COVID-19 patients increase in number, severity

INCREASE: Several people leave Guam Memorial Hospital on Sunday, Sept. 27, in Tamuning. David Castro/The Guam Daily Post

Not only are the number of patients at the Guam Memorial Hospital rising, but the severity of COVID-19 patients’ illnesses are increasing in acuity, an official said.

“We continue to surge COVID into the hospital," said William Kando, associate administrator of operations for GMH. "This has certainly been our worst wave of the pandemic since it started in March. Not only is it more in numbers but the severity in illness is the worst that we’re seeing to date."

“We’re not sure if it's because they waited too long to come in, it’s probably a multitude of factors," he said.

Kando said in addition to expanding their COVID-19 rooms, they're also hiring more nurses and medical staff to monitor the additional beds. 

COVID-19 patients come from various backgrounds and from up and down the socio-economic spectrum. “It doesn’t discriminate,” he said of the virus. 

He noted, however, that those who don’t have insurance or who are underinsured may not have the same access to preventive health care that could help them manage COVID-19 earlier - before symptoms get too harsh, particularly if they have underlying health conditions.

“When people who aren’t insured or are low (on the) socioeconomic spectrum maybe they’re just waiting until it’s too late, instead of seeking earlier health care - that certainly doesn’t help the situation for them,” he said.

This is an issue Dr. Annette David, of Health Partners LLC, raised during a press conference Thursday with Gov. Lou Leon Guerrero. David said some residents, particularly those without health insurance, are less likely to get preventive health care. 

"There could be some difficulties in accessing care so that medical conditions are not under optimal control therefore they're at higher risk (and) they're more susceptible," said Dr. David, commenting on the reasons why some people may be more susceptible to COVID-19. "Access to health care is very critical ... one thing we have to think of is many people have lost their jobs and therefore may have lost access to health insurance.

"We need to encourage regular medical care to ensure that hypertension, cancer, diabetes, cardiac disease are all well-controlled," she said. "And if access to health care has been impeded because of the loss of employment, one of the interventions to consider is can we have emergency healthcare insurance for all those who have lost their insurance because they have lost their jobs." 

She said getting access to health care would help people address possible co-morbidities and improve their chances of surviving a COVID-19 infection. 

The Guam Daily Post asked Adelup if emergency health insurance is something they're looking into. No response was received as of press time. 

Increasing COVID-19 numbers

As of Saturday afternoon, Guam had 79 new COVID-19 cases from the 558 tests conducted – a 14% positive rate. The new cases raise the number of active cases to 1,257, and the total number of cases to 3,617, according to the Joint Information Center.

Officials have reported 2,297 people have completed isolation. There have been 63 deaths linked to the respiratory illness.

There’s been an increase in number of COVID-19 cases on Guam, and with that an increase in the number of hospitalizations. There were 67 people hospitalized as of Friday. Of those, 62 were at GMH - 12 were in the intensive care unit and four were on ventilators. 

To address the increasing number of COVID-19 patients, they've hired 19 new nurses and medical staff, because personnel has been one of their greatest challenges. With the current surge anticipated to continue, they are asking for an additional 42 nurses. 

"These are potentially reimbursable and they suggested that once we get the documents we may even be able to get a 50% advance on it," he said referring to Health and Human Services and Federal Emergency Medical Agency. He said they're looking at a possible 75% FEMA reimbursement and 25% from CARES Act funding. 

GMH also is working with the Army Corps of Engineers, which has contracted local companies to do electrical and mechanical upgrades in COVID-19 Units 3 and 4 on the third and fourth floors of the hospital.

“They’re helping us to increase our negative pressure capacity - so we’ll have additional negative pressure rooms,” Kando said. “And they’re bringing in an additional 43 circuits. So in these rooms they just didn’t have enough outlets to use for medical equipment. Typically our patient rooms are capable of plugging in your monitor, pumps, ventilators, but if you go beyond that and try to do dialysis or reverse osmosis, you’re going to overload it. And then you have a situation where you have critical medical equipment shutting down.”

He said in total the upgrades will provide GMH with 21 additional rooms.

“That’s huge for us,” he said, noting that the upgrades allow the units to provide ICU level care.

That and moving medical staff to the Skilled Nursing Facility at Barrigada Heights expand the hospital's capacity in anticipation of another surge in patients. Low acuity COVID-19 patients, those who are getting better and will soon be released, are being moved to the Skilled Nursing Facility/COVID Isolation Facility.

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