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Janny Rodriguez, 47, a community leader in the Barreal neighborhood in Peñuelas, Puerto Rico, is an operations supervisor at an asphalt plant. At the height of the pandemic last March, he was unable to stop working, as he is one of the few workers responsible for maintaining the liquid of the composite material.
The father of three was worried about potentially exposing his eldest son to the virus, as he suffers from a lung disease, or his elderly mother who lives next to him. After all, the World Health Organization had just declared the Covid-19 a pandemic.
Rodriguez and his colleagues wore masks, kept their social distances, lived under strict curfews, and had their temperatures checked and their hands and shopping carts checked every time they walked into a supermarket or drugstore.
A year after the start of the pandemic, his fears about Covid-19 have not come true. So far, neither her children nor her mother have been infected with the virus. In fact, no one in his neighborhood, which is home to around 200 families, has been infected, Rodriguez said.
Puerto Ricans in the U.S. have avoided overwhelming their already fragile health care system during the pandemic, largely because of the extraordinary measures the local government put in place early on – and people’s willingness to comply with them.
“In Puerto Rico, the pandemic has never been politicized,” said Daniel Colón-Ramos, professor of cellular neuroscience at Yale University and chair of the Puerto Rico Science Coalition, a group of experts advising the governor Pedro Pierluisi on the island’s response to Covid-19. “People were really rowing in the same direction.”
Since the start of the pandemic, at least 94,336 cases of Covid-19 have been confirmed in Puerto Rico, an island of 3.2 million people. The virus has so far killed at least 2,073 people on the island.
However, Puerto Rico has not seen a surge in cases since December, even after major holidays such as Christmas, New Years Day and Three Kings Day. The lowest positivity rate was reported in February (5.2%) since deaths from Covid-19 increased around Thanksgiving.
With the deployment of the Covid-19 vaccine underway, Puerto Rico is now on track to fully immunize two of its municipalities: Vieques and Culebra, two smaller islands off the coast of Puerto Rico.
A strict curfew, uniform sanitary measures
In a drastic effort to limit crowds, Puerto Rico was among the first U.S. jurisdictions to implement an island-wide curfew last March that required people not to leave their homes after dark. Non-essential businesses have been closed. All schools have closed and cruise ships have been banned from docking on the island.
Puerto Rico closed its doors the following month while the curfew was still in effect. Puerto Ricans were to stay home at all times. If they left, it could only be for essential purposes and they had to return home before the nighttime curfew.
Puerto Rico was also among the first US jurisdictions to issue a mask warrant, alongside New Jersey.
“Most people don’t leave the house without first grabbing their phone. Now people take their face masks first, then their phones,” Rodriguez said in Spanish.
For most of the past year, Rodriguez remembers that the government would send an alert to everyone’s phone to remind them that curfew was approaching.
“At first it was the right thing to do, I can’t deny that. Some people criticized it, but if it hadn’t been done like this things would have been worse, ”Rodriguez said. Many have criticized the efforts, saying it was very rushed, but they have been very helpful in controlling the pandemic. “
Rodriguez recently went to his local mall to get some college books for his daughter. People could only enter through specific entrances, so the guards could count the number of people inside at any given time. Businesses also have signs indicating how many people can be allowed into the store, and before entering, people should have their temperature checked and their hands sanitized.
When he goes to the supermarket, Rodriguez can’t just grab the first shopping cart he sees. He must catch one that has already been disinfected. Before putting his groceries on the conveyor belt for the checkout, the cashier disinfects the area. It’s been like that for the islanders since last year – and the islanders have complied.
“These are the things that make me feel more secure,” Rodriguez said. “Plus the fact that people are wearing their masks and the government is doing what it can to deter the crowds as it tries to reopen safely.”
The realities of the island’s health system
Critics pointed out that officials were putting drastic restrictions in place without having enough scientific information to back up their decisions. Puerto Rico had the lowest per capita testing rate of any state at the start of the pandemic and lacked an island-wide contact tracing system.
But they knew a fact: Puerto Rico was relying on a few doctors to carry the brunt of the pandemic, according to an Urban Institute report, mainly due to a decade of mass exodus of doctors to the Americas. Administering Resources and Services, 72 of the island’s 78 municipalities are considered medically underserved and face “unmet health care needs”.
To some extent, Colón-Ramos said he wondered whether the experience of Hurricane Maria, one of the deadliest natural disasters in the United States in 100 years, which resulted in the deaths of at minus 2,975 people in 2017, had contributed to an overwhelming majority of Puerto. Americans take Covid-19 restrictions seriously.
“I don’t wish these tragedies on my people, but if they hadn’t happened, I wonder if the tragedy of the pandemic would have been more serious,” he said in Spanish. “Because otherwise the people would not have taken it seriously and the closure of the country would have protested.”
Even with little information, officials predicted that a peak in Covid-19 cases would occur last May. That’s when Puerto Rico’s scientific community and city mayors stepped up, Colón-Ramos said. Many mayors have recruited scientists, doctors and other health workers as volunteers to help them create their own systems to test people for the virus and perform contact tracing.
Many of those grassroots efforts put in place between April and May were eventually adopted by Puerto Rico’s health department as official methods to deal with the pandemic, Colón-Ramos said.
While it’s still unclear whether the May peak has arrived, officials lifted the lockdown on June 12. But they maintained the curfew as Puerto Rico continued to slowly reopen businesses with restrictions in place.
Lessons from the deadliest months
Almost all of the Covid-19 deaths in Puerto Rico occurred between August and December, Colón-Ramos said. According to him, “many of those 2,000 lives could have been saved if the necessary systems had been in place when we closed in April and May”, especially since the number of cases was so low and residents of most of the island met the restrictions.
As Puerto Rico celebrated its controversial two-week gubernatorial primaries in August, the island began to see an increase in cases, forcing officials to double the curfew and implement a Sunday lockdown on Sunday. Dr Victor Ramos, President of the Association of Physicians of Puerto Rico. , mentionned.
Sunday lockdowns were lifted in September and put back in place in December following an increase in Covid-19 cases and deaths. The second Sunday lockdowns were lifted on January 5.
“Even though things could have been a lot worse than they did, it’s still one of my biggest frustrations,” Colón-Ramos said, adding that if he had noted the Covid- response 19 from Puerto Rico so far he would give him a B.
A gradual reopening
Currently, Puerto Ricans are not allowed to leave their homes after midnight. The curfew has changed over time based 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 are now operating at 50% of their capacity – with the exception of bars, nightclubs and stadiums, which always remain closed. Malls are open but only allow one person per 75 square feet.
Ninety-six of Puerto Rico’s 858 public schools reopened for the first time on Wednesday, exactly one year after the outbreak of the pandemic, with restrictions. Starting Monday, children in Head Start programs will be able to return to class.
Since Covid-19 hospitalizations have declined so dramatically, most patients currently in intensive care are those with chronic illnesses whose care was interrupted amid the pandemic, not those with Covid-19 Ramos said.
Families can now visit older relatives in nursing homes and prisons for the first time in a year since those populations were vaccinated, Ramos said. “It’s also important because they have suffered a lot from not seeing their loved ones. It affects their mental health, ”he said.
Since Puerto Rico began receiving vaccines in December, about 12 percent of the population of Puerto Rico have been vaccinated with the first dose, while about 7 percent have been fully vaccinated with both doses.
While in Rodríguez’s opinion, the vaccinations are even slower than he had expected, he remains hopeful. Ramos said Puerto Rico was set to receive around 100,000 Covid-19 vaccines per week, up from 40,000 vaccines. As new vaccines become available, Ramos remains optimistic, saying Puerto Rico could achieve herd immunity between August and September.
Ramos-Colón also remains optimistic, saying he “sincerely believes that the pandemic could end in the coming months”.
“But the real tragedy would be if we don’t come out of this pandemic with a strengthened health system,” he said.
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