Pago Pago, AMERICAN SAMOA — Governor Lemanu Peleti Mauga signed on Friday an amended version of the recent Emergency Declaration.  It now gives DOH the authority to quarantine a person for up to 21 days without a court order.  This is a result of the recent cluster of new cases currently in quarantine. 

According to an email to the media from the Governor’s Office, this quarantine is for people who have been exposed to contagious diseases, not sick people.  Isolation is for sick people.  Here are the definitions from A.S.C.A. § 13.0203: 

(28) “Isolate”, “isolated”, or “isolation” means the physical separation and confinement of an individual or groups of individuals who are infected or reasonably believed to be infected with a contagious or possibly contagious disease from non-isolated individuals, to prevent or limit the transmission of the diseases to non-isolated individuals.

(39) “Quarantine” means the physical separation and confinement of an individual or groups of individuals, who are or may have been exposed to a contagious or possibly contagious disease and who do not show signs or symptoms of a contagious disease, from non-quarantined individuals, to prevent or limit the transmission of the disease to non-quarantined individuals.

This comes after two more positive cases were detected after the third round of tests. Details as they become available.

In the meantime, concerns over “self-swabbing” by travelers at the testing provider company in Honolulu for those coming to American Samoa, and provisions of the law that ASG plans to use to prosecute those who were not truthful in filing out the TALOFAPASS registration online were some of the issues covered in a Senate committee hearing Wednesday with Health Department and LBJ Medical Center officials.

The American Samoa Medicaid State Agency announced in a news release late last year that the cost of the required COVID testing in Hawaii for travelers to the territory, who are bona fide local residents, is covered under the American Samoa Medicaid Plan.

ASG Medicaid director Sandra King-Young was also quoted in the statement that the testing provider in Honolulu is Capture Diagnostics and: “We have agreed with the provider they will prioritize testing for American Samoa travelers because of the time sensitivity of the testing protocols —  will be provided within 24 hours of testing.”

But there have been reports from travelers that have reached lawmakers since early on at the re-start of commercial flights last September, that it’s the traveler who actually does the nasal swab for the testing in Honolulu — not medical staff.

And at least four senators shared this same issue with DoH officials during Wednesday’s hearing, as the committee sought to find out why there’s a high number of positive COVID-19 cases from the Jan. 27 flight from Honolulu — 39 travelers — compared to previous flights.

One of the many questions raised by Sen. Magalei Logovi’i deals with the tests done in Honolulu for travelers, whose three tests must all be negative and posted to the TALOFAPASS system where travelers register to enter the territory.

Magalei shared with the DoH officials about calls he received from quarantine travelers who had to do their own nasal swab and that some of the travelers are not doing it correctly. For example, a traveler puts the swap up to the tip of the nose and then returns it to the test provider official who observed the process.

Sen. Uti Petelo who recently returned from Honolulu spoke from experience because he actually observed travelers not doing the nasal swab correctly.

Sen. Togiola T.A. Tulafono shared the same concern after hearing similar reports of travelers not being honest with the nasal swab when doing it themselves, while in American Samoa it’s the DoH medical personnel who conduct the tests.

DoH Clinical Service acting director Dr. Elizabeth Lauvao responded that Capture Diagnostic’s “protocol is self-swab” by the traveler while being observed by a company official.

Togiola disagrees with “self-swab” by the traveler, saying that the protocols and directive for testing comes from American Samoa.

Health director Motusa Tuileama Nua responded that this same issue has been raised by the community, discussed by the COVID-19 Task Force as well as with the testing provider, which is the only contractor able to work with travelers on the time-frame required for three separate tests prior to boarding the flight to the territory. Other providers require the traveler to make an advance appointment and then await the results.

(Samoa News received information that other providers also require the traveler to pay a fee for the test.)

Togiola said Motusa’s explanation still doesn’t answer his question, because the response doesn’t provide a “solution” to address this concern. He points out that if there were previous complaints about this testing protocol, why weren’t corrective actions taken.

According to the former governor, travelers from previous Hawaiian Airlines flights have raised the same complaints and there should have been a solution in place by now.

LBJ Medical Center’s Chief Medical Officer, Dr. Iotamo Saleapaga — who along with other hospital officials attended the hearing — said this is the same issue that was raised in the recent task force meeting, questioning the testing protocol in Honolulu due to the high number of positives on the Jan. 27 flight compared to previous ones.

Senators became even more concerned when DoH’s Dr. Aifli John Tufa — the territory’s lead Epidemiologist — told the committee that the testing machine utilized by DoH is “a lot more sensitive” compared to the one used by the Honolulu testing provider.

Dr. Tufa explained that the Honolulu testing provider uses the Accula machine and provided “very good test” results; however, if a person has a lower “viral load” — the machine won’t be able to capture the lower “viral load” compared to the Gene-Xpert machine, which is “a lot more sensitive” and used by DoH.

He further explained about travelers who previously had the virus but were not infectious — “those individuals have very low viral-load, but they’re not infectious. When they come here” the DoH test can pick up the low viral load.

Dr. Tufa’s explanation and revelation came when he provided answers as to possible reasons for the high number of positives on the Jan. 27 flight.

He noted that some of those who were infected with the virus prior to travelling here, are “historical positive” — and DoH can review these cases, if there is documentation to show the traveler had a prior infection.

But if the traveler who was previously infected but didn’t provide that information to DoH, those cases — when later tested positive — are “classified” by DoH as a “new positive”.

The committee suggested that DoH put more “focus” on the testing in Hawaii for future flights.

Senators also queried DoH officials on reports that some of the travelers weren’t truthful in filling out the registration on TALOFAPASS — not reporting that they previously had tested positive for the virus.

Motusa responded that those travelers who “falsify information” on TALOFAPASS — not reporting that they had previously tested positive for the virus — will have their names submitted to the Attorney General, who will make the decision whether or not to prosecute. He said a list of names is being compiled of these individuals, along with the names of travelers who damaged property at the quarantine sites for submission to the AG.

Togiola recalled hearing reports about the task force chairman, Lt. Gov. Talauega Eleasalo Ale saying that there are penalties under local law to deal with travelers who are untruthful in registration on TALOFAPASS.

Togiola, a practicing local attorney and a member of the American Samoa Bar Association, asked the task force — what specific law is Talauega referring to as well as its penalties.

Motusa said he would refer the question to the task force to provide the appropriate reply.

Togiola revealed that legislation is being drafted to address this issue, to penalize the person who is untruthful, and the Senate wants to know where the current law stands.

The senator said the Senate cannot find provisions of the law with a penalty as stated by the task force chair.

In a news release Wednesday, based on the weekly meeting on Monday, the task force said it has recommended that the names of the unruly travelers and also those who fail to disclose their previous COVID-19 history on TALOFAPASS be referred to the Attorney General’s Office for prosecution.

Samoa News notes that a provision in the last and current COVID-19 declarations states that: “Any person who makes false statements or provides fraudulent documents to TALOFAPASS will be subject to criminal prosecution and civil liability.”

Another penalty noted during the last task force meeting for people who make false statements, or provide fraudulent documents to TALOFAPASS, as well as those who damage quarantine facilities or physically or verbally assault quarantine staff, is that such individuals would be required to “pay” for their quarantine. Currently all quarantine expenses are being paid for by the government.

Another issue covered by the committee hearing was whether a person who is fully vaccinated, with a booster can be infected with the virus. (See Samoa News editions Wednesday and Monday this week for details from the DoH press conference in which this issue was discussed.