Guam, one of the external territories of the United States of America confirmed its first case of the COVID-19 pandemic on March 15, 2020, and the first death on March 22. The Government of Guam ordered the general lockdown of the island in mid-March. Governor Lou Leon Guerrero announced the implementation of a four-step "Pandemic Condition of Readiness" (PCOR) on April 30, 2020. Travelers to Guam from designated high-risk areas must provide a recent negative COVID-19 test or undergo mandatory quarantine in a government-approved facility. Guam moved from PCOR 1 to PCOR 2 on May 10, allowing some business activity with restrictions, and then to PCOR 3 on July 20. An outbreak in mid-August was not controlled for several months, resulting in the 7-day rolling test positivity rate to spike above 15% in early October 2020, as well as infections in both the Governor and Lieutenant Governor. Guam announced a return to the lockdown conditions of PCOR 1 on August 14 to control the outbreak, which was not loosened to PCOR 2 until January 15, 2021. It was further relaxed to PCOR 3 on February 21, 2021. From December 2020 to July 2021 cases stayed very low until a surge in August 2021 largely as a result of the delta variant. By October 2021, 90% of the population was vaccinated.
By May 7, 2021, there had been 8,023 confirmed and suspected cases, resulting in 139 deaths. 95 cases were in active quarantine. According to the weekly situation report issued on May 7, 2021, 59 cases had tested positive in the previous seven days, for a test percent positivity of 2.9%. Nine cases was identified through contact tracing and seven were travelers from other parts of the United States, of which six were identified in quarantine. The 1,156 cases and one death from the USS Theodore Roosevelt, which docked at Guam amid its 2020 outbreak, are counted separately.
Background On 12 January, the World Health Organization (WHO) confirmed that a novel coronavirus was the cause of a respiratory illness in Wuhan City, Hubei Province, China, who had initially come to the attention of the WHO on 31 December 2019. Unlike SARS of 2003, the case fatality ratio for COVID-19 has been much lower, but the transmission has been significantly greater, with a significant total death toll.
Tourism from East Asian countries is a pillar of Guam's economy. In December 2019, there were 67,000 visitors from Japan (first confirmed COVID-19 case on 15 January) and 71,000 from South Korea (first case 20 January). Visitors from the US, Taiwan, Philippines, and China made up less than 10% of December 2019 arrivals. In comparison, the total population of Guam is about 165,000.
Timeline
February 2020
February 7: The Government of Guam denied the entry request by the cruise ship , which had potentially infected passengers.
March 2020
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. March 13: Antonio B. Won Pat International Airport began checking arrivals for fever. March 15: The first three cases of COVID-19 in the territory were confirmed. 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. March 16: Public schools closed. Gathering of 50 or more people in a single room prohibited. Arriving travelers from areas affected by COVID-19 subject to mandatory quarantine. March 17: Naval Base Guam and Andersen Air Force Base closed on-base programs and limited base access. Defense Department schools were closed until further notice. 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.
March 22: The Governor of Guam declares a State of Emergency. The territory's first death from the virus, a 68-year-old woman with "multiple co-morbidities." March 25: Four sailors with COVID-19 evacuated from and flown to Naval Base Guam for treatment. (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. USS Theodore Roosevelt docked at Naval Base Guam due to an outbreak on board. March 27: The territory had confirmed 45 positive COVID-19 cases out of 308 total tests. 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. The President also signed the national $2 trillion COVID-19 relief bill with approximately $111 million allocated to Guam. 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.
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. Governor Leon Guerrero announced that residents would be prohibited from driving for non-essential reasons from April 7. Road checkpoints would be guarded by both police and the Guam National Guard. Residents rushed to stores and banks before the restrictions. The Navy announced that they had secured an agreement to quarantine about 3,000 sailors from USS Theodore Roosevelt in local hotel rooms. April 5: The Public Health Emergency was extended until May 5. 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. GovGuam announced that the military would be contributing 30 ventilators to local efforts. April 6: The Guam Department of Education Superintendent officially canceled classes for the remainder of the school year. April 7: It was reported that most of Guam's positive cases had tracked epidemiological links to other known cases. 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." 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. 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. April 13: A sailor from USS Theodore Roosevelt died. 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. Gov. Leon Guerrero urged the Legislature of Guam to pass bills that would allow her to set a curfew and create checkpoints with penalties.
April 15: The Department of Defense is building COVID-19 field hospitals on two military properties on Guam: a 150-bed hospital from the US Navy Seabees at the South Finegayan property in Dededo and a 75-bed field hospital from the US Air Force Red Horses 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.
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. 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 preventive 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. 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. 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. 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.
May 2020
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. 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. 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. About 75% of Guamanians identify as Roman Catholic. 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. 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. 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.