Janny Rodriguez, 47, a community leader in the Barreal area of Peñuelas, Puerto Rico, is an operations supervisor at an asphalt plant. During the height of the pandemic in March last year, he could not stop working because he is one of a few workers who have to maintain the fluid of the composite material.
The father of three was worried about the possible exposure of his eldest son to the virus, as he suffers from a lung condition, or to his older mother who lives next to him. After all, the World Health Organization has just declared Covid-19 a pandemic.
Rodriguez and his colleagues wore masks, kept their social distance, lived strict evening clock rules and had their temperature checked and cleaned their hands and shopping carts every time they went to a supermarket or drug store.
A year into the pandemic, his fear of Covid-19 has not yet come true. So far, neither his children nor his mother have been infected with the virus. No one in his neighborhood with about 200 families was infected, Rodriguez said.
Puerto Ricans in the U.S. have avoided overwhelming their already fragile health care system during the pandemic, largely because of extraordinary measures taken by the local government early on – and the willingness of people to comply.
“In Puerto Rico, the pandemic was never politicized,” said Daniel Colón-Ramos, professor of cellular neuroscience at Yale University and president of Puerto Rico’s scientific coalition, a group of experts advising Governor Pedro Pierluisi on the Covid. 19 reaction on the island. “People really rowed in the same direction.”
Since the onset of the pandemic, at least 94,336 Covid-19 cases have been confirmed in Puerto Rico, an island of 3.2 million. The virus has so far killed at least 2073 people on the island.
However, Puerto Rico has not seen an increase in cases since December, even after major holidays such as Christmas, New Year’s Day and Three Kings Day. The lowest positivity rate was reported in February (5.2 percent) since deaths in Covid-19 rose around Thanksgiving.
With the launch of the Covid-19 vaccine, Puerto Rico is now on track to fully immunize two of its municipalities: Vieques and Culebra, both smaller islands off the coast of Puerto Rico.
A strict evening bell, uniform sanitary measures
In a drastic effort to curb crowds, Puerto Rico was one of the first U.S. jurisdictions to institute an island-wide curfew rule last March asking people not to leave their night after night. Non-important businesses were closed. All schools closed and cruise ships were banned from docking on the island.
Puerto Rico closed the following month while the curfew rule was still in place. Puerto Ricans had to stay at all times. If they leave, it can only be for essential purposes and they had to be back before the night clock.
Puerto Rico was also one of the first U.S. jurisdictions to issue a mask mandate with New Jersey.
“Most people do not leave home without first grabbing their phones. Now people grab their face masks first and then their phones,” Rodriguez said in Spanish.
For most of last year, Rodriguez recalled that the government would send a warning to every person’s phone to remind them that the evening bell would ring.
“In the beginning it was the right thing to do, I can not deny it. “Some people were critical of it, but if it hadn’t been done that way, things would have been worse,” Rodriguez said. Many criticized the efforts, saying it was very hasty, but they helped a lot in controlling the pandemic. “
Rodriguez recently went to his local mall to pick up university books for his daughter. People could only enter through specific entrances so that the guards could count how many people were inside at a given time. Businesses also have signs that say how many people can be allowed in the store, and before they walk in, people should have their temperature checked and their hands disinfected.
When he goes to the supermarket, Rodriguez can’t just grab the first shopping cart he sees. He needs to grab one that was previously disinfected. Before putting his groceries on the conveyor belt for checkout, the cashier disinfects the area. This has been the case for islanders since last year – and islanders have responded.
“These are the things that make me feel safer,” Rodriguez said. “Also the fact that people are wearing their masks and that the government is doing what they can to discourage crowds while trying to reopen safely.”
The realities of the island’s health system
Critics have pointed out that officials impose drastic restrictions without having enough scientific information to support their decisions. Puerto Rico had the lowest per capita test rate at the beginning of the pandemic compared to any state and did not have an island-wide contact tracking system.
But they knew one fact: according to a report by the Urban Institute, Puerto Rico has relied on some doctors to bear the brunt of the pandemic, largely due to a decade of large-scale exodus of doctors to the mainland of the USA. According to the Health Resources and Services Administration, 72 of the 78 municipalities on the island are considered medically understaffed and an unmet health care need.
To some extent, Colón-Ramos said he wondered if the experience with Hurricane Maria, one of the deadliest U.S. disasters in 100 years in America, which killed at least 2,975 people in 2017, contributed to ‘ an overwhelming majority of Puerto Ricans take Covid-19 restrictions seriously.
“I do not want to wish the tragedy to my people, but if it did not happen, I wonder if the tragedy of the pandemic would have been greater,” he said in Spanish. “Because if not, the people would not have taken it seriously and would have protested the closure of the country.”
Even with little information, officials predicted a peak in Covid-19 cases would occur last May. That was when the scientific community in Puerto Rico and mayors of the city acted, Colón-Ramos said. Many mayors have recruited scientists, doctors and other health professionals as volunteers to create their own systems to test people for the virus and do contact detection.
Many of these grassroots efforts launched between April and May were eventually adopted by the Puerto Rican Department of Health as official methods of addressing the pandemic, Colón-Ramos said.
Although it remains unclear whether the May peak would ever come, officials lifted the exclusion on June 12. But they kept the evening clock in place as Puerto Rico continued to slowly reopen businesses with restrictions.
Lessons from the deadliest months
Nearly all of the Covid-19 deaths in Puerto Rico occurred between August and December, Colón-Ramos said. According to him, ‘many of the 2000 lives could have been saved if the necessary systems had been put in place when we closed in April and May’, especially since the number of cases was so low and people on the island mostly met the restrictions.
When Puerto Rico celebrated its controversial two-week by-elections in August, the island began to see an increase in affairs, forcing officials to double the curfew and apply a lockout on Sundays, Dr. Victor Ramos, president of the Puerto Rico Medical Association. , said.
The Sunday lock was lifted in September and put back in place in December following an increase in Covid-19 cases and deaths. The second Sunday exclusion was lifted on January 5th.
“Even though things could have gone much worse than they did, it’s still one of my biggest frustrations,” Colón-Ramos said, adding that if he had judged Puerto Rico’s Covid-19 response so far, he gives an answer B.
A gradual reopening
Currently, Puerto Ricans are not allowed to leave their homes after midnight. The curfew has changed over time, depending on the number of new Covid-19 cases reported on the island, making it the longest pandemic-related curfew of any U.S. jurisdiction.
Most businesses now operate at 50 percent capacity – with the exception of pubs, nightclubs and stadiums, which remain closed. Shopping malls are open, but only allow one person per 75 square meters.
Ninety-six of Puerto Rico’s 858 public schools reopened for the first time Wednesday, exactly one year since the pandemic, with restrictions. Children in Head Start programs can return to class from Monday.
Because Covid-19 hospitalizations have decreased so dramatically, most patients currently in intensive care are those with chronic conditions whose care has been disrupted amid the pandemic, not people with Covid-19, Ramos said.
Families can now visit elderly family members in nursing homes and prisons as the population is vaccinated, Ramos said. ‘It’s also important because they suffered a lot because they did not see their loved ones. “It affects their mental health,” he said.
Since Puerto Rico began receiving vaccinations, about 12 percent of Puerto Rico’s population has been vaccinated with the first dose, while about 7 percent have been completely vaccinated with both doses.
Although the vaccination, according to Rodríguez, is still slower than he expected, he remains hopeful. Ramos said Puerto Rico will receive about 100,000 Covid-19 vaccines a week, an upgrade of 40,000. As more vaccines become available, Ramos remains optimistic, saying Puerto Rico can achieve herd immunity between August and September.
Ramos-Colón also remains optimistic, saying he “really thinks the pandemic could end in the coming months.”
“But the real tragedy would be if we did not emerge from this pandemic with a strengthened health system,” he said.
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