CNMI moves to Community Vulnerability Level Green

The Commonwealth Healthcare Corporation (CHCC) and the Governor’s COVID-19 Task Force announced that the CNMI will move to Community Vulnerability Level GREEN beginning Friday, June 18, 2021. 

“I want to thank all our federal and local partners, our businesses, our CEO Esther Muna, our Task Force Chairman Warren Villagomez, our first responders, and our doctors and nurses for their hard work and collaboration, as well as our entire community for their patience and support,” said Governor Ralph DLG. Torres

“For more than a year, the challenge of keeping everyone safe was not easy, but together we successfully made the CNMI one of the safest places in the world, and it is recognized by our federal partners, our source markets, and our regional counterparts. Let us continue to be vigilant and safe and work together as we move forward in this next step towards true normalcy.”

“I want everyone in our community to know that since the start of the pandemic, our priority was always to ensure everyone was protected by mitigating the spread of COVID-19 in the CNMI,” said CEO Esther L. Muña. 

“With the milestone achievements of fully vaccinated CNMI residents, I want to reassure you that our priority has not changed with this new guideline. I urge all organization leaders to continue to exercise caution with this new normal and that if you’re unsure of the vaccine status, then strengthen your safety measures to protect those who have not had their COVID-19 vaccines or who might have a health condition that makes them vulnerable to severe coronavirus infection. Let’s all strive to achieve the goal of 80% of our eligible population being fully vaccinated. CNMI can do this!”

Overview

Since the start of the COVID-19 pandemic, Governor Ralph DLG. Torres issued several executive orders which declared a state of significant emergency and outlined restrictions on activities throughout the Commonwealth in efforts to contain and mitigate the spread of the disease throughout the community.

It has always been the intention of the Commonwealth Healthcare Corporation (CHCC) and the Governor’s COVID-19 Task Force to create a framework for the resumption of domestic economic activity in a manner that is cognizant of community concerns regarding COVID-19, administered in a way that ensures protection against further outbreaks in the CNMI, and that allows for community participation in mitigating future threats of the disease.

Initial estimates from the US Centers for Disease Control (CDC) and the Federal Emergency Management Administration (FEMA) originally forecasted the peak infection numbers for the CNMI would occur in May 2020. Due in large part to the quick implementation of risk mitigation measures from the CNMI Government and community, the CNMI effectively flattened the peak of this curve, pushing the zenith outward toward June 2020. This approach builds upon this strength of the community and promotes the testing capabilities of the CNMI government to continue to mitigate the spread of this disease while involving the community throughout the totality of the effort.

CNMI Economic Recovery Plan and Successful Containment & Mitigation

Last May, Governor Torres unveiled the CNMI Economic Recovery Plan, which targeted testing for SARS-CoV2 as its benchmark and using color codes to determine the COVID-19 Community Vulnerability Level.  The numbers of tests completed were aggregated and based upon the testing statistics provided by the Commonwealth Healthcare Corporation (CHCC) and the Covid-19 Task Force.

The last rating of BLUE was announced in September 2020. No rating was announced thereafter as fewer individuals found the need to get tested when community cases were limited to a cluster case that occurred in March 2021.

A rating of GREEN is now applicable.

To date, cases are continuously detected and contained at the CNMI’s ports of entry.  The CNMI’s total cases as of June 17, 2021, is 183 with an overall positivity rate of 0.1%, far below most other US jurisdictions. Since the first detection of COVID-19 in the CNMI, two (2) lives were unfortunately lost and four (4) were hospitalized.

Mask-Wearing

While the CNMI did not have an official mask mandate, guidance from the CDC, the CHCC, and the Governor’s COVID-19 Task Force emphasized the importance of the 3 Ws of wearing a mask, washing hands, and watching your distance successfully to mitigate the spread of COVID-19.

Current guidance from CDC emphasizes that if one is fully vaccinated, masks are to be worn when required by the location or jurisdiction. Unfortunately, determining who is vaccinated can be difficult and therefore some restrictions must remain until CNMI reaches herd immunity of 80% and greater.

CNMI’s Vaccination

In December 2020, the CNMI joined other US states and territories in rolling out COVID-19 vaccines to its residents. Since then, vaccine effectiveness continues to become more evident. The CDC recently provided the key points on vaccine effectiveness:

Key Points

  • All COVID-19 vaccines currently authorized in the United States are effective against COVID-19, including serious outcomes like severe disease, hospitalization, and death.
  • Available evidence suggests the currently authorized mRNA COVID-19 vaccines (Pfizer-BioNTech and Moderna) provide protection against a variety of strains, including B.1.1.7 (originally identified in the United Kingdom) and B.1.351 (originally identified in South Africa). Other vaccines show reduced efficacy against B.1.351 but may still protect against severe disease. Continued monitoring of vaccine effectiveness against variants is needed.
  • A growing body of evidence indicates that people fully vaccinated with an mRNA vaccine (Pfizer-BioNTech and Moderna) are less likely to have asymptomatic infection or to transmit SARS-CoV-2 to others. Studies are underway to learn more about the benefits of Johnson & Johnson/Janssen vaccine. However, the risk for SARS-CoV-2 infection in fully vaccinated people cannot be completely eliminated as long as there is continued community transmission of the virus.
  • At this time, there are limited data on vaccine effectiveness in people who are immunocompromised. People with immunocompromising conditions, including those taking immunosuppressive medications, should discuss the need for personal protective measures after vaccination with their healthcare provider.
  • This updated science brief synthesizes the scientific evidence supporting CDC’s guidance for fully vaccinated people and will continue to be updated as more information becomes available.

Reference: https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/fully-vaccinated-people.html

As of June 17, 2021:

  • 72.7% of the adult population received their first dose
  • 66.4% of the 12 and older population received their first dose
  • 25,435 individuals or 60% of the 12 and older population have been fully vaccinated.

As more people get vaccinated and risk mitigation continues at the Ports of Entry, the CHCC and the Governor’s COVID-19 Task Force see vaccination rates as a significant factor for easing restrictions ordered in the Governor’s directives. 

Color Classification of GREEN Plus Vaccination Rate

The Community Vulnerability Level Green corresponds to a COVID-19 Rating between 1.80 and 2.00 or greater. At this level, the levels of positive cases for COVID-19 and the risk to public health are LOW as long as Points of Entry mitigation continues as necessary and until the Governor rescinds the Emergency Declaration for the Commonwealth.

The following color classification of GREEN incorporates the Vaccination rate of the 12 and older population that have been fully vaccinated. CNMI is currently at 60%.

         GREEN + Less than 60% Vaccination rate

  • Individuals should remain cautious and continue to wear face masks and practice social distancing at all times when not at home.
  • Restaurant dine-in and Bar service permitted up to 75% occupancy
  • Businesses hours restricted to 4:00 am to 11:00 pm hours of operation
  • Establishments should enforce social distancing precautions and promote the wearing of face masks
  • Community events permitted under strict social distancing parameters and reduced occupancy
  • Gatherings of people from different households of less than 50 people are permitted throughout the Commonwealth
  • Individuals and entities are highly encouraged to remain cautious

         GREEN + 60% Vaccination rate

  • Fully vaccinated people are able to participate in outdoor and indoor activities, in accordance with CDC guidelines.
  • Unvaccinated individuals should remain cautious and continue to wear face masks and practice social distancing at all times, especially when in the company of others who are not vaccinated and those whose vaccinations cannot be verified
  • All entities are permitted up to 100% occupancy if vaccination completion is verifiable, and 75% if not verifiable.  See Compliance Monitoring & Enforcement for more information on verification.
  • Entities should enforce social distancing precautions and promote the wearing of face masks, when vaccinations are not verified or when customers are from a different household.
  • Community events are under strict social distancing parameters and reduced occupancy if vaccinations are not verifiable.
  • Indoor gatherings of people from different households of less than 150 people are permitted throughout the Commonwealth if vaccination completion is not verifiable.  See Compliance Monitoring & Enforcement for more information on verification.
  • Indoor/Outdoor gatherings of 100% fully vaccinated individuals are permitted throughout the Commonwealth and as long as vaccination is verifiable.  See Compliance Monitoring & Enforcement for more information on verification.

         GREEN + 80% Vaccination rate

  • Individuals should remain cautious and have the option to continue to wear face masks and practice social distancing
  • Indoor/Outdoor gatherings are permitted throughout the Commonwealth

Compliance Monitoring and Enforcement

To ensure customers and staff are protected, the CNMI businesses and workplaces are urged to confirm vaccine status as “fully vaccinated” before letting them take off masks.  Although vaccination cards alone are not acceptable for travel into the CNMI, this form of verification on a hard copy or a smartphone can be acceptable for entities to use as a form of verification for their compliance and enforcement. 

“Fully vaccinated” means the entity has documentation showing that the person received, at least 14 days prior, either the second dose in a two-dose COVID-19 vaccine series or a single-dose COVID-19 vaccine. Vaccines must be FDA approved or have an emergency use authorization from the FDA.

Customers and staff are not required by this order to disclose their vaccine status, however, businesses and other entities have the option to enforce it.  If they choose not to enforce it or they simply cannot legitimately verify vaccine status, entities should therefore follow the guidelines that limit occupancy and enforce mask-wearing. 

Note that disclosing vaccination status does not violate health privacy laws because individuals have the option of leaving their masks on and entities have the option to not increase their occupancy.  While there may still be restrictions set as we reach a 60% vaccination rate, it is CNMI’s goal to achieve “herd immunity” at 80% and remove most restrictions.

Building upon existing Commonwealth Public Law 12-48 “Commonwealth Environmental Health and Sanitation Act of 2000,” Environmental Health and Disease Prevention (EHDP) through the Governor’s Task Force and partnership with key agencies (Department of Public Works – Building Code, Bureau of Environmental and Coastal Quality, Department of Commerce – ABTC, Attorney General’s Office – Consumer Protection) will expand these authorities to conduct visual inspection of establishments as part of COVID-19 compliance monitoring.  Entities who choose to enforce an increased capacity with vaccination verification will be certified after inspection and training. Similar to publishing food safety ratings, COVID-19 regulatory compliance information will be publicly available for residents to make informed decisions.

The CNMI is reminded to watch out for misinformation and to follow updates directly from the Governor’s COVID-19 Task Force and the CHCC. The spread of misinformation is just as dangerous as the virus itself.

Updates from the COVID-19 Task Force and CHCC can be found on Facebook, Instagram, and Twitter accounts @governorcnmi and @cnmichcc, as well as through CNMI media partners.

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