COVID-19 Physicians’ Alerts

March 30, 2020 – Click for PDF Version

PHYSICIANS’ ALERT ON COMMERCIAL TESTING FOR COVID-19 AVAILABLE THROUGH DIAGNOSTIC LABORATORY SERVICES (DLS) via DPHSS Health Professional Licensing Office (HPLO)

Effective March 31, 2020, commercial testing will be available through Diagnostic Laboratory Services (DLS). Health care providers can now refer specimens from patients who do not meet the criteria for priority group testing directly to Diagnostic Laboratory Services (DLS).

COVID-19 testing is covered under MEDICARE, MEDICAID, and MIP. If you have a mild illness and want to be tested, contact your health care provider.

GUAM PUBLIC HEALTH LABORATORY (GPHL) COVID-19 Testing remains limited to these Priority Groups:

Please swab priority patients and forward specimens to the GPHL accordingly.

Telephone contact no longer necessary unless you have additional questions (888- 9276).

April 10, 2020 Click for PDF Version

PHYSICIANS’ ALERT ON PATIENT INSTRUCTIONS SUSPECT COVID-19 via DPHSS Health Professional Licensing Office (HPLO)

Thank you for your continued collaboration with the Guam Department of Public Health and Social Services (DPHSS) in combating COVID-19 in Guam.

We are reminding providers to ask all patients swabbed for COVID-19 to start home self­-isolation while waiting for the test results. We hope this will add another layer of action to help slow the spread of COVID-19 in Guam. To help support this, the Guam DPHSS has developed the attached two-page information sheet on home self-isolation. We are asking you to give this sheet to patients you will swab for COVID-19.

In addition, to help improve our analysis of the outbreak dynamics, we are asking that clinic staff do their best to completely fill out the PUI testing request form.  This data is used to help evaluate the outbreak and refine our mitigation efforts. Consider each piece of information you add to the form as another step you are taking to help stop COVID-19 transmission in Guam.

Click for Self-Isolation Instructions and PUI Testing Request PDF

July 7, 2020 Click for PDF Version

PHYSICIANS ALERT ON MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN (MIS-C) ASSOCIATED WITH COVID-19via DPHSS Health Professional Licensing Office

On May 14, 2020, the U.S. Centers for Disease Control and Prevention (CDC) released a Health Advisory for Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19). All healthcare providers on Guam are urged to be on alert for possible cases of MIS-C and to report them to the Guam Department of Public Health and Social Services (DPHSS).

Patients with MIS-C have presented with persistent fever, fatigue, and a variety of signs and symptoms including multiorgan (e.g., cardiac, gastrointestinal, renal, hematologic, dermatologic, neurologic) involvement, and elevated inflammatory markers. Not all children will have the same signs and symptoms, and some children may have symptoms not listed here. MIS-C may begin weeks after a child is infected with SARS-CoV-2. The child may have been infected from an asymptomatic contact and, in some cases, the child and their caregivers may not even know they had been infected.

Case Definition for Multisystem Inflammatory Syndrome in Children (MIS-C)

  • An individual aged <21 years presenting with feveri, laboratory evidence of inflammationii, and evidence of clinically severe illness requiring hospitalization, with multisystem (>2) organ involvement (cardiac, renal, respiratory, hematologic, gastrointestinal, dermatologic or neurological); and
  • No alternative plausible diagnoses; and
  • Positive for current or recent SARS-CoV-2 infection by RT-PCR, serology, or antigen test; or COVID-19 exposure within the 4 weeks prior to the onset of symptoms

iFever >38.0°C for ≥24 hours, or report of subjective fever lasting ≥24 hours
iiIncluding, but not limited to, one or more of the following: an elevated C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen, procalcitonin, d-dimer, ferritin, lactic acid dehydrogenase (LDH), or interleukin 6 (IL-6), elevated neutrophils, reduced lymphocytes and low albumin

Additional comments

  • Some individuals may fulfill full or partial criteria for Kawasaki disease but should be reported if they meet the case definition for MIS-C
  • Consider MIS-C in any pediatric death with evidence of SARS-CoV-2 infection

Healthcare providers who have cared or are caring for patients younger than 21 years of age meeting MIS-C criteria should report suspected cases to DPHSS.

Information for healthcare providers regarding evaluation and treatment of MIS-C cases can be found at https://www.cdc.gov/mis-c/hcp/.

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