I sat glumly in coronavirus prison, being subjected to isolation and quarantine while the days slowly passed and Guam Public Health debated whether to run my lab specimen.
I had not traveled to China in the past 14 days, most especially to Wuhan. Nor had I traveled to an area with widespread sustained community transmission like Seattle, California, or New York. Heck, I had been so busy swabbing coronavirus suspect patients. I had not even been to the Dededo flea market in about a month.
I had been coughing more and more for the past four days and had noticed being a little short of breath as I got ready to start my Family Practice clinic at the American Medical Center. Long hours, lots of sick patients, the ever-ominous threat of global pandemic over the past six weeks had taken its toll. I didn’t look too good. No fever though.
Didn’t matter. My colleagues put me in a chair, came at me in full protective gear, forcibly swabbed my nasopharynx, and kicked me out of my own clinic. These AMC people take their job seriously.
So for the next two days, I stayed home and avoided contact with others. Even my dog wouldn’t look at me. I felt like a pariah.
Finally, my coronavirus test was completed and it revealed that I was negative for infection. My family and friends expressed great relief. I am now happily back at work on the front line of this war against Covid-19.
Over the past week, Guam’s medical community has rallied together, setting aside simmering animosities and commercial antagonisms. A great resolve has emerged. Guam’s doctors and Allied Health professionals are tough, competent and ready for this existential threat which is Covid-19.
According to the Centers for Disease Control, if there is widespread transmission of Covid-19 in the United States, schools, childcare centers, workplaces and other places for mass gatherings may become epicenters of disease transmission. Predictably, large numbers of very sick people will need medical care at the same time. Public health centers and hospitals may become overloaded, with terrifying rates of critical illness and unnecessary deaths. Other critical infrastructure, such as law enforcement, emergency medical services, and transportation industry may be overwhelmed.
Accurate testing is critical to stopping a disease outbreak. When a case is confirmed, health officials move to isolate this person in an effort to contain the disease's spread. There's then an attempt to get in touch with the people with whom the victim of coronavirus came in contact with so that they, too, do not spread the virus.
As more cases are found, health officials will need to test contacts of people who carry the virus, and other ill people in affected communities may demand tests, all escalating the need for more tests.
Over the past two weeks, since island doctors were finally allowed to run a single test, 14 percent of every Guamanian allowed to be tested demonstrated active infection. In only 14 days, our island has gone from being coronavirus-free to being the new epicenter of coronavirus infection in the world.
Since President Donald Trump declared a Covid-19 public health emergency on Jan. 31, Guam’s penetrance of Coronavirus infection is among the highest in the United States.
The superstars who might yet save us from this invisible pandemic saw their super powers go up in smoke last year just as the novel virus was mutating into its murderous form. This past November, GovGuam’s penchant for payroll politics and deferred maintenance finally resulted in the structural condemnation of the entire Mangilao Public Health headquarters including the pandemic sentinel lab.
One electrical fire, one State of Emergency and several lost months of infectious disease surveillance later, Guam’s Public Health lab was finally resurrected from the ashtray of broken political promises. Exceeding expectations, in a very short time, Team Guam’s medical technologists brought to life Covid-19 data collection. Real-life heroes with virtue already tested, Guam Public Health’s laboratory scientists are a courageous group of home-grown medical scientists dedicated to fighting for Truth, Justice, and the Guamanian Way.
Moving forward, Guam needs to test more people and be precise about disease containment. We need to be coherent and frequent about public education in order to ensure treatment and mitigation compliance. We need to be intentional and definitive about rectification of individual noncompliance with prescribed treatment. The homeless and the nonconformist will need to effectively addressed. We need to be more like South Korea and less like Italy.
Guam now needs to progress from total lockdown to prudent panic to structural control to evolutionary adaptation. Guam cannot survive in our air-conditioned, coronavirus-incubator caves forever. We must evolve. We must all mutate fearlessly into coronavirus-killers. During this prudent 30-day period where our nation reinvents itself to be of the people, by the people, and for the people who are immune to coronavirus and forever prepared for any future pandemic, let us not be afraid.
The solution to reopening Guam’s economy is precision coronavirus testing, focused isolation, aggressive medical control and modified travel regulations. A key component will be meaningful personal data management to allow for efficient and accurate disease tracking. An electronic data system model already exists that has improved medical care for homeless people in the San Francisco Bay Area. Data systems such as this will ensure one citizen, one record functionality that can be extended to our 1.9 million visitors as well.
With the leadership of Governor Lou Leon Guerrero and the support of the business community, meaningful work can be done over the next 14 days that will ensure Guam will be open for business as soon as possible. For those of us who have known the bitterness of isolation and quarantine, that time of freedom from fear of coronavirus cannot come soon enough.
Dr. Vincent Akimoto practices Family Medicine at the American Medical Clinic. Send feedback to akimotovince@yahoo.com