HAGÅTÑA (The Guam Daily Post) — The majority of recent Covid-19-related deaths were classified as dead on arrival and it’s possible most of them didn’t even know they had the disease, according to a mortality report from the Office of Epidemiology and Research and the Covid-19 Surveillance unit at the Department of Public Health and Social Services.
The report was dated Sept. 20.
There have been 181 Covid-19-related deaths overall, but 39 deaths were recorded between July 7 and Sept. 20 this year, which is the timeframe of the recent surge in Covid-19 cases.
According to the report, 62% of the recent Covid-19-related deaths, or 24 individuals, were pronounced dead on arrival. Seventeen tested positive for the disease on the same day they died or immediately afterward, “implying that neither they nor anyone else knew they were infected,” the report stated.
“Less than one-third, 29%…tested positive within 2 to 12 days before they died,” the report added. “In contrast, the other deaths during this recent surge ranged from 2 to 21 days after testing positive before dying, an average of 10 days.”
The vast majority of those pronounced dead on arrival, 87%, experienced cardiac arrest, while more than half of those who were not dead on arrival reportedly experienced shortness of breath or other acute respiratory distress when admitted to the hospital, the report stated.
Most of those pronounced dead on arrival were male, about 75%. This is in contrast to those who were admitted alive and treated, the majority of whom were female, at 60%, or nine out of 15 individuals.
“The majority of all deaths during this period were among the middle-aged or elderly. Among those DOA, only one was under 30 years of age, with an average age of 64 years and a range from 29 to 95 years. Among those who were not DOA, there were two under age 40, with an average age of 66 and a range of 34 to 88 years,” the report stated.
The majority of these recent deaths were unvaccinated individuals. One person among the 24 who were pronounced dead on arrival was fully vaccinated. Five of the 15 who were admitted to the hospital but died later were vaccinated.
This recent phenomenon of patients showing up dead on arrival has been discussed by local officials and doctors, who have called attention to silent hypoxia, or a dangerous lack of oxygen that goes unnoticed.
The government of Guam released a video advising residents of “emergency warning signs for Covid-19.”
Dr. Luis Cruz, a member of a GovGuam medical task force, stated in the video that traditional symptoms, such as cough or shortness of breath, may not be apparent or may even be nonexistent, but patients’ oxygen levels still can be very low. And that has led people to die in their sleep or show up dead on arrival at the emergency rooms, he added.
The Guam Legislature held an oversight hearing Tuesday on Guam Memorial Hospital. There was a brief discussion about the patients who were pronounced dead on arrival. GMH reported 25 DOA, one more than Monday’s mortality report.
Sen. Tony Ada wanted to know who determines the causes of death.
Lillian Perez-Posadas, the administrator of the Guam Memorial Hospital Authority, said the Office of the Attorney General has a contract with the pathologist in Saipan, who arrives on the island every two weeks to perform a “look and see examination,” and he makes the determinations.
“If it’s a Covid patient, they don’t do an autopsy, they do a ‘look and see’ physical examination to see if there’s any kind of questionable event that may have caused or contributed to that individual’s demise,” Perez-Posadas said.
There is a GMH pathologist who also will perform “look and see” examinations on occasion, but neither of the doctors are forensic pathologists, she added.
Guam has had no chief medical examiner since Dr. Aurelio Espinola retired in early 2019. By law, the chief medical examiner must be a licensed forensic pathologist.
The AG has a contract with forensic pathologists in Honolulu, and they can be called to Guam if there is a need for a forensic autopsy, according to Perez-Posadas.
Ada pointed to the lack of a local forensic pathologist as a cause for concern.
“We can all say that, yes, they had Covid, and, yes, they passed away on the way in, but the actual determination I think is very critical to that,” Ada said, adding that the media have reported on patients who died last year, only to be reclassified recently as Covid-19 deaths. He called that alarming.
“If they weren’t Covid status then…what is different today that they didn’t see in December?” Ada said. “It doesn’t fall on the purview of the hospital, but…the hospital, too, should be concerned that if we can’t determine the cause of death because we don’t have a medical examiner, are the staff and patients at the hospital susceptible to any other bacteria or whatever it may be that could result in an individual’s demise?”
Perez-Posadas said patients who are pronounced dead on arrival are swabbed and tested for the coronavirus, so that’s one way to determine whether Covid-19 is involved.
Guam Memorial Hospital in Tamuning is shown March 15, 2021.
