by Samoa News staff

While waiting for at least one-week to verify a second surge of the community spread of COVID-19 in the territory, the Health Department has already proposed a response plan, as the number of new positive cases increased to 344 for the week of July 4 to 10 compared to 317 new positives in the previous week.

DoH presented its proposed plan, during Tuesday’s COVID-19 Task Force meeting, where Health Clinical Service director, Dr. Elizabeth Lauvao presented the department’s weekly COVID-19 Situational Report, which shows a spike in the number of positive cases including Manu’a as the community spread reaches Olosega island.

Dr. Lauvao pointed to the Epiccurve chart, which indicates a slow-surge in the community spread, or a second surge, but DoH needs one more week to get a better picture, according to ASG officials who attended the task force meeting.

DoH also noted that most cases are in the Tafuna area and are in the age group of 12-40 years old. And DoH will keep an eye on the “second surge” as the department urged the community to mask up and observe social distancing — especially indoors.

DoH also presented to the task force a proposal for a “COVID-19 Second Surge Response Plan”.

Under Plan A, DoH would adopt the three levels of alert in relation to a second surge of the COVID-19 outbreak. “These alert levels are predicated upon the total number of cases to the potential worst case of widespread community transmission,” according to DoH documents.

Based on daily positive cases count, Level 1 alert is activated when new cases are fewer than 100, in the double digits; Level 2 when new positives are more than 200; and more than 300 daily cases for level 3, which is the highest level.  DoH also provided a summary explanation for each level and actions to be taken.

DoH also has a Plan B, which does not recommend reinstating local COVID-19 restrictions, but suggested to observe and provide targeted individual medical response only as necessary.

“This plan is based on data showing that surges are to be expected but will not be high as the initial surge as demonstrated by other countries,” it says and provided justifications for Plan B.

“Although the number of cases is increasing, it is not a true reflection of the burden of disease in the community,” DoH explained in one justification. “Absolute numbers are rarely used to assess a situation in Epidemiology. Instead, rates are used to standardize numbers for comparison.”

Other factors to consider include: the 7-day case average; whether the cases are symptomatic or not; the number of hospitalizations and whether the primary complaint was COVID-19 related or not; the test used and its sensitivity/specificity; mortality rates and the primary cause of death; ICU admissions/ventilation rates and the primary cause of admission/ventilation.

For example, the current surge includes a lot of asymptomatic individuals whose contribution to the disease burden is not significant. Also, out of those admitted only a small proportion are admitted with a primary diagnosis of COVID-19. For others, COVID-19 is a secondary diagnosis.

DoH also says that restrictions were essential before the introduction of the virus to the territory. And now that “we have the outbreak and there are cases on every village both in Tutuila and Manu’a then the strategy changes from community-based restrictions to patient-centered treatments,” said DoH.

In conclusion, DoH emphasized that there are only suggestions for a way forward for the current surge in COVID-19 cases.

Samoa News will report on the specifics of DoH’s response plan, once its given final approval and released by the task force. The response plan has already circulated among several lawmakers, who plan to call for Fono hearings.