Written by:  Luana Scanlan, MBA PRIME 
The first COVID vaccines were approved for use and mass distributed in the U.S. mid-2021. The first booster was approved at the beginning of 2022 as researchers found the original vaccines losing their effectiveness over time. Between 2019 and 2022 SARS-COVID 19 mutated thousands of times, but only four variants were concerning enough for researchers to develop specific vaccines to minimize their ability to cause severe disease (Epicentre.org.za).
Recently the FDA and CDC approved an updated Omicron-specific COVID booster to target the dominant BA.4 and BA.5 strains circulating worldwide.  The only bivalent boosters currently authorized are Pfizer for those 12 and older, and Moderna for those 18 and older.  This is the first time these mRNA vaccines have been updated.
The updated booster is bivalent meaning it’s half original strain, and half Omicron BA.4, BA.5 (Fryhofer, 2022).  The booster provides antibody protection for at least six months and demonstrated effectiveness for up to nine months in people with or without past COVID infections.  Estimated booster effectiveness against severe COVID-19 was 87.4% (Ng et al., 2022).
The CDC recommends that everyone aged 12 and older receive the new booster but you must be ‘up to date’ with your vaccines first.  You are up to date and fully protected if you have received the first two primary shots of any COVID vaccine product, plus at least one booster. If you’ve already had COVID, you should get the updated booster after you’ve recovered and at least 3 months after testing negative.
In a recent California study, 56% of participants (N=210) who were infected with the Omicron variant were unaware of the infection, and only 10% reported symptoms, most of which were mild (Joung et al., 2022). 94% of participants had at least one COVID vaccine.  Experiences like these may deter people from getting the updated vaccine. However, the CDC, FDA, World Health Organization recommend getting the new booster in preparation for future mutations.  Like the flu, annual shots are recommended going into ‘flu season’.  Each year the flu shot is modified for specific mutations in the flu virus. Experts predict that COVID will become the new ‘flu’ with annual shots recommended for protection.
The following are the CDC’s current vaccination recommendations:
AGE
1ST SHOT
2ND SHOT *
1ST BOOSTER
UPDATED BOOSTER

6 mos.-4 years
Primary series – any vaccine
8 weeks after 1st shot – Pfizer or Moderna
8 weeks after 2nd shot
No recommendation

5 – 11 years
Primary series – any vaccine
8 weeks after 1st shot – Pfizer or Moderna
5 months after 2nd shot
8 weeks after 1st booster (if Pfizer in 2nd shot must use for this booster)

12 – 17 years
Primary series – any vaccine
8 weeks after 1st shot – Pfizer or Moderna
2 months after 2nd shot (Pfizer only)
8 weeks after 1st booster (Pfizer only)

18 – 49 years
Primary series – any vaccine
8 weeks after 1st shot – Pfizer or Moderna
2 months after 2nd shot – either product
2 months after 2nd shot – either product

50 years and older
Primary series – any vaccine
Pfizer 21 days after 1st shot
Moderna 28 days after 1st shot
2 months after 2nd shot – either product
2 months after 2nd shot – either product

*CDC recommends NOT mixing products in your primary series – if you received Pfizer or Moderna in the first shot, you get the same product for the 2nd shot.  Click on these links for more information:
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html#footnote01
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/coronavirus-disease-(covid-19)-vaccines?adgroupsurvey={adgroupsurvey}&gclid=EAIaIQobChMI__aBjvmN-gIV2HRvBB2cYQ7PEAAYAiAAEgJ7KfD_BwE
Daignault, M., Gandhi, M. (2022). CDC’s Booster Recommendations May Not Provide Optimal Protection. Time (Sept. 6). https://time.com/6211075/covid-19-vaccine-omicron-boosters/
Fryhoffer, S. (2022). New Omicron boosters available from Pfizer and Moderna. AMA (Sept. 8). https://www.ama-assn.org/delivering-care/public-health/new-omicron-boosters-available-pfizer-and-moderna-sandra-fryhofer-md
Joung SY, Ebinger JE, Sun N, et al. Awareness of SARS-CoV-2 Omicron Variant Infection Among Adults With Recent COVID-19 Seropositivity. JAMA Netw Open. 2022;5(8):e2227241. doi:10.1001/jamanetworkopen.2022.27241
Ng OT, Marimuthu K, Lim N, et al. Analysis of COVID-19 Incidence and Severity Among Adults Vaccinated With 2-Dose mRNA COVID-19 or Inactivated SARS-CoV-2 Vaccines With and Without Boosters in Singapore. JAMA Netw Open. 2022;5(8):e2228900.
Image retrieved:  ​https://www.google.com/search?sxsrf=ALiCzsYyRJ7DBJfajeauDeK0RycWsZ5F6Q%3A1663090617374&q=covid-19%20pandemic%20images&ved=2ahUKEwiuhemrp5L6AhUHFjQIHaquAwwQmoICKAF6BAgDEAk&biw=1506&bih=748&dpr=2.55#imgrc=5A8vE-yczNbqVM

Written by:  PROVISION
​With Covid 19 variants on the rise, it’s important that we do our part.  Get vaccinated, get boosted, wash your hands, social distance and mask up.  Some businesses are not requiring masks, but if you feel sick or you’ve been around someone who has shown symptoms, mask up for those around you.  


Infectious Disease Specialist, Mark Rupp, M.D. said, “The original omicron variant is gone now.  Currently sub variants of omicron are circulating, including BA.4, BA.5 and BA.2.12.1.”  The two newer omicron sub variants, BA.4 and BA.5 are increasing.  “These variants ebb and flow across the country.  Now it’s our turn to be dealing with BA.4 and BA. 5 as the situation evolves.”

The best way to prevent the new variants is to slow the spread of the virus.  Once again, get a boosted, if you're eligible, get vaccinated, choose outdoor activities whenever possible, wash your hands, avoid close contact with others, wear a mask in public whenever possible and stay home if you're sick or have Covid 19 symptoms.  

Specific findings from a CDC systematic review found that physical activity is associated with a decrease in Covid 19 hospitalizations and deaths, while being inactive increases the risks.  Physical activity is one of the best ways to improve your health now and in the future.  

People who sit less and engage in moderate to vigorous activity develop some healthy habits.  Being physically active is important for your mental health, and can have immediate benefits for your mood while reducing anxiety.  

Regular physical activity helps to reduce the risk of some chronic conditions such as type 2 diabetes, heart disease and some types of cancer.  Exercise can also improve sleep quality.  Getting adequate sleep is not a luxury, it’s fundamental to good health.  Emerging research also suggests physical activity may also boost immune function.

One in four adults is inactive, meaning that they don’t get any exercise outside of their regular job.  Only about one in four adults and one in six high school students fully meets the physical activity guidelines.  Being inactive contributes to 1 in 10 premature deaths.  Remember, any exercise is better than nothing at all.  It's recommended to get at least 150 minutes of exercise a week.  That doesn’t mean all at one time, you can break it up to what fits your schedule.  The main takeaway is get out and get active!

Image retrieved from:  https://www.outsourcing-pharma.com/Article/2022/01/18/Pfizer-COVID-19-treatment-shows-promise-against-omicron-variant
References: 
CDC, C. D. C. (n.d.). https://www.cdc.gov/physicalactivity/physical-activity-and-COVID-19.html. Retrieved from https://www.cdc.gov/physicalactivity/physical-activity-and-COVID-19.html 
Medicine, N. (2022).
​What COVID-19 variants are going around in July 2022? Retrieved 2022, from https://www.nebraskamed.com/COVID/what-covid-19-variants-are-going-around-in-july-2022#:~:text=%22The%20original%20omicron%20variant%20is,Proportions%20on%20July%207%2C%202022.

Photo from:  Written by Sosefina Iose ​

Since June 21st of this year, there have been approximately 31 deaths related to the coronavirus, about 6,353 individuals in American Samoa who have contracted the virus, and 6,251 individuals have recovered from the coronavirus.
Acting Governor, Talauega Ale, is enforcing all of American Samoa to keep using their masks in enclosed settings and to remain a 6-feet distance from each other to lessen the possibilities of contracting the coronavirus.
This Declaration of the ongoing outbreak will not affect any village councils to enact regulations imposing curfews or restricting public gatherings. It is enforced that whoever violates any of the requirements will be punished by up to 12 months in jail or pay a fine of $1,000.
However, this is a note quoted from the declaration signed by Talauega E. V. Ale; “This Declaration will be effective June 27, 2022, and supersedes the Declaration dated May 27, 2022, and the amendments to that Declaration. It will be in effect for thirty (30) dates and expires on July 27, 2022. Exclusive authority for rendering all final decisions pertaining to the implementation of all prescribed mandates of this Emergency Declaration is vested in
the Governor of the Territory of American Samoa and the GAR. Dated: June 24, 2022”

Written by:  Luana Yoshikawa-Scanlan, PRIME
During a pandemic, service providers can redirect social services and psychosocial support through online, phone, social distanced mechanisms. Several tools for communicating safety and reducing fear during pandemics were piloted prior to the COVID-19 outbreak. Digital interventions have been confirmed to promote and enable safety behaviors (Decker, et al., 2020). Virtual interventions have been successfully tested to address gendered burdens and their impact specifically on women (Viveiros, et al., 2020). 
A few surveys indicate that victims prefer guided online support and found web-based interventions ‘supportive and a motivation for action’ (Hegarty, et al., 2019, Jewkes, et al., 2020, Koziol-McLain, et al., 2018). 

The following web-based applications can help victims establish safety:            https://www.myplanapp.org/
myPlan – the app content, interface and implementation can be adapted for use in American Samoa. A study in Kenya demonstrated its high feasibility, and the acceptability of community-partnered technology-based safety planning interventions like this (Decker, et al, 2020). MyPlan has a ‘My Safety’ risk assessment section that converts responses to validated levels of exposure to danger. The ‘My Priorities’ section is an interactive visual aid to set priorities for safety – gauging importance between priorities such as privacy, severity of violence, wellbeing of children, social support etc. and emphasizes importance of safety and inclusiveness (Glass, et al., 2015, Decker, et al., 2020). ​

Written by:  Luana Yoshikawa-Scanlan, MBA, PRIME. Photos from: (1)  https://www.gettyimages.com/detail/photo/face-mask-with-painkillers-royalty-free-image/1218077734?utm_medium=organic&utm_source=google&utm_campaign=iptcurl (2)

     In addition to developing effective vaccines to protect us against the worst symptoms of COVID-19, amazing scientists created drugs to treat symptoms before they progress into life-threatening complications.

     There are two types of drug treatments approved by the U.S. Food and Drug Administration or FDA: Veklury or remdesivir, an antiviral drug, for adults and some children. Commonly known as remdesivir, this drug is delivered through intravenous therapy or an IV. The second is Olumiant which helps the adult immune system fight infection when hospitalized with COVID-19.  These drugs are not substitutes for the COVID-19 vaccine, they simply provide additional support once you are infected and if you experience symptoms.

      There are several additional treatments approved under the national Emergency Use Authorization for public health emergencies such as a surge of COVID-19 infections.  Monoclonal antibody treatments for adults and children contain antibodies to fight infection. These come in pill form and IV therapy to reduce the risk of experiencing the most severe COVID symptoms.

     Prevention treatments include Evusheld; bebtelovimab is a monoclonal antibody treatment; oral antiviral therapies include Lagevrio, Paxlovid, and Renal Paxlovid.
As of May 23, 2022, the following therapeutics were reportedly in stock at the LBJ Hospital*:
Bebtelovimab                    Paxlovid               Lagevrio (molnupiravir)  Evusheld             
As of May 20, 2022, the following therapeutics were reportedly in stock at the Amouli Health Center*:
Bebtelovimab                    Paxlovid               Lagevrio (molnupiravir) 
*Source: https://covid-19-therapeutics-locator-dhhs.hub.arcgis.com/

     If you test positive for COVID-19, by either a health worker or using an at-home kit, you may be eligible for treatment. Visit your doctor to report symptoms you are experiencing. Based on your medical history, symptoms, and health risks you may receive treatment, or it may be determined that you are healthy enough to fight off the disease without treatment.  Most people experience mild, cold-like symptoms which go away on their own within days much like the common cold. Rest, lots of water, social distancing, and healthy foods support the immune system’s ability to fight the virus.
Again, treatment is not a substitute for vaccination. Vaccines protect you against severe symptoms that would put you in the hospital, and possible death. Treatments provide added support to the immune system to fight the virus. 
Resources:  
Visit the Department of Health’s Facebook page for daily updates on test, vaccination, and treatment sites: https://www.facebook.com/americansamoadoh 
or partner sites for more information:    https://www.facebook.com/ACTASONEamericansamoa
                                                                                https://www.facebook.com/AmericanSamoaAlliance
                https://omny.fm/shows/pacificmedianetwork/covid-19-messages-for-our-pacific-community

Written by:  Luana Yoshikawa-Scanlan, MBA,  PRIME Consultant; Photo from:  https://www.samoanews.com/features/thousands-take-part-samoa-mass-covid-19-vax-drive-photo-caption
First and foremost, victim services must be categorized ‘essential services’ by the local government to ensure access to the women’s shelter, court, and protection orders.
Secondly, advocates can organize community responses to stay-at-home orders:

• Use media to make abusers aware that the community is ready to support victims;
• Use visual and audio signals outside homes or on their person, code words on the phone or online to signal for help – community members can respond to signals by calling emergency hotlines or bringing in appropriate cultural interventionists. 
• A community volunteer system can ensure those in isolation receive food deliveries, prescriptions, mail, counseling.
• Enhanced surveillance like ‘neighbor watch’ to report signs of abuse.
• Social support can be provided through virtual chat groups, support groups, telemedicine, and counseling to keep people connected.  E-talanoa is a concept coined by Faleolo (2016; 2019; 2020b) referring to ongoing dialogue, sharing of ideas, and storying experiences using online forums while maintaining important Pasifika protocols and understandings of vā. Enari and Fa’aea (2020) furthered the concept as ‘digital vā’.

There is a critical need for social safety nets – social support networks online during a Pandemic. Informational support is focused on the what’s happening in the community – closures, restricted hours, help hotlines, virtual town halls with health professionals.  Community engagement is a critical factor tying this support system together.  UN Women recommends raising visibility of increased violence and building strong networks. 
The 2020 IPSOS Pub poll shows 1 in 5 Americans under age 35 sought professional counseling since the pandemic began which indicates a need to address the impact of social isolation among young people.  Tools like the Daily Coping Toolkit (smartpatients.com) and the free COVID Coach app (https://play.google.com/store/apps/details?id=gov.va.mobilehealth.ncptsd.covid&hl=en_US) focus on wellbeing in the face of COVID related environmental changes that impact mental health outcomes. Several domestic violence and mental health websites offer tools to apply ‘psychological first aid’ (PFA) to address health anxiety – stress directly resulting from COVID-19 and related impacts such as violence:
https://apps.apple.com/us/app/pfa-mobile/id551079424 The free PFA Mobile app was designed by the U.S. Dept. of Veterans Affairs to assist first responders who provide psychological first aid or PFA. The app can be used by victim advocates and outreach workers.
The PFA Pocket Guide includes a day-to-day Stress Assessment and other exercises to understand self-care, the stress from caring for others, personal factors and support systems. https://www.globalfirstaidcentre.org/wp-content/uploads/2021/01/19-0420PS-PFA_Pocket_Guide_2020_EN_FA.pdf
The ABCDE Handbook guides the lay-person in applying PFA in various crisis contexts. https://www.preventionweb.net/publications/view/67196

Written by: Kathy Fitisone, ASADSV Staff
After many months of closed borders followed by many months of exclusive repatriation flights, we have finally arrived at some sort of normalcy with flights to and from the mainland, albeit not as often or as regular as we are used to but nonetheless, the opportunity to travel exists.  What still remains the same in our fight against COVID-19 is the process of quarantining for a certain period of time before being released out into the general population.
Because the flight schedules are not set in stone and because many possible outcomes could cause the duration of quarantine to be longer than normal, there is the possibility that you may have to spend Christmas in quarantine.  Bah-humbug you may say.  Stop being such a Grinch.  Look on the bright side of things to have a holly, jolly, merry Christmas.

• Turn that Christmas music up – Most of us have smart phones these days and there are tons of selections of Christmas music to listen to.  Find a karaoke app and belt out those holiday tunes.
• Decorate your room – Use your imagination!  Those red and green t-shirts and ie lavalava in your suitcase will add a wonderful Christmas splash to your room décor.
• Go online and watch a Christmas movie or download a Christmas book – Once again, the possibilities are endless.
• Host a virtual party – Send all your friends and family a Zoom link and party the time away.
• Have someone livestream Christmas church service – You’ll feel like you are part of the congregation and won’t have to worry about getting all dressed up.
• Get dressed up!  - Wear your Sunday best on Christmas day!  Wear your PJs and lounge around all day!  It’s Christmas, whatever lights your tree!
• Spend time in silence and prayer – It’s going to be noisy on the outside and you will be busy when you are back to reality.  Take the time to rest, reflect, and rejuvenate.

 
If you must be in quarantine during Christmas, we ask that you make the most of it.  Be thankful you are home.  Many people wish they could be home for the holidays; you are one step closer and we are excited to have you home! 
American Samoa has been extremely fortunate to date to not have experienced the effects of COVID-19 encountered by so many countries throughout the world.  We have seen our government leaders and various Government agencies at the forefront of this battle and they should be commended for putting procedures and policies in place that have allowed us to continue life as normal as possible with very minimal interruptions.  We continue to ask everyone to adhere to the COVID-19 procedures of getting vaccinated and boosted, quarantining, social distancing, wearing a mask, and keeping hands and faces clean.  Also keep abreast of updates from the CDC and the latest news regarding COVID-19.  We as a community must continue to do our part – even if it means quarantining during Christmas. 
Merry Quarantine Christmas and welcome home!  Ia manuia le Kerisimasi, malo le malaga manuia mai!

Written by: PROVISION Media
With Covid-19 and the Delta Variant cases still on the rise, it’s important that we remain mindful during this holiday season and don’t let our guard down.  Whether you are vaccinated or not, we can still enjoy the things we love and spend time with our loved ones, but we need to take extra precautions to keep everyone safe.

As we gather for the holidays, let us not forget that those 65 and older are at high risk, as well as those with underlying medical conditions; such as asthma, a weakened immune system, heart conditions, or diabetes.  Here are some tips and guidance that can help:

Shopping:
Wear a mask at all times.  If you go shopping, plan and pick a time to avoid large crowds.  Keep your distance and make a list to do your best to stay on task.  If possible, shop online.  

Traveling:
If you have to travel take extra precautions by wearing your mask at all times, keeping your distance, minimizing contact with others, and always washing your hands.

Gatherings:
During gatherings, try to plan for a smaller get-together with friends or family who live near you.  Keep the area well ventilated and remember that being outdoors is always better than indoors.  If you feel sick or have symptoms don’t host or attend any gatherings.  Put a friendly sign on the door encouraging loved ones to refrain from kissing or hugging each other when greeting them.  Remember, the main goal is to be safe with loved ones during the holidays.

The Samoan culture is very family-oriented and we love to have get-togethers, but we must do our best to keep our loved ones safe.  Often when greeting someone, a kiss or hug is exchanged. Instead, try a simple hello with a nod of the head to try and show respect.  Explain to them you want to keep them safe and would hate for them to get sick.  Do your best to keep your distance, wash your hands, and if you don’t feel well, don’t attend.  These things sound simple, but sometimes they are very hard to do because we don’t want to offend anyone.  It’s crucial that with monthly flights now entering our territory, we be educated and help keep our friends and family safe.  As simple as it may sound, it’s up to us to do our part.  Remember the main goal, is to be with loved ones and to enjoy the holidays without worrying about getting anyone sick.  
Photo retrieved from:  https://www.ebay.com/itm/samoa-PAGO-PAGO-The-Gathering-Place-1920s-RPPC-Postcard-/233125885789?_ul=IL