintaining that score range should be two weeks before a decision like that can be made.
Thanksgiving is the wild card.
"We just don't know how that day will go," Dr. Cabrera said. "If Halloween was the preview for how the community will respond to the current restrictions, then Thanksgiving is like the matinee, and Christmas is the main show."
If Guam's CAR Score can reach 5.0 or below, and stay there or go even lower for a two week period shortly after Thanksgiving, then the risk of the virus spreading through Christmas gatherings will be much lower.
What if the virus infects many more people on Thanksgiving?
Kandit put together a simple calendar graphic showing what happens when someone is infected with Coronavirus on Thanksgiving.
"That timeline is pretty accurate," Dr. Cabrera said upon his review.
Based on the timing from infection through the typical incubation period, to the onset of symptoms then to the time it takes to get very sick and land in the hospital, a person without a strong immune system who contracts COVID-19 on Thanksgiving will spend Christmas in the hospital.
Guam's population is filled with people of all ages who either have co-morbidities or otherwise suppressed immune systems. These include people with heart disease, high blood pressure, diabetes, cancer, lupus, and smokers, to name a few. In the prison, where there is a high prevalence of hepatitis-C, the risk of death from COVID-19 has risen now that 164 prisoners have tested positive.
"If a patient has cirrhosis because of hepatitis C (many don’t ever develop cirrhosis) then that is a significant comorbidity that can be complicated by COVID," Dr. Cabrera said.
Gathering is cultural
Dr. Cabrera acknowledges that the gathering of families and friends for special occasions, especially Thanksgiving, is a major part of our culture.
"The virus feeds on our cultural values," he said. "With personal responsibility in mind, we can find ways to experience love with family and friends on Thanksgiving that doesn't have to be in person. If it has to be in person - if you have to gather with others from a home you're not living in - then do it outside. At least the air is circulating. That's very important. And if you must have your gathering inside someone's home, then at the very least open all the windows and let that air circulate."