GUIDELINES CHÅLAN PARA HINEMLO’ Presented by: Artemio “Ricky” Hernandez, Ph.d. Guam Recovery Panel of Advisors WHEN? Triggers to inform a decision based on medical data and public health preparedness capabilities. OVERVIEW WHAT? Select business/NGO, government, and individual activities authorized. HOW? Responsibilities of businesses/NGOs, government, and individuals during each phase oF reopening. 2 - Based on medical Data and Public Health Preparedness Proposed Phased Approach - Mitigates Risk of Resurgence - Prevents overwhelming the health care system - Implements Familiar Condition of Readiness Levels 3 PCOR 1 Pandemic Condition of Readiness PCOR 2 Maximum Restrictions Moderate Restrictions PCOR 3 Minimum Restrictions PCOR 4 No Restrictions 4 Main Triggers to Inform a Decision to Move into Next PCOR Level MEDICAL DATA PUBLIC HEALTH PREPAREDNESS CASES: statistical data relative to positive TESTING: Guam’s testing capacity and cases of COVID-19 on Guam. capabilities. HOSPITALIZATION: the level of CONTACT TRACING: DPHSS capacity to hospitalized individuals due to COVID-19 at the Guam Memorial Hospital Authority and the Guam Regional Medical City. conduct adequate monitoring of COVID-19 cases and tracings of their contacts. 5 When? Triggers to inform a decision based on medical data and public health preparedness capabilities. 6 Triggers to Inform Decision to Move from PCOR1 to PCOR2 Triggers to Inform Decision to Move from PCOR2 to PCOR3 − CASES*: Downward trend of confirmed cases and a downward trend of positive tests as a percent of total tests over a 14-day period, utilizing a 5-day rolling average; and − CASES*: Downward trend of confirmed cases and a downward trend of positive tests as a percent of total tests over a 28-day period, utilizing a 5-day rolling average starting from when PCOR 2 declared; and − HOSPITALIZATION: Guam hospitals are able to treat all inpatients without resorting to alternate standards of care due to COVID-19 cases; and − HOSPITALIZATION: Guam hospitals continue to be able to treat all inpatients without resorting to alternate standards of care due to COVID-19 cases; and − TESTING: Guam has the capacity to test all people with COVID-19 symptoms; and − TESTING: Guam continues to have the capacity to test all people with COVID-19 symptoms AND the availability and affordability of rapid and reliable testing of travelers as it relates to quarantine requirements. − CONTACT TRACING: The DPHSS has the capacity to conduct adequate monitoring of all COVID-19 cases and tracings of their contacts. PCOR 1 − CONTACT TRACING: The DPHSS continues to have the capacity to conduct adequate monitoring of all COVID-19 cases and tracings of their contacts. PCOR 2 PCOR 3 Triggers to Inform Decision to Move from PCOR3 to PCOR4 − IMMUNITY: Ability to confer adequate immunity on Guam either by mass administration of an FDA authorized SARSCoV-2 vaccine, if ever developed, OR by the confirmation that enough herd immunity has developed, via natural disease and recovery, to prevent another outbreak. PCOR 4 * New positive case variations that stay below 5 per day may still be considered a stable state of the pandemic. 7 10 March 15 March 16 March 17 March 18 March 19 March 20 March 21 March 22 March 23 March 24 March 25 March 26 March 27 March 28 March 29 March 30 March 31 April 1 April 2 April 3 April 4 April 5 April 6 April 7 April 8 April 9 April 10 April 11 April 12 April 13 April 14 April 15 April 16 April 17 April 18 April 19 April 20 April 21 April 22 April 23 April 24 April 25 April 26 April 27 April 28 April 29 April 30 25 Guam’s COVID-19 Daily New Cases and Hospitalization Census As of April 29, 2020 20 15 COVID-19 Hospitalization Census (5-Day Rolling Average) 5 Daily New COVID-19 Cases (5-Day Rolling Average) <5 new cases per day may be considered controlled activity of COVID-19 as it relates to following trends of new cases. Guam’s COVID-19 Daily Tests Performed and the Rate of Positive Results 4.0% 200 As of April 29, 2020 180 3.0% < 3% is Ideal 140 2.5% 120 2.0% Daily Test Performed 1.5% 0.5% 40 20 April 29 April 28 April 27 April 26 April 25 April 24 April 23 April 22 Daily Test Positivity Rate 5-Day Rolling Average April 21 80 60 Daily Test Positivity Rate 1.0% 100 DAILY TEST PERFORMED 160 April 20 DAILY TEST POSITIVITY RATE 3.5% A LA A A I SELECT AND INDIVIDUAL ACTIVITIES AUTHORIZED. PCOR 1 PCOR 2 What is Authorized to Re-open on a Limited Basis during PCOR 2? Businesses/Non-governmental organizations* Business/NGO Activities to be authorized upon PCOR 2 Declaration:  All Essential Businesses Operating in PCOR 1  Retail Stores  Real Estate and Automotive Sales  Beauty/Hair/Nail Salons & barbershops  Shopping Centers/Malls  Elective Medical and Dental procedures/Treatments/therapies Business/NGO activities to be under review in PCOR levels 2 and beyond:  Restaurants (sit down)  Gyms  SPAs  Bars/clubs  Outdoor sports activities (i.e. golf courses, tennis courts, swimming pools, baseball fields, etc.)  Group Tours/Events  Bingo Halls * All Businesses and Non-Governmental Organizations will be operating on a limited basis and will require Adjusted Operating Guidelines to be submitted by industry representatives to the DPHSS prior to business opening, based on USDOL & OSHA Guidance on Preparing Workplaces for COVID-19 as well as industry Best Practices. Limited Occupancy rate will be established. Business/NGO activities not identified in this slide may be covered in a future DPHSS advisory. 9 PCOR 2 What is Authorized to Re-open on a Limited Basis during PCOR 2? Government Services* Government customer-focused Services opened on a limited Basis:      All Government Services operating in PCOR 1 Department of Revenue and Taxation • Taxpayer services division • Real Property Tax Division • Driver’s License and Motor Vehicle Registration Branches • Business License Branch • Insurance and Banking Division Department of Public Works • Building/Occupancy Permit Processing and Inspections Department of Land Management • Recording and real estate related services and other services related to the permitting process Department of Administration • Operations           Guam Department of Labor • Pandemic Unemployment Assistance Program • All regulatory-related services Department of Public Health and Social Services • Health and Sanitary Licenses and certificates Department of Parks and Recreation, Historic Resources Division Guam Environmental Protection Agency Guam Police Department, Records Division Department of Agriculture Guam Housing and Urban Renewal Authority • Housing Assistance Programs Office of Veterans Affairs Guam Election Commission Mayors’ Council of Guam K-12 Schools and Higher Education Institutions remain CLOSED * Government offices and associated services will ensure social distancing mandates, physical workplace modifications, training of employees, and other actions as necessary 10 HOW? Responsibilities of businesses/ngos, government, and individuals during each phase of re-opening. 11 Responsibilities During Re-Opening (Use Time During PCOR 1 to Begin Planning) Businesses/ngos Government PCOR 2 Individuals Face Masks* and social distancing are required at all times, and Special accommodations should be made for Vulnerable individuals. Adjusted Operating Guidelines to be submitted by industry representatives to the DPHSS prior to business opening, based on USDOL & OSHA Guidance on Preparing Workplaces for COVID19 as well as industry Best Practices. Limited occupancy rate will be established. certain public gatherings or congregations for specific purposes will continue to be prohibited. To lower the risk of spread of COVID-19, Customer-focused and commerce-related services and activities must be adjusted to incorporate: 1. social distancing mandates 2. physical workspace modifications 3. training of employees on updated policies and protocols 4. Other actions deemed necessary by each agency. Continue practicing good hygiene (i.e. wash your hands with soap and water or use hand sanitizer, avoid touching your face, sneeze or cough into a tissue or inside your elbow, disinfect frequently used items and surfaces as much as possible. People who are sick should stay home and/or contact and follow the advice of your medical provider. * Continue to adhere U.S. Centers for Disease Control and Prevention Guidance, particularly with respect to face coverings. 12 Role of The Department of Public Health and Social Services The DPHSS will advise and inform the governor on emerging medical data and public health preparedness related to the triggers. For any inquiries related to The opening of businesses/non-governmental organizations: Guam Economic Development Authority: TEL: 671-647-4332 roadtorecovery@investguam.com EMAIL: Website: www.investguam.com/roadtorecovery Guam Visitors Bureau: Tel: 671-646-5278 CommunityRelations@visitguam.org EMAIL: Website: www.visitguam.com Guam Chamber of Commerce: TEL: 671-472-6311 ccastro@guamchamber.com.gu EMAIL: Website: www.guamchamber.com.gu Guam Women’s Chamber of Commerce: TEL: 671-487-7022 connect@guamwomenschamber.com EMAIL: WEBSITE: www.guamwomenschamber.com 13 Governor Lourdes A. Leon Guerrero Lieutenant Governor Joshua F. Tenorio Guam Recovery Panel of Advisors: Organizational affiliations are provided for the purposes of member identification, not as indications of institutional endorsement of the ChÅlan para hinemlo’ guidelines. Artemio “Ricky” Hernandez, Ph.D., CGFM Michael W. Cruz, M.D., MBA Deputy Administrator, Guam Economic Development Authority; Adjunct Instructor of Accounting and Public Administration, University of Guam State Surgeon, Guam; President and Chief Executive Officer, Guam Regional Medical City; Former Lieutenant Governor of Guam Christine Baleto, MBA David John Chairwoman, Guam Chamber of Commerce; Chief Financial Officer, Docomo Pacific Chairman, Guam Economic Development Authority Board of Directors; Chief Financial Officer, ASC Trust Corporation Joseph P. Bradley Senior Vice President/Chief Economist, Bank of GUam Joaquin P. Cook Pilar LaguaÑa President and Chief Executive Officer, Guam Visitors Bureau President and Chief Executive Officer, Bank of Guam Holly Rustick W. Thane Hancock, M.D. President, Guam Women’s Chamber of Commerce; Founder and Owner, WEGO Consulting; Instructor of English, College of Liberal Arts and Social Sciences, University of Guam Medical Epidemiologist, Centers for Disease Control and Prevention 14