Puerto Rico faces staggering explosion of Covid cases

Armed with her vaccine passport and a giddy urge to celebrate the holiday season, Laura Delgado – and 60,000 other people in Puerto Rico – attended a Bad Bunny concert three weeks ago.

Three days later, she was ill with Covid-19, one of some 2,000 people who fell ill as a result of the two-day event.

“We did so well; we followed the rules, ”said Ms. Delgado, a 53-year-old interior designer. “We followed the mask’s mandate. Our vaccination rate was so high that we let our guard down. The second Christmas has arrived, we said to ourselves: “We’re going to party!”

The super-spreader concert helped usher in an explosion of Covid-19 cases in Puerto Rico, which until then celebrated one of the most successful vaccination campaigns in the United States. The concert was part of a series of business events, corporate parties and family reunions that have resulted in a 4,600% increase in cases on the island, an increase that public health officials have reported. fear that it may persist into the New Year; the holiday season in Puerto Rico runs until Three Kings Day on January 6.

While the Omicron variant has besieged the entire country, it is particularly worrying in Puerto Rico, an American territory already overwhelmed by government bankruptcy, an exodus of health workers and a fragile health system. Authorities have imposed a new wave of severe restrictions on travelers and diners in hopes of averting the new wave of cases.

Rafael Irizarry, a Harvard University statistician who maintains a Puerto Rico Covid-19 data dashboard, tweeted The disheartening facts: A third of all coronavirus cases the island has recorded since the start of the pandemic have occurred in the past month. The number of cases per 100,000 inhabitants rose from three to 225 in three weeks.

In December, the number of hospitalizations doubled – twice.

Without the polarizing politics that plagued the vaccine debate in other parts of the country, nearly 85% of Puerto Rican people have received at least one dose of the vaccine and about 75% have received both vaccines.

But in the face of a new, highly contagious variant, a high vaccination rate no longer makes so much sense, Mr Irizarry said. Most people in Puerto Rico are past the six-month limit after which the vaccine’s effectiveness begins to decline, but at least 40% have yet to receive their booster shots, officials said. health.

At one point this week, the number of daily cases had surpassed 11,000, a very high figure for an island of just 3.2 million people. The exponential increases have started to decline, but the number of cases continues to rise, Mr Irizarry said.

“I noticed for the first time that something was happening on December 13 and alerted the Ministry of Health,” he said. “On the 14th and 15th, it was obvious. I called the guy who manages the database and said, “Is there some kind of problem in the database? “

There are currently 317 people hospitalized with Covid-19, more than a quarter of whom are children, according to the island’s health ministry. That’s about half the number of people hospitalized with the disease around the same time last year, before so many were vaccinated. But it remains a challenge for hospitals.

“The problem is, let’s assume Omicron is half as bad,” Mr. Irizarry said. “If you have eight times as many cases, the math doesn’t work in your favor. “

Governor Pedro R. Pierluisi ordered lower capacity limits in restaurants. To attend major public events, people must now be vaccinated and present a negative Covid-19 test. Passengers arriving on domestic flights must present a negative test carried out within 48 hours of arrival, regardless of their vaccination status. Similar rules were already in place for international flights.

Mass public events, including a major celebration to commemorate the 500th anniversary of the island’s capital, San Juan, have been canceled. “Dick Clark’s New Year’s Rockin ‘Eve,” which ABC had planned to broadcast live from Puerto Rico to large crowds, has been demoted to a virtual event.

After a few dozen Miss World contestants fell ill, the pageant finals in Puerto Rico were called off.

On Thursday, the Scientific Coalition, a group of scientists and medical professionals who advised the governor, recommended even stricter measures, such as limits on alcohol sales and shorter hours for bars and others. establishments. On Friday, the governor followed the recommendation and ordered businesses to close between midnight and 5 a.m. January 4-18. He also imposed booster shots on restaurant workers and public security officers.

“It’s a difficult message to digest when two weeks ago the number of cases here was among the lowest in the world,” said Daniel Colón-Ramos, professor at Yale University and chairman of the coalition.

The measures are especially tough in Puerto Rico, he said, where it’s hard to overstate the importance of a holiday season that begins on Thanksgiving and lasts until Jan.6. He described it as “July 4th plus the Super Bowl”.

“Christmas is a week in which Puerto Ricans celebrate their identity,” he said. “They celebrate their family. They celebrate their faith. They celebrate their heritage.

The average age of those infected on the island is 33, health officials said. But experts fear that if young people who are infected while attending parties and other events visit elders on New Year’s Eve and Three Kings Day, the number of sick elderly will certainly increase. With so many of its young professionals moving in recent years to Florida, Texas and other states, Puerto Rico has a disproportionate percentage of seniors, many of whom suffer from diabetes, obesity, and other illnesses that affect them. are at a higher risk of complications from the coronavirus. .

“We have a health system that is – it’s no secret – fragile,” said Carlos R. Mellado López, the island’s health secretary. He urged people not to unnecessarily overwhelm testing centers and insisted Puerto Rico has the necessary tools, such as monoclonal antibody treatments, to fight the crisis.

But experts also warn that thousands of medical professionals have left Puerto Rico in recent years in search of higher salaries, which could complicate the island’s ability to care for large numbers of sick people. . The number of doctors on the island has fallen by 5,000 since 2006, and another exodus of primary care doctors is expected as they have been excluded from recent tax incentives designed to prevent specialists from leaving, Víctor M. Ramos said. Otero, president of the Puerto Association of Doctors of Rico.

“The problem we have is not the beds,” Ramos said. “The main problem is the staff.

José R. López de Victoria, an epidemiologist who has helped design coronavirus protections for Puerto Rican basketball teams, said the crisis was still dragging on.

“From what we’re seeing on the test sites, it’s not over yet,” he said. “It’s going to be another two weeks. The rate of cases is expected to increase.