COVID-19 pandemic in Guam

• February 7: The Government of Guam denied the entry request by the cruise ship MS Westerdam, which had potentially infected passengers.[9]

Guam Army National Guardsman at a COVID-19 isolation site, March 22

• March 9: The Guam Department of Public Health and Social Services received its first COVID-19 test kits from the U.S. Centers for Disease Control and Prevention.[10]
• March 13: Antonio B. Won Pat International Airport began checking arrivals for fever.[11]
• March 15: The first three cases of COVID-19 in the territory were confirmed.[12]

  The Mayors' Council of Guam suspended all village-sponsored events and activities. It was announced that public senior citizen centers would close on March 18. Guam Memorial Hospital restricted its emergency department to staff and patients only.[13]

• March 16: Public schools closed.[14]

  Gathering of 50 or more people in a single room prohibited. Arriving travelers from areas affected by COVID-19 subject to mandatory quarantine.[15]

• March 17: Naval Base Guam and Andersen Air Force Base closed on-base programs and limited base access.[16] Defense Department schools were closed until further notice.[17]
• March 20: Governor Lou Leon Guerrero's executive order shuts down nonessential businesses and gatherings. The same day, Japan Airlines announced flights from Narita Airport would be suspended until April 24.[18]

The Guam Air National Guard assisting Guam police at an isolation facility. The Guam National Guard was activated by Gov. Lou Leon Guerrero on March 21 to assist with COVID-19 efforts.

• March 22: The Governor of Guam declares a State of Emergency.[19]

  The territory's first death from the virus, a 68-year-old woman with "multiple co-morbidities."[20]

• March 25: Four sailors with COVID-19 evacuated from USS Theodore Roosevelt and flown to Naval Base Guam for treatment.[21] (See COVID-19 pandemic on USS Theodore Roosevelt.)
• March 26: The University of Guam announced that all classes were moving to an online or alternate format for the remainder of the spring semester. The university planned to complete the semester on its current schedule.[22]

  USS Theodore Roosevelt docked at Naval Base Guam due to an outbreak on board.[23]

• March 27: The territory had confirmed 45 positive COVID-19 cases out of 308 total tests.[24]
• March 28: United States President Donald Trump approved a disaster declaration for Guam that orders Federal assistance to supplement territory and local coronavirus recovery efforts.[25] The President also signed the national $2 trillion COVID-19 relief bill with approximately $111 million allocated to Guam.[25]
• March 31: The Governor's Press Secretary Krystal Paco-San Agustin confirmed two new cases of the coronavirus. Guam's Public Health Lab had tested 20 samples with the remaining 18 coming back negative.[26]

Military personnel from the Guam National Guard and Air Force's 254th REDHORSE Squadron coordinating the potential transformation of a high school in Dededo to an alternative COVID-19 care facility in April 2020

• April 4: The government projected that with a 20% reduction in the spread, COVID-19 would kill 3,000 people in five months. The population of Guam is approximately 160,000 – indicating that COVID-19 would kill about 1.8% of the territory in five months. The governor urged the populace to reduce the rate of spread.[27]

  Governor Leon Guerrero announced that residents would be prohibited from driving for non-essential reasons from April 7. Road checkpoints would be manned by police and the Guam National Guard.[28] Residents rushed to stores and banks before the restrictions.[29]

  The Navy announced that they had secured an agreement to quarantine about 3,000 sailors from USS Theodore Roosevelt in local hotel rooms.[30]

• April 5: The Public Health Emergency was extended until May 5.[31]

  An executive order authorized extra pay for government workers based on their potential exposure to the virus; the maximum of an additional 25% was reserved for law enforcement, health care providers, and others with direct contact with likely infected members of the public.[31]

  GovGuam announced that the military would be contributing 30 ventilators to local efforts.[31]

• April 6: The Guam Department of Education Superintendent officially canceled classes for the remainder of the school year.[32]
• April 7: It was reported that most of Guam's positive cases had tracked epidemiological links to other known cases.[33]
• April 9: GovGuam cleared land for an additional 500 plots at the island's public cemetery in anticipation of future COVID-19 casualties. GovGuam has also temporarily waived the $500 burial fee at Vicente A. Limtiaco Memorial Cemetery in Piti. The director of the Guam Department of Parks and Recreation stated, "We're all praying the surge doesn’t happen."[34]
• April 10: Governor Leon Guerrero announced the closure of designated road lanes, where traffic will be funneled into chokepoints and National Guardsmen will ask drivers about the purpose of their trip. These can no longer be referred to as "checkpoints," as the Attorney General of Guam has advised that the government does not have the authority to create disease checkpoints.[35]
• April 12: The University of Guam announced that it was delivering almost 300 meals daily to health care workers and volunteers at the Department of Public Health and Social Services sites. The food was donated from various restaurants, wholesalers, organizations, and individuals, with any bulk food prepared by restaurant and catering business Nayon Express, before being delivered by UOG staff.[36]
• April 13: A sailor from USS Theodore Roosevelt died.[37]

  Joint Region Marianas Commander Rear Adm. John Menoni announced that a sailor from USS Theodore Roosevelt had broken quarantine in the local hotel that they were located within and an investigation was ongoing.[38]

  Gov. Leon Guerrero urged the Legislature of Guam to pass bills that would allow her to set a curfew and create checkpoints with penalties.[39]

National Guard officers go over administrative procedures for COVID-19 testing at the Readiness Center in Barrigada, April 23

• April 15: The Department of Defense is building COVID-19 field hospitals on two military properties on Guam: a 150-bed hospital at the South Finegayan property in Dededo and a 75-bed field hospital on the grounds of Naval Hospital Guam in Agana Heights. Gov. Leon Guerrero reported that Defense Secretary Mark Esper told her that the military would make the field tents and equipment available for use by Guam once their mission in completed.[40][41]

Gov. Lou Leon Guerrero and Lt. Gov. Josh Tenorio visiting temporary medical facilities on Naval Base Guam, April 29

• April 22: Most airlines extended their flight cancellations until the end of May. United Airlines remained the sole operator during the pandemic, with daily service to Honolulu and thrice-weekly service to Narita.[42]

  Guam Regional Medical City, which was designated for non-COVID-19 care on the island, reported that it was being overwhelmed with serious cases, partially because many patients had delayed preventative care and early treatment during the pandemic. Nurses reported a 300% increase in rapid response calls and the corresponding increase in the number of deaths.[43]

  In response to GovGuam claims that the epidemiological curve had been flattened, a Guam Daily Post editorial noted that recent COVID-19 testing had been a third of that conducted earlier in the pandemic, and urged caution about re-opening measures.[44]

• April 30: Gov. Lou Leon Guerrero signed Executive Order 2020-11 adopting the Chålan Para Hinemlo’ (Road to Recovery) plan developed by the Guam Recovery Panel of Advisors, including a four-step Pandemic Condition of Readiness (PCOR) system ranging from maximum restrictions at 1 to no restrictions at 4.[45][46]

  Leon Guerrero announced that GovGuam is tentatively planning to move from PCOR 1, restricting social gatherings and shutting down non-essential businesses and activities, to PCOR 2 on May 9, allowing some government offices and businesses to open.[47]

Government of Guam officials touring the Expeditionary Medical Facility onboard Naval Base Guam.

• May 5: U.S. Immigration and Customs Enforcement executed an armed raid of MedPharm Group of Companies, one of the island's largest provider of medical supplies and pharmaceuticals. The Homeland Security spokesperson confirmed that it was related to a criminal investigation regarding the pandemic.[48]
• May 6: The Department of Health and Human Services announced that it had taken 806 samples from April 25 to May 2 in an expanded testing effort with focus on those with lack of access to health care and densely populated apartment complexes, of which two were positive. Expanded testing focused on senior care facilities and apartment complexes continued.[49]
• May 7: The Roman Catholic Archdiocese of Agaña updated its Sacramental Protocols to allow live Mass with parishioners seated in their cars in church parking lots for the coming weekend. Eucharist would be offered to parishioners standing by their vehicles or seated inside. It further allowed in-person confession, anointing of the sick for non-COVID patients, and baptism. Parishioners with flu-like symptoms or compromised immune systems were instructed to remain home.[50] About 75% of Guamanians identify as Roman Catholic.[51]
• May 8: Gov. Leon Guerrero announced that Guam would move to PCOR 2 on Sunday, May 10, allowing malls, salons, shopping centers and flower shops to open at 50% capacity. People in public would continue to be required to wear masks.[52] The Agana Shopping Center and Micronesia Mall, two of the largest malls in the territory, stated that they would limit the number of open entrances and total number of occupants, and screen all entering customers for fever with thermometers.[53]

  The Guam office of the United States Census Bureau announced that they would begin a phased reopening of operations to conduct the 2020 Census starting on May 11, with full functioning not expected for several weeks.[54]

  All 26 students of the University of Guam's nursing program chose to graduate in an accelerated program so they could take their licensing exams and enter the workforce early.[55]

• May 9: Gov. Leon Guerrero stated that the mandatory 14-day quarantine of all arrivals to Guam, located at the Pacific Star Resort & Spa, would continue at least until Guam entered PCOR 3.[56]
• May 17: The Joint Information Center announced that contracts had been signed with Hotel Santa Fe and Wyndham Garden Guam to act as quarantine facilities for incoming travelers. Occupants in quarantine at the Pacific Star were to be transferred.[57][58]
• May 18: The re-opening of the Department of Revenue and Taxation in Barrigada for the first time since March drew an overflow crowd seeking to register vehicles and resolve tax situations. Guam Police and National Guard were on hand to ensure order.[59]

  Gov. Leon Guerrero indicated that the government is planning to allow dine-in service at restaurants, at 50% capacity, starting on May 25, assuming that she receives draft public health guidance for consideration on May 21. Leon Guerrero also indicated that yoga and pilates businesses may be allowed to open soon as well, though she indicated that gyms are "a little bit more risky."[60]

• May 21: A "residential cluster" of ten positive cases were discovered through contact tracing and had contact with two other confirmed cases; the one unrelated positive case was also traced via a confirmed case. The governor stated that the island would not elevate to PCOR 1.[61]

  USS Theodore Roosevelt returned to sea with a reduced number of crew to conduct carrier qualification flights for Carrier Air Wing Eleven. Capt. Carlos Sardiello released a statement thanking the government and people of Guam for their support and hospitality.[62]

• May 22: With the discovery of a "residential cluster" in Yigo, with the third largest single-day increase in confirmed cases since the pandemic began, GovGuam announced that Guam will stay at PCOR 2 with no immediate lifting of restrictions, as had been planned for May 25.[63]
• May 23: Archbishop Michael J. Byrnes announced that the Archdiocese of Agaña would begin conducting services inside churches starting on May 30. Masks will be required and churches will be limited to 50% capacity.[64]
• May 27: GovGuam announced that, barring a surge in new cases, the following operations are allowed to reopen on May 29, with specified conditions and safeguards: dine-in restaurants; churches; yoga, pilates, and dance businesses; and public beaches and parks. Salad bars, buffets, and other types of food self-service are prohibited. Groups of up to 25 will be allowed.[65][66]

  Similarly, beginning July 1, visitors from Japan, South Korea, and Taiwan will be able to enter Guam without a 14-day quarantine. Gov. Leon Guerrero explained that those countries are not hotspots and have effective infection control. Besides United Airlines, which continues to be the sole carrier servicing Guam, only Korea's Jeju Air and Philippines Airlines have indicated that they would consider resuming operations to Guam in the summer.[66][65]

  The Guam Department of Education indicated that high school students in summer school would physically meet with teachers once or twice a week and be otherwise remote. Kindergarten though eight grade will continue with remote learning. GDOE assumes that Guam will be at PCOR 3 and school buildings will be open for the new school year, but is examining options for distance learning if not.[67]

• June 1: All GovGuam agencies reopened. Gov. Leon Guerrero announced that returning residents will be allowed to quarantine at home, as long as they have proof of residence.[68]
• June 4: USS Theodore Roosevelt left Guam about two months after it first docked amid its outbreak. Some sailors who had not yet been medically cleared remained on Naval Base Guam.[69]
• June 8: Food courts, gyms, pools, and water parks were allowed to open, with specified health protocols. GovGuam announced that arrivals from "international hot spots" would have to undergo a 14-day quarantine.[70][71]

  The five-day rolling positivity rate for testing was 0.34%, compared to the 3% benchmark the government had set to move to PCOR 3. An advisor to the governor indicated that Guam was on track to move to PCOR 3 on July 1.[72]

• June 9: The first new confirmed COVID-19 case in several days was identified on Andersen Air Force Base and described as asymptomatic.[73]
• June 10: A study on the outbreak aboard USS Theodore Roosevelt found that two-thirds of sailors had been infected.[74]
• June 12: The resumption of Philippine Airlines' service to Manila was delayed until June 15 due to "evolving national and provincial government restrictions and limitations." Guam had designated the Philippines as a "hotspot" requiring travelers to quarantine for 10 days.[75]
• June 13: Naval Base Guam restored all-week access to military facilities for all authorized users on Guam.[76]
• June 15: GovGuam increased the standard for confirmed cases to be released from quarantine to 10 days after recovery.[77]
• June 16: Philippine Airlines resumed flights to Guam, with plans to operate weekly flights in July. Korean Air, Jin Air, Jeju Air and T'way Air tentatively plan to resume flights on July 27, subject to travel demand and the lifting of mandatory quarantines in South Korea. Japan Airlines extended it flight suspension to July 31, while China Airlines has suspended flights through August.[78]
• June 17: Authorities revealed a cluster of seven Air Force airmen that arrived on Guam on May 25 and were housed together at a local hotel. Seventeen days after arrival one of the airman began showing symptoms. COVID-19 is generally thought to become symptomatic within 14 days. The Department of Public Health and Social Services and Andersen Air Force Base are contact tracing.[79]
• June 19: Bars, taverns, daycare centers, bowling alleys, travel agencies, museums, zoos, and aquariums were allowed to open at 50% capacity. Bars were allowed to open at 25% capacity and bar-restaurants at 50% capacity.[80][81]

  The Guam Visitors Bureau reported that tourism-related retail sales have dropped $34 million per week from before the pandemic.[82]

• June 22: The total Air Force servicemembers infected with coronavirus reached 37. The cluster in the Air Force unit that was housed at the Guam Reef Hotel reached 35 infected. All members of the unit were tested and put in mandatory quarantine on Andersen Air Force Base. Several airmen reportedly violated orders limiting their movement to the hotel and their work on base, and potentially exposed local businesses and employees. DPHSS was notifying businesses and planned to conduct testing of potentially exposed employees.[83][84] Rear Adm. John Menoni, Joint Region Marianas Commander, stated, "Today we don't have all the facts as to how and why. We know we have an issue, we are working to find solutions, we need to fix this problem."[85] DPHSS has

  Gov. Lou Leon Guerrero indicated that the government is looking to reopen more business types and increase the limit on social gatherings to 50, from 25, on July 1. She stated "our infection rate, even with the increase through the military, still remains below 1%. That is still really amazing."[86] Leon Guerrero further stated that plans to lift the mandatory quarantine on incoming travelers by July 1 remained on track, but that shifting to PCOR 3 remained tentative.[87]

• June 23: A positive test came back for someone with no known contact with other confirmed COVID cases.[88]
• June 24: DPHSS identified 30 businesses visited by airmen in the Guam Reef Hotel cluster who tested positive for COVID-19. Residents who patronized these businesses on affected dates were urged to closely monitor their health as DPHSS arranged for additional testing capacity in the following week.[89][90]

  Disaster food relief distributions will restart on June 25, 2020 and continue every other Thursday, on a first-come, first-served basis.[91]

• June 25: A symptomatic Department of Corrections employee was one of 14 new positive cases.[92][93]

  DPHSS confirmed that the initial patient at the Guam Reef Hotel outbreak was a local resident.[92]

  DPHSS Director Linda Unpingco-DeNorcey announced that she would retire on July 3, with Laurent Duenas to become acting director.[92]

• July 26: Gov. Leon Guerrero extended the public health emergency through July and canceled the reopening of tourism planned for July 1. Gatherings will limited to 25 people through July 1. The islandwide beach cleanup and beautification scheduled for June 27 was canceled. Guam had the greatest one-week increase of confirmed COVID-19 cases in the United States at 438%. The governor appealed for continued vigilance from the public.[94]

As the plan was announced, Guam was currently at PCOR 1 with plans to transition to PCOR 2 by May 9.

Guam transitioned to PCOR 2 on May 10. At PCOR 2 the following business and non-governmental organizations are authorized to open at a limited basis after such organizations receive an approved adjustment of operations from the Guam Department of Public Health and Social Services:[97]

• All Essential Organizations in operation under PCOR 1;
• Retail Stores;
• Real Estate and Automotive Sales;
• Beauty Salons, Cosmetic stores, and Barber Shops;
• Shopping Centers and Malls; and
• Elective medical and dental procedures.

Under PCOR 2, the following organizational activities are under review:

• Sit down Restaurants and Bars;
• Gyms and Spas;
• Outdoor sporting;
• Group Tours; and
• Bingo.

The following activities fulfilled by the Government of Guam are authorized under PCOR 2:[97]

• All government services available under PCOR 1;
• Department of Revenue and Taxation services:
  • Taxpayer Services;
  • Real Property Tax Division;
  • Motor Vehicle License and Registration Offices;
  • Business License Operations; and
  • Insurance and Banking Operations.
• Department of Public Works permit processing and inspections;
• Department of Land Management real estate and permitting services;
• Department of Administration operations;
• Department of Labor regulatory and COVID-19 relief services;
• Department of Public Health and Social Services health and sanitary licensing;
• Department of Parks and Recreation services;
• Environmental Protection Agency services;
• Police Department records services;
• Department of Agriculture services;
• Housing and Urban Renewal Authority services;
• Office of Veterans Affairs services;
• Election Commission services; and
• The Guam Mayors' Council services.

According to the recovery plan, in order for Guam to have transitioned from PCOR 1 to PCOR 2 the following conditions must have been met:[97]

• Cases: a downward trend of confirmed and positive cases as a percent of total tests over a two-week period;
• Standard of Care: Hospitals have adequate resources to ensure that every patient is able to receive the appropriate standard of care, unless altered for non-COVID-19 reasons;
• Testing: All residents of Guam needing COVID-19 testing are able to receive testing; and
• Contact Tracing: The Guam Department of Public Health and Human Services has the capacity to monitor all current COVID-19 cases.

In order for Guam to transition from PCOR 2 to PCOR 3 the following conditions must be met:[97]

• Cases: a downward trend of confirmed and positive cases as a percent of total tests over a 4-week period;
• Standard of Care: Hospitals have adequate resources to ensure that every patient is able to receive the appropriate standard of care, unless altered for non-COVID-19 reasons (same as PCOR 2);
• Testing: All residents and travelers through Guam are able to receive affordable and reliable COVID-19 testing; and
• Contact Tracing: The Guam Department of Public Health and Human Services has the capacity to monitor all current COVID-19 cases (same as PCOR 2).

In order for Guam to transition from PCOR 3 to PCOR 4, where all COVID-19 quarantine restrictions are lifted, one of the following conditions must be met:[97]

• Vaccination: Adequate herd immunity for Guam is achieved and confirmed through the administration of FDA approved COVID-19 vaccines; OR
• Herd Immunity: Adequate herd immunity for Guam is achieved and confirmed through natural disease and recovery.