On September 3, 2022, a team of eight (8) health professionals from the Republic of Palau Ministry of Health and Human Services (Palau MHHS), the U.S. Centers for Disease Control and Prevention (CDC), as well as the Pacific Island Health Officers' Association (PIHOA), flew to Yap State to assist with a surge in COVID-19 cases. Between mid-August and mid-September, nearly 3,000 positive COVID-19 cases were identified.

The emergency medical team includes Dr. Richard Brostrom, CDC Center for State, Tribal, Local, and Territorial Support’s ( CDC CSTLTS) Hawaii State COVID-19 Point of Contact, Pacific Regional TB Field Medical Officer, and Hawaii State TB Program Clinical Consultant, and Ms. Stephanie Kern-Allely, PIHOA Regional Communicable Disease Epidemiologist. Dr. Brostrom and Ms. Kern-Allely are also supporting Yap’s epidemiology surveillance team.

The remaining emergency medical team members are health professionals from the Palau MHHS. They are: Dr. Catherine Decherong (physician), Dr. Tzun Rafael (physician), Ms. Minda Benjamin (nurse), as well as members of the COVID-19 testing team: Ms. Roxana Lawichifeg (Environmental Health Technician), Ms. Jane Decherong (Patient Navigator), and Ms. Krystle E. Renguul (Training Officer).

The emergency medical team is assisting at two locations:  the Test-To-Treat (T2T) site at the Sports Complex in Abay and the Milew Multi-Purpose Center in Rull, as well as the Emergency Operation Center (EOC). Palau MHHS staff members have been able to step in at the T2T sites, while nearly 70% of the Yapese T2T staff was out with COVID-19. 

Current clinical and operational support includes a review of staffing levels as well as plans for streamlining the data collection process and improving customer satisfaction. A new policy under consideration is to separate first-time symptomatic individuals from those being re-tested; progress is being made toward instituting a COVID test certification form at T2T sites for persons who have already tested positive.

Technical assistance from Dr. Brostrom and Ms. Kern-Allely includes working with the Yap Staff to improve outward situation reports, implementing a system for evaluating and reporting only new cases (first in the FSM), and enabling real-time data to be linked and updated automatically.

By streamlining data entry and reporting processes, developing a data cleaning tool for the Epi Data team, creating a situation report generation system, collecting and verifying case hospitalization and death data, evaluating curve hints at a possible slowdown of cases, and modeling tests and treatment supplies needed for continued outbreak response efforts on Yap Proper and Outer Islands, Yap State will be better positioned to manage the current situation and any future outbreaks. The emergency medical team communicated its progress on recommended practices in a meeting with Yap State Governor Jesse Salalu and his Cabinet.