Overview of the State

Like every country and territory, Guam was not spared from the impact of the COVID 19 pandemic. The COVID 19 pandemic dramatically altered the behavior of businesses and people in a manner that is having adverse effects on the global and Guam economy. The pandemic and governmental actions in response to the pandemic, and expected to cont8nue to cause significant disruptions of daily life and business activity globally, nationally, and on Guam. These disruptions include the cancellations and prohibitions of public gatherings, the prohibitions of non-essential workers working outside of their homes, and the closure of some governmental buildings, schools, gyms, religious institutions, bars, dine-in restaurants, and other commercial facilities. The COVID 19 pandemic and related consequences have also disrupted supply chains and could disrupt or delay construction.

In March 2020, the World Health Organization (WHO) declared COVID 19 to be a pandemic. The first three cases of COVID 19 were identified on March 15, 2020. By the end of the month, Guam had 69 positive cases and 2 deaths.

In March 2020, a dozen sailors with COVID 19 evacuated from the USS Theodore Roosevelt while the ship was out at sea and flown to Naval Base Guam for treatment. Within days, the number of sailors that fell ill climbed, and the USS Theodore Roosevelt was ordered to Guam and docked. By mid-April, hundreds of crew members, including the captain, had tested positive for COVID 19 with one death.

In total, 1,271 crew members had tested positive for COVID 19. An additional 69 crew members had suspected COVID 19 but did not test positive; 76.9% of those tested positive were asymptomatic at testing, and only 55% developed any symptoms.[1]

At the beginning of the pandemic, the Governor of Guam signed Executive Order (E.O.) 2020-04, which limited GovGuam to essential operations only, closed all schools, prohibited gatherings of 50 or more people, subjected businesses with fewer than 50 people to operate at no greater than 50% occupancy and no greater than 50% of seating capacity, mandated social distances and restricted entry to the island.

After empaneling a recovery advisory group of public and private sector members, the Governor adopted the panel’s recommended Chalan Para Hinemlo’ (Our Road to Recovery) Guidelines in April 2020. The guidelines established the Pandemic Condition of Readiness (PCOR) system in which there were four levels whereby PCOR 1 represents the most urgent conditions and justifies imposing maximum restrictions. In contrast, PCOR 4 illustrates the state of normal operating conditions and no limits.

Together with her Physicians Advisory Group, the Governor created the COVID 19 Area Risk (CAR) scoring system. The CAR score would assist in assessing the risk of the potential spread of COVID 19 to other countries from travelers who enter Guam.

The CAR scoring system factors in three key assessments:

• Case Doubling Time – the speed at which the virus has the potential to spread exponentially.
• Test Positivity rate – the percentage of people who test positive out of the total number of those who have been tested; and
• New cases per 100k population – the ratio used to track the rate of COVID 19 cases per capita in a jurisdiction.

As of August 21, 832 additional residents received their first dose in a two-dose series, 158 residents received their dose in the single-dose series, and an additional 350 residents have become fully vaccinated. To date, a total of 107,145 (78.61%) of Guam’s eligible population (residents 12 years and older) is fully vaccinated. This percentage includes 8,600 fully vaccinated residents between the ages of 12 – 17, as well as Guam's fully vaccinated adult population of 98,545. 

Impact on Families

Guam families experienced increased financial burden and stress because of the pandemic. This negative impact would have been worse if not for several financial and in-kind assistance made available through different COVID 19 related assistance programs.

1. Pandemic Unemployment Assistance (PUA) provided benefits up to $345 per week for up to 39 weeks.
2. Federal Pandemic Unemployment Compensation (FPUC) added $600 of weekly benefits to recipients of PUA between April 1 and July 25, 2020.
3. Loss Wages Assistance (LWA) Program became effective after the FPUC expired. This added $300 per week to PUA benefits. This program ended in September 2020.

The unemployment rate in Guam for March 2021 was 16.5%, a decrease of 29% from December 2020 data of an unemployment rate of 19.4%. The total number of persons unemployed in March 2021 was 12,660, which decreased in the last quarter but remained above the figure of 4,670 in December 2019.

On May 5, 2020, the Governor signed the CARES Act Budget, followed by two executive orders establishing direct cash payments to Guam individuals and households.

Executive Order 2020-12 established the “Prugraman Salappe Ayudon I Taotao” with $20 million from the $118 million CARES Act funds. This program made a one-time payment of $300 per eligible recipient and up to $1,200 per eligible household. Eligible recipients included those receiving benefits from public assistance programs and those who applied and were approved by June 30, 2020.

The Ayuda I Mangafa (AIM) Help for Families Program was a one-time $500 for each eligible dependent. The AIM Program was designed for those eligible Guam families with dependents who were “overlooked under the CARES Act of 2020 and did not receive the economic impact payment (EIP) for those dependents.”

In-Kind Assistance

The Supplemental Nutrition Assistance Program (SNAP) was already in place and assisted thousands of families in Guam. Those currently participating in the program but receiving less than the maximum benefits had their benefit amount increased to the maximum level during the pandemic.

The Guam Department of Education (GDOE) is the distribution agency for The Emergency Food Assistance Program (TEFAP) under the United States Department of Agriculture (USDA). TEFAP provides food assistance to needy individuals through the distribution of USDA commodities. Under TEFAP, commodity foods are available for distribution to households to prepare meals for home consumption or organizations that prepare and provide meals for needy people.

The Mayors of individual villages in Guam conducted distribution of TEFAP via drive-thru or door-to-door delivery. Recipients receive one bag of TEFAP food commodities per household, including canned chicken, dried pasta, mixed fruits, dry cereal, and bottled juices. The food is distributed on a first-come, first-served basis. Commodity distribution in each village was available to village constituents.

As educational institutions shifted toward remote learning by spring 2020, the Guam Department of Education created the “Grab-N-Go” meal program that allowed their students who were age 18 and younger to receive free meals from designated schools around the island. The program entailed a drive-thru at the local schools where families could stay in their cars and pick up one free meal per child. The purpose of the meal program was to ensure that students were provided with meals that satisfied their daily nutritional intake and alleviated the additional stress on students and their families during the pandemic.

As of February 19, 2020, the number of “Grab-N-Go” breakfast and lunch meals distributed was 6,857,730, which equates to 137,610 meals every week,

The pandemic impacted student learning in Guam and globally as education systems adapted to changes brought on by the pandemic. These changes began when Guam identified the first COVID 19 positive case in March, followed by the Governor’s 14-day suspension of non-essential operations, including all educational institutions.

When the lockdown was extended after the initial 14-day period, GDOE canceled the remainder of School Year 2019-2020, and students were allowed to participate in remote learning voluntarily. However, at least 30% of students across the public school system lacked reliable internet access and computers needed to connect to online learning platforms, posing a challenge for GDOE. This was compounded by students who lacked the necessary resources for remote learning came from the island’s poorer households. Students in this situation were given the alternative to receive hard copy course materials provided by their schools.

As students faced the trouble of acquiring the necessary resources for remote learning, the GDOE Superintendent announced that teachers would not grade distance-learning students for SY 2019-2020. Similarly, all Guam private schools closed due to the Governor’s Executive Orders that extended the lockdown. Private school students continued and finished their academic year learning at home and used online platforms to stay connected to their teachers and classmates.

As for higher education institutions, the University of Guam (UOG) and Guam Community College (GCC) shifted to remote learning for all their students for the remainder of the academic year. UOG transitioned all its courses online for the rest of the spring semester. Accustomed to face-to-face classes, students and faculty alike experienced difficulty adapting to the new changes and new online platforms. As a solution, UOG created an alternative grading option so the undergraduate students could replace their letter grades with a corresponding “pass,” “credit,” or “no credit” without affecting their overall GPA. GCC offered students the option to receive an “incomplete” for their current courses or allowed them to complete their work on a time-relaxed basis.

Impact on Mental Health

Millions of Americans have reported coping with stress and anxiety associated with the fear of the disease and the financial worries and economic fallout caused by the pandemic. The same can be said for Guam as stay-at-home orders and the added stress of lost jobs or being furloughed have contributed to the adverse effects to mental health contributed to at least 15 suicides in 2020.

The Covid 19 pandemic has likely magnified many barriers individuals experience when trying to access the help they need. Limited access to mental health services and treatment may lead to self-harm, challenges with emotional regulation, and adaptive coping. As a result of Covid 19, individuals have experienced unprecedented interruptions to their daily lives. Some recent findings indicate that Covid 19 restrictions have impacted mental health due to the lack of interpersonal contact, social support, activities, familial stress, and economic hardship within the family.

Three days after the first confirmed positive Covid 19 case on the island, Guam Behavioral Health and Wellness 24-hour Crisis Hotline saw a dramatic increase in calls from an average of 25 per month to over 20 per day, with calls varying from general Covid 19 anxieties about health and employment, suicide ideations as a result of home quarantine with an abusive spouse, to active suicide attempts stemming from hopelessness and despair.

The Covid 19 pandemic’s toll on mental health is beginning to show itself through an increased suicide rate in Guam. Numbers indicate that the mental suffering caused by Covid 19 may be more fatal than the virus itself. The Office of the Chief Medical Examiner recorded 26 suicides from January to August or an average of 3.25 per month. As Covid 19 continues, the number of suicide deaths is expected to surpass the 31 suicides recorded in 2019.

Impact on Businesses

At the beginning of the pandemic, a Guam Chamber of Commerce survey on the impact COVID 19 had on its business members in Guam revealed that most of the businesses had to “reduce hours, implement furloughs, or layoffs.”

Within a few months after the survey was conducted, several businesses had to make the difficult decision to permanently close. Their business operations were restricted by the Governor’s Executive Orders that put Guam in PCOR 1 or local down when the COVID positivity rates were increasing.

The private sector experienced a 66% decline in revenue in 2020 compared to 2017. Construction industry revenues fared 45% better than all other businesses. The number of businesses with fewer than 20 employees increased from 82% to 89% from 2017 to 2020, with 95% of tourism-related businesses employing fewer than 20 people.

Nearly half of tourism businesses have furloughed most of their employees, with 12% continuing to pay those employees. More than one-third of tourism businesses have laid off employees, with 20% laying off all of their employees.

Impact on Public Safety

Guam’s public safety officials and lawmakers implemented several measures to limit and prevent the spread of the COVID 19 virus amongst the public. In the early pandemic, curfews applied to minors were put in place and enforced by the Guam Police Department (GPD). Any minors, those 17 years of age and younger, violating curfew laws would be fined $500.

Between April 11 and 30, 2020, Executive Order 2020-10 ordered road closures at four locations around the island to deter motorists from taking non-essential trips and potentially spreading the virus. More than three dozen Guam National Guard members were assigned to work the roadblocks with the assistance of the GPD as authorized by the Governor. In addition to roadblocks, the Guam National Guard had been activated to complete various missions in efforts against the spread of COVID 19, such as security at COVID 19 isolation and quarantine facilities, traffic and crowd management at testing sites, food distribution, pandemic unemployment sites, and disinfection of government facilities.

During the early weeks of the pandemic, court facilities were closed to the public, while services were limited to essential matters only. When Guam went to PCOR 1, the Judiciary of Guam announced that they would be closed to the public. However, scheduling continued for magistrate proceedings, preliminary hearings for detained juveniles, civil protection orders, search warrants, etc.

Guam lawmakers worked to propose bills to ensure the health and safety of Guam’s residents during the pandemic. One Guam Public Law (P.L. 35-96) prioritized public safety and the well-being of residents. This law canceled the Primary Election and reallocated the resources to enhance safety protocols during the General Election. Despite this law and the resulting efforts in support of it, the pandemic discouraged voter turnout during the General Election.

Impact on Public Health

With the surge in COVID-19 cases, most territories reached hospital and ventilator capacity quickly. They needed to recruit health care providers, especially nurses, from the mainland United States or neighboring international islands. For example, in September 2020 in Guam, when fatalities increased and more providers left the island, island officials recruited 100 nurses from mainland U.S. or the nearby Philippines. An infusion of funds from the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) helped some hospitals purchase additional hospital equipment and personal protective equipment (PPE).

Working with the Mayors, under the leadership of Public Health Director Art San Agustin, and with our dedicated Public Health employees, we expanded our testing capacity from just dozens a day to a daily average exceeding more than 500 tests. As testing grew, so too did our ability to track and trace positive cases. We turned a bureau of 12 contact tracers into an army of 138 throughout the public and private sectors.

DPHSS and the Guam National Guard began vaccinations at UOG, initially vaccinating hundreds of people daily. The Hawaii-based Army medical team has already helped maintain a daily vaccination rate of more than 2,000 doses in the critical weeks before the May 1 goal.

In Guam, Chamorros and Chuukese made up the highest proportions of hospitalized cases, making up just over 30 percent of the total hospitalizations combined.

Furthermore, a report issued by the Guam Department of Public Health in December 2020 identified ethnicity as a risk marker for COVID-19 mortality, with Chuukese having the highest fatality rates overall in Guam. While comprising only 7.1 percent of Guam’s population, those identifying as Chuukese accounted for 16 percent of total cases and 31 percent of COVID-19 deaths.

As the Covid 19 pandemic continues, Guam DPHSS will remain at the forefront of helping stem the health impact of this crisis. Title V funds remain vital to keeping mothers, children, and those with special health care needs, adolescents, and families safe and healthy.

[1] New England Journal of Medicine