FOR IMMEDIATE RELEASE (September 10, 2020 – Hagåtña, Guam) – Senator Therese Terlaje, Chair for the Committee on Health, held a critical oversight hearing today with the Department of Public Health and Social Services (DPHSS) and a confirmation hearing for the appointment of Arthur San Agustin to be Director of DPHSS.  The focus of the oversight hearing was to get a clear picture of where we are today with the department’s case investigations and contact tracing resources and its protocols regarding public disclosure of investigations to prevent the spread of COVID-19.  The Chair addressed concerns about the capacity of the department to mitigate risk through contact tracing in anticipation of opening businesses and the economy. 

The oversight chair, through several oversight hearings, meetings, and letters over the course of the last six months has consistently asked about contact tracing and the release of more information and sought action regarding these vital functions of DPHSS.

Senator Therese Terlaje stated, “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.” 

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.

Workforce Capacity

Annette Aguon, Administrator for the Bureau of Communicable Disease Control, stated that they started out with 6 contact tracers and 6 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.

In addition, 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 Director Art San Agustin is hopeful the Bureau will be fully operational next year and for the long term.

Funding

In response to inquiries from the Oversight Chair on the status of funding, Tommy Taitague, DPHSS Administrative Services Officer, advised that the Governor budgeted $313,000 of Coronavirus Relief funding for testing but it was reprogrammed for quarantine services for the first two months. An additional $397,092 was also allotted to DPHSS from this same funding source and currently 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 M for 30 additional staff, PPE, and equipment for DPHSS divisions directly responding COVID-19.  This request was approved by the Governor but has not been allotted yet to DPHSS.

Public Health has received $6.1 M through an Epidemiology and Laboratory Capacity (ELC) grant and $1.2 M from a Community Health Clinic (CHC) grant.  To date, $1.1 M has been used from these two funding sources, and about $6.2 M is still available for use on contract tracing, testing, and investigations and the division through 2022.

Containment and Technology

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 stated that 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 under the name Guam COVID Alert today, which will function as another tool to help contact tracing to be more efficient and effective.

DOD Contact Tracing Data

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 advised that some delay in information was attributed 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. 

Public Disclosure of Information

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 yesterday from the Attorney General regarding the public disclosure and the parameters of information that can be released to the public.  Acting Director San Agustin advised that 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.

Senator Therese 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” said the Senator.  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.”

The Senator closed by congratulating the department on the release of the Guam COVID Alert App today and is encouraging the community to download it.  Assurances of privacy were given by Apple and Google and the experts in the non-profit foundations and MIT.  The app will not be effective for Guam unless we get 60% of our population signed on within the next week.

To see the full public hearing, click on this link or the video below: