FEMA approves Guam request for assistance; 21 DoD medical personnel on the way

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Guam’s request for more medical personnel has been approved by FEMA and we’re awaiting our first incoming batch of staff as soon as this week.

The ink is just barely drying on the contract with the federal government.

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The Region 9 coordinator, Jonathan Bartlett with the Department of Health & Human Services, arrived Monday night, to serve as a technical advisor during Guam’s additional staff up from the feds.

Bartlett will be the middle-man, basically approving or facilitating approvals while on the island and coordinating shipments of resources Guam has been asking for from federal agencies.

Guam Office of Civil Defense Administrator Charlie Esteves said he just signed the final contract with FEMA Sunday and now, we’re waiting for the staff to deploy.

“It took quite a bit of time to adjudicate this request. There were questionnaires, an agreement, we had data and analytic calls with FEMA and HHS, CDC to determine what their numbers are saying, and if their models match our models. And we basically came to an agreement that yes, the Territory of Guam does need this capability for a period of no more than 30 days,” said Esteves.

FEMA approved a 2-phase staffing pattern for Guam.

What the Island is actively waiting for right now is Phase 1 which is: 2 intensivists (doctors), 15 nurses and 4 respiratory therapists (RT).

Phase 2, according to the agreement, would be 4 doctors, 36 nurses, and 8 RTs.

But Esteves says getting to Phase 2 is not time-driven but rather, event-driven, and based on Guam’s needs.

“They don’t want to take away resources from another state or territory. So, if we really do demonstrate the need then we will increase potentially to Phase Two. I don’t know if we would get all of the requested resources from Phase Two, so it will come down to that continuous assessment of the need.”

FEMA assigned Guam’s staffing to the Department of Defense, so the additional personnel will be military but they will be given clearance to work at GMH and at Public Health.

Guam has been approved for 30 days of support … so far.

Esteves says they’re working through the Restriction of Movement and quarantine requirements so staff are able to come and hit the ground running as soon as possible.

While the federal government foots most of the bill, Guam is on the hook for a 25% cost-share. The current contract is for a maximum of $2.5 million, meaning Guam at most (as it stands) is looking at $625,000.

It’s no secret that Guam’s health care capacity has been stretched and GMH is reaching its limits.

Lillian Perez-Posadas, the Hospital’s Administrator, said they’re already tapping into resources on Guam.

“We’re also getting 6 or 7, possibly 8 more medical personnel from the Guam Army National Guard Medical Unit so, we’re getting those individuals either tomorrow or Wednesday. So at least that will help offset our medical staff in the care units.”

In addition, 13 GDOE nurses started on-site training Monday.

“Hopefully, we can get them geared to complete the training and get their skills and their practice with regards to hospital nursing. Some of them have been away from it and so, we want to make sure that they go through this training so that they are successful and they feel confident taking care of hospital patients again,” said Perez-Posadas.

She added: “We’re just constantly moving and juggling beds to make more beds available. It’s the staffing we’re really challenged with, particularly because some have, with exposure to COVID, have become positive. So they’re in sickly/isolation status. We have the SNU and we have the temporary chiller stationed there already at the facility and they’re hooking it up. Hopefully, by this afternoon the facility will be cooled comfortably to begin moving acute care patients from GMH as an overflow to the SIF – that’s 54 beds. We re-opened up the 4th floor Care 3 again, and that has 17 beds at GMH, that’s increasing capacity. We moved our non-COVID telemetry patients over to the medical surgical area, we do have some telemetry beds that can accommodate patients that are non-COVID.”

With peak hospitalizations expected by this Friday, according to Dr. Felix Cabrera from the Governor’s Physician’s Advisory Group, all the additional resources can’t come soon enough.

As of Monday morning, GMH had 39 hospitalized patients admitted for COVID-treatment plus one Person Under Investigation.

Five people were in intensive care and one on a ventilator.

At last check, Naval Hospital still had three patients being treated there.

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