The U.S. Surgeon General had a clear message for the people of Guam: hunker down, follow the public health guidance and we could be over COVID-19 by the end of this year.
Vice Admiral Jerome Adams says he’s hopeful Guam can regain control of COVID-19 and “have a normal Thanksgiving” at the earliest, but more realistically “a normal Christmas” if residents double down and obey public health restrictions.
Adams’ rallying cry for residents to get past the pandemic fatigue and make it to the finish line came via ZOOM conference from Washington, D.C.
He joined Governor Lou Leon Guerrero and Lt. Governor Joshua Tenorio, along with other island officials and medical leaders to speak on the status of COVID on Guam.
Ultimately, he says for the island, it’s about short-term pain, for long-term gain.
“We are almost to the finish line. Once we get to the distribution of a vaccine, which again will hopefully be by the end of this year, we will start to get back to normal,” said Adams.
“I know you’re tired… but whether it’s Mother Nature and natural disasters, or surviving and rebuilding after WWII, the people of Guam, you’re fighters! You’re survivors! And one of your greatest strengths is how much you deeply care for and look out for one another. So I’m asking you to look out for one another and hang in there with these public health measures just a little bit longer.”
The country’s Surgeon General said COVID runs a course of about 4-6 weeks between infection, symptoms, hospitalizations, and unfortunately, sometimes, death.
“If we take the right measures now then in 4-6 weeks we can get this virus under control,” said Dr. Adams.
“Thanksgiving is possible but I have to be honest with you, we may still have to have limited Thanksgiving gatherings. But if we want to have Christmas and I know how important Christmas is to you…It is possible, it can happen, we just have to work hard.”
What is that hard work?
Adams says we all need to be vigilant, follow public health guidance, keep away from indoor and crowded places, and practice the 3 “W’s”
“Wear a mask. Watch your distance, meaning avoid indoor spaces, crowded spaces, and maintain 6 feet distance between you and others. And, the third ‘W’ is wash your hands frequently and thoroughly.”
Adams says there’s actually a fourth ‘W’ he likes to throw in: the “will it to make it happen.”
The biggest dose of news delivered during the conference:
“Guam will absolutely be on the list of communities getting the vaccine once we have one proven safe and effective. And again I expect that to happen before the end of this year,” said Adams.
Adams says the elderly, those with chronic diseases, and health care workers should be the first in line to get the vaccine.
He also says Guam’s 160,000 or so population plays in our favor, compared to mainland states.
“We can get herd immunity in Guam by February or March, we really could if we get a vaccine over the finish line, we get those doses ramped up and we get enough people on the island to actually take that vaccine, you can truly get back to a sense of normal a lot quicker than anywhere else simply because you’re a small island with smaller numbers of people and that allows you to more quickly get to herd immunity.”
COVID spread on Guam:
The U.S. Surgeon General commented on Guam’s vicious round two with COVID which has seen massive spikes in cases, hospitalizations and deaths.
“Guam is clearly in the COVID crosshairs now. And let me say right now to all of you, with confidence, that just as your forceful and collective action fought back this virus before, I am certain that you can regain control of this virus once again.”
The doctor pointed to the island’s test positivity rate as a key indicator of community spread.
“And the rolling 7-day average ending October 28th is 12%. We really think once you get over 10% that you’re starting to be in trouble.”
A rise in cases, says Adams, is typically followed in 2-3 weeks by a rise in hospitalizations, which is a great concern because Guam has a limited hospitalization capacity.
“I don’t need to tell you that here in Washington D.C., if a hospital is full, we can put you in an ambulance and send you a mile or two down the street. You can’t do that in Guam.”
He does offer some hope, saying treatment of severe COVID cases has improved over the last 9-10 months and survival rates have increased dramatically.
“Your chance of dying is much lower now than what it was in March and April. We had a 30% mortality rate if you got COVID in March and April vs. 8% right now.”
The point he kept coming back to throughout the virtual conversation, is Guam’s resilience and community spirit, which got us through the first wave, relatively unscathed.
“We talked about you on the mainland as really the exemplars for really how to control this virus. You were all who we bragged about on the Coronavirus Task Force and I know that you can do this yet again, you just need to have the confidence and the will to do it.”
Lockdowns and the Economy
While he recognizes the outcry from Guam’s business community wanting to open up again, he says nothing will be possible at our current infection and test positivity rates.
“Reject that false dichotomy, reject that false comparison that you’re either for reopening or you’re for health. Every business on the island of Guam should be going around and telling their employees and to anyone who will listen that we need you to do your part because that’s what allows us to reopen and get back to business again,” said Adams.
He said the Governor’s hands are forced into a lockdown when people don’t follow restrictions, for fear of overwhelming the fragile healthcare system.
“Understand that if you take the measures today, we can get this virus under control in a few weeks, and then we can get to a place where your Governor, other health officials, and other politicians can safely reopen. That’s what we want to do…we don’t want to just reopen and cause people to die.”
Adams commented on Guam’s dismal tourism industry, saying our source markets in Asia, even without a vaccine, are open for business. He says that’s not because they ignored public health measures and pushed to reopen; instead, it’s because they followed all the requirements closely, driving down disease transmission.
He also offered hope for the island’s unemployed population, working in the tourism sector, saying advanced testing could bring people back sooner:
“We now have BinaxNOW testing which can give you a result in 15 minutes. So we have the ability to be able to open in a controlled manner to tourism in certain places with a smart strategy of testing people when they come in so that you know whether or not they’ve been exposed.”
But he did make it clear that it’s a stretch for Guam to even think about tourism returning right now, with a 12% test positivity rate.
Adams got specific about the virus affecting ethnic minorities in a larger way because of pre-existing social determinants:
“Things like access to transportation, childcare, and safe, affordable housing – they contribute to medical determinants. Chronic diseases such as diabetes, lung disease, and high blood pressure and quite frankly it shouldn’t be a surprise that many of these chronic diseases are especially common in communities of color and again in indigenous persons,” said the doctor.
He references the importance of teleworking to maintain social distancing and yet the percentage of colored people with jobs that allow them to telework is lower, including those living on Guam.
He says in the mainland, people of color have been hospitalized at 5 times the rate of caucasian people.
“In Guam, the data suggests that the Chuukese and the Micronesian communities have been hardest hit,” said Adams.
Despite this, Adams says anyone can be infected and the virus does not discriminate, with around 230,000 fatalities in the U.S. and almost 9.3 million cases thus far.
He says he himself has three relatives with COVID-19, one of which is in the hospital.
America’s top doc says there are a couple of ways to get to herd immunity. The first: let the virus run its course.
“There’s no virus in our history that we can point to as our strategy for letting people just get the virus and die,” he said.
The second: to get herd immunity scientifically through a vaccine.
“We get people vaccinated and enough of them get vaccinated that they become immune to the virus and we expect that we’ll have a vaccine by the end of 2020.”
He says there are five candidates in Phase 3 of vaccine trials, which is, “nothing short of miraculous,” according to Adam. “The fastest that’s ever been done before was for the mumps vaccine and that took 5 years.”
He says there was no compromise on safety, instead, there was a lot of work that happened concurrently to make it happen so quickly.
“We’re just spending a whole lot of taxpayer money to get the vaccine ready sooner…safely.”
In Texas, there’s a $150 million, 200,000 square foot facility already up and Adams says they’re just waiting for the vaccine to get there for production.
“It can produce 20 million vaccines in a batch,” said Adams.
Vaccine hesitancy can rear its “ugly head,” said the doctor, and prevent Guam from getting to herd immunity. He says it’s crucial for people to be open to getting the vaccine.
He says either way on Guam we can get back to some normalcy before we get a vaccine by just buckling down and following the 3ws
“We absolutely can get this thing under control by Christmas on the island if everyone does their part. Thanksgiving is going to be a tall order but it’s possible if you look at the transmission of the virus. But you have to take measures now. This virus is tricky. This virus is terrible and this virus is unforgiving so we have to have an incredibly high level of compliance with these public health measures, which is why your Governor has been so strict recently.”
“Culture change takes time,” said Adams in reference to residents breaking restrictions or not following precautions. “It took us 50 years to get people to wear seatbelts in America.”