Janny Rodriguez, 47, a community leader in the Barreal neighborhood of Peñuelas, Puerto Rico, is supervising operations at an asphalt plant. During the height of the pandemic last March, he was unable to stop working, as he is one of the few workers in charge of keeping the liquid from the compound material.
The father of three was concerned about the possibility of exposing his oldest son to the virus, as he suffers from a lung problem, or his elderly mother who lives next to him. After all, the World Health Organization had just declared Covid-19 a pandemic.
Rodriguez and his colleagues wore masks, maintained their social distance, lived in strict curfews and had their temperature checked and their hands and shopping carts cleaned whenever they went to a supermarket or drug store.
A year after the pandemic began, his fears about Covid-19 did not come true. So far, neither her children nor her mother have been infected with the virus. In fact, no one in his neighborhood, home to about 200 families, has been infected, said Rodriguez.
Puerto Ricans in the United States have avoided overburdening their already fragile health system during the pandemic, mainly because of the extraordinary measures that the local government has implemented since the beginning – and the willingness of people to comply with them.
“In Puerto Rico, the pandemic has never been politicized,” said Daniel Colón-Ramos, professor of cell neuroscience at Yale University and president of the Puerto Rico Scientific Coalition, a group of experts who advised Governor Pedro Pierluisi on the Covid- 19 of the island. “People were really paddling in the same direction.”
Since the beginning of the pandemic, at least 94,336 cases of Covid-19 have been confirmed in Puerto Rico, an island of 3.2 million. The virus has killed at least 2,073 people on the island so far.
However, Puerto Rico has not seen an increase in cases since December, even after major holidays such as Christmas, New Year and Kings Day. The lowest positive rate was reported in February (5.2 percent) since Covid-19’s deaths increased around Thanksgiving.
With the implementation of the Covid-19 vaccine underway, 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 curfew, uniform sanitary measures
In a drastic effort to limit the crowds, Puerto Rico was one of the first U.S. jurisdictions to implement a curfew across the island last March, which asked people not to leave their homes after dark. Non-essential deals have been closed. All schools closed and cruise ships were banned from docking on the island.
Puerto Rico was blocked the following month, while the curfew was still in effect. Puerto Ricans had to stay home all the time. If they left, it could only be for essential purposes and they would have to go home before the night curfew.
Puerto Rico was also one of the first US jurisdictions to issue a masking warrant, alongside New Jersey.
“Most people don’t leave the house without first picking up their phones. Now, people get their masks first and then their phones,” said Rodriguez in Spanish.
For most of last year, Rodriguez recalls that the government sent an alert on everyone’s phone to remind them that the curfew was coming.
“In the beginning it was the right thing to do, I cannot deny it. Some people criticized it, but if it weren’t done, things would have been worse, “said Rodriguez.” Many criticized the efforts, saying it was too hasty, but they helped a lot to control the pandemic. “
Rodriguez recently went to the local mall to buy college books for his daughter. People could only enter through specific entrances, so guards could count how many people were inside at any given time. The companies also have signs indicating how many people can enter the store and, before entering, people must check the temperature and wash their hands.
When he goes to the supermarket, Rodriguez can’t just take the first shopping cart he sees. He has to get one that was previously disinfected. Before placing your groceries on the checkout mat, the cashier disinfects the area. It has been that way for island residents since last year – and the islanders have obeyed.
“These are the things that make me feel more secure,” said Rodriguez. “In addition, the fact that people are wearing masks and that the government is doing what it can to discourage the crowds while trying to reopen safely.”
The realities of the island’s health system
Critics pointed out that the authorities were placing drastic restrictions without having enough scientific information to support their decisions. Puerto Rico had the lowest test rate per capita compared to any state at the start of the pandemic and did not have a contact tracking system across the island.
But they knew one fact: Puerto Rico was counting on some doctors to withstand the impact of the pandemic, according to a report by the Urban Institute, mainly due to a decade of massive exodus of doctors to the American continent. Administration of Resources and Services, 72 of the 78 municipalities on the island are considered medically underserved and face “unmet health needs”.
To some extent, Colón-Ramos said he wonders whether the experience with Hurricane Maria, one of the most deadly natural disasters in the United States in 100 years, which led to the death of at least 2,975 people in 2017, contributed to the overwhelming majority of Puerto Ricans take Covid-19 restrictions seriously.
“I do not wish these tragedies on my people, but if they had not happened, I wonder if the tragedy of the pandemic would have been greater,” he said in Spanish. “Otherwise, the people would not have taken it seriously and the country’s closure would have protested.”
Even with little information, officials projected that a peak in Covid-19 cases would occur last May. That was when Puerto Rico’s scientific community and city mayors intensified, said Colón-Ramos. Many mayors have recruited scientists, doctors and other health professionals as volunteers to help create their own systems for testing people for the virus and tracking contacts.
Many of these grassroots efforts established between April and May were eventually adopted by the Puerto Rico Department of Health as official methods for tackling the pandemic, said Colón-Ramos.
While it is not clear whether the peak in May has arrived, authorities lifted the blockade on June 12. But they kept the curfew in place, as Puerto Rico continued to slowly reopen companies with restrictions in place.
Lessons from the deadliest months
Almost all Covid-19 deaths in Puerto Rico took place between August and December, said Colón-Ramos. In his opinion, “many of those 2,000 lives could have been saved if the necessary systems had been established when we closed in April and May”, especially since the number of cases had been so low and most people on the island were complying with the restrictions.
While Puerto Rico celebrated its primary controversies for two-week governor in August, the island began to see an increase in cases, forcing authorities to double the curfew and implement a Sunday blockade, Dr. Victor Ramos, president of the association of Puerto Rico doctors said.
Sunday’s blocks were lifted in September and put back in December after an increase in Covid-19 cases and deaths. Sunday’s second blocks were lifted on January 5.
“Even though things could have been much worse than they were, this is still one of my biggest frustrations,” said Colón-Ramos, adding that if he rated the Covid-19 response from Puerto Rico so far, he would have given him a 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 cases of Covid-19 reported on the island, making it the longest pandemic curfew in any jurisdiction in the United States.
Most companies now operate at 50% capacity – except bars, clubs and stadiums, which are still closed. The 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 a year after the pandemic, with restrictions. Starting on Monday, children in the Head Start programs will be able to return to classes.
As hospitalizations for Covid-19 have dropped dramatically, most patients currently in intensive care are those with chronic illnesses whose treatment was stopped in the midst of the pandemic, and not people with Covid-19, Ramos said.
Families can now visit older relatives in nursing homes and prisons for the first time in a year, since these populations were vaccinated, Ramos said. “This is also important because they suffered a lot for not seeing their loved ones. It affects their mental health, ”he said.
Since Puerto Rico started receiving vaccines in December, about 12 percent of Puerto Rico’s population has been vaccinated with the first dose, while about 7 percent have been fully vaccinated with both doses.
Although, in Rodríguez’s opinion, vaccinations are still slower than he expected, he remains hopeful. Ramos said Puerto Rico is scheduled to receive about 100,000 Covid-19 vaccines per week, an update of 40,000. As more vaccines become available, Ramos remains optimistic, saying that Puerto Rico may achieve collective immunity sometime between August and September.
Ramos-Colón also remains optimistic, saying that “he genuinely believes that the pandemic could end in the coming months”.
“But the real tragedy would be if we don’t get out of this pandemic with a strengthened health system,” he said.
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