• Peter Lombard MD

Guam COVID update for April 7th, evening edition.

Guam COVID update for April 7th, evening edition.

Big day of testing, 35 done locally for Guam, 5 for Saipan. Let’s all take a moment to realize how important it will be for Saipan to control their coronavirus outbreak considering the high frequency of travel between the two islands. I think everyone would agree it’s appropriate for us to help them in whatever capacity we can. Extension of traveler quarantines will help prevent sparks from crossing over one way or another, but this won’t be around forever.

Testing numbers back up to maximum today. Let’s assume we’ll have to ask about decreased testing numbers again in the future. Regarding the past 2 days, there it was offered that there simply were less samples being taken, but it would also be nice for them to directly address if there is a backlog, and how many there are.

8 positives yesterday, that was welcome news considering it was a large batch. We can accept 10 or 11 positives per day and still stay under the 10% growth rate curve (Figure 2). On Figure 1, I removed the cumulative growth line, it doesn’t serve much purpose anymore. I replaced it with a 7 day rolling average, so I take the daily growth rate for the past 7 days and plot it. We nudged down from 10% to 8% on the 7 day rolling average. I’m also changing the way the growth rate is represented. Instead of 10%, it’ll be 1.10x, instead of 8%, it’ll be 1.08x. One of the primary reasons for doing this is that some of the online charts I reference also show growth rates like this, so it’s more useful for comparison.

Hospitalization numbers still appear flat. Eerily so. Given that yesterday’s spike had a lot of children, it’s unlikely they will translate to hospitalizations a few days from now, but there were 6 individuals from yesterday’s cases that were in the 60-69 age group. 1 or 2 of those may end up being hospitalized. All the other cases were below 60.

The surge. I’m hesitant to stick my neck out too far on this, but I just don’t think we’re going to see a massive surge based on what the data is showing me. A small surge, maybe based on the recent clusters identified. I still wholeheartedly agree with the Governor’s medical advisors’ assessments about how bad things might get, but we’re far enough along the timeline that I think there would be more signals by now if a big surge was impending .The spike yesterday was a concern, yes, but not appears like it was more of an outlier. Let us hope so.

If you head over to and look at the COVID cases by country, normalized by population and hover all the countries that have reached the 35th day, what do their 7-day growth rates look like? We’re at day 23 and already in the range of 1.08 to 1.10. What appears to happen by day 30+ is that there’s fluctuations up and down in growth rate, sometimes very low, close to 1.01 but also bouncing up to 1.15 or higher at times, but lots of numbers between 1.05 and 1.10. If we keep our growth rate here, and our recoveries start to match up with our new cases, we’ll be close to a sustainable level. 1.10 is still too high to sustain in the long run though..:

Active cases. As our recoveries increase, our active cases decrease. When daily recoveries match our new cases, we’ll be at a steady state and if we haven’t overtaxed our heath care system, we might be in the clear.

8 healthcare workers are positive out of 113 (yesterday’s numbers). That’s 7.1% of all cases. Pretty close to the Italy numbers, and really unfortunate. Let’s hope none of these suffer from severe disease. And if these were early in the course of our crisis, pray we have learned from how they were exposed to prevent future cases.

From my physician advisory group colleagues I learned some testing samples have been sent off through the DLS system, and the testing subcommittee of the group is working hard to finalize what we’ll do with the positive test results from this group, and also how we’ll handle the rapid tests that should be arriving very soon. I say very soon but I don’t have a firm date. It’s been over 3 weeks and we still have only the single device at DPHSS. The rapid tests will likely be run from the private clinics

A gem from Dr. Schiffer’s latest blog post: a very nice article, doesn't solve any problems but discusses a variety of strategies to handle the second waves, and their limitations.

Good night Guam stay safe and stay home!

(charts accessible at



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