Public Health releases preliminary mortality analysis of DOAs during COVID surge

Guam Memorial Hospital (PNC file photo)

The Department of Public Health and Social Services has released its preliminary mortality analysis of persons dead on arrival (DOA) versus non-DOA during the recent COVID-19 surge.

The analysis presented in the report includes all deaths in 2021 with death certificates from January 1, 2021, to November 8, 2021.

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According to the report, from the ethnic comparison of COVID-19 related non-DOA and DOA deaths, Chuukese and other Pacific Islanders are disproportionately more likely to die of COVID-19 compared to their proportions in the Guam population.

“Chuukese are even more disproportionately represented in DOA cases. Chamorros are less likely and Filipinos slightly more likely to be represented as DOA cases given their proportions in Guam’s population,” the report stated.

According to the report, both DOA (65.1%) and non-DOA (59.3%) cases skew heavily toward males, but with higher proportions among the DOA cases.

By age, both DOA (56.8%) and non-DOA (67.9%) are more likely to be elderly (60+ years), but with higher proportions among those non-DOA.

Among those aged 40-59, slightly more are DOA (34.1%), than non-DOA (22.2%). Among those 18-39 years, there are more non-DOA (9.9%) than DOA (2.3%). Among those less than 18 years, there are 3 DOA cases, of which two were infants less than 4 months of age.

“Most DOA and non-DOA cases are from the northern part of the island, which is Guam’s most populated area. Interestingly there are more DOA cases from the south compared to non-DOA cases,” the report stated.

Information on cases can be found at:

While both DOA (81.8%) and non-DOA (58%) are both more likely to be unvaccinated, among those DOA cases, this is much higher.

By education, those DOA cases have higher proportions with lower education (8th grade or less, or some high school) , and are less likely to be high school graduates.

Examining chronic conditions, the biggest risk factors among non-DOA cases include diabetes, cardiovascular disease, chronic lung disease, obesity, and former smoking.

Among DOA cases, the biggest risk factors are diabetes, chronic renal disease, and hypertension.

“It is important to point out that risk factors (obesity, current or former smoking) have been vastly underreported throughout the pandemic, as can be noted by the population prevalence estimates from the 2019 CDC-BRFSS, for chronic conditions and risk factors,” the report stated.

Examining cases of death, most of the DOA (n=81)and non-DOA cases (n=44) have respiratory diseases or complications of COVID-19 infection, as immediate or underlying causes of death.

“Both non-DOA and DOA cases have cardiovascular conditions, hypertension, diabetes, and chronic renal disease as contributory causes of death,” the report concluded.