Some Caribbean countries took COVID-19 seriously. Will it work?
While spring breakers were still cramming South Beach bars earlier this month, Puerto Rico’s government was trying to turn the tourism-dependent island into an inhospitable fortress.
Starting March 16, Gov. Wanda Vázquez shut down the island’s beaches, clubs and all “non-essential businesses.” She closed schools, government, imposed a nighttime curfew and required all residents — and visitors — to stay indoors through the end of the month.
This week, she finally got permission from the federal government to close down all but one airport to commercial aviation, forcing incoming passengers to run a gauntlet of health screeners who are informing them that they must spend their first two weeks indoors and isolated.
“You can’t do any activity that requires you to leave your hotel or home,” Vázquez warned potential visitors again this week. “We’re recommending that you don’t travel during the emergency.”
While much of the U.S. mainland is just starting to take serious measures to stop the propagation of the coronavirus, Puerto Rico has been an outlier, putting up bolder barriers faster than perhaps any other
U.S. jurisdiction.
And it joins a small hemispheric club that includes Jamaica, El Salvador, Peru and a handful of others that responded to the crisis with forceful measures that seemed excessive just days ago but now seem prescient.
Jamaica was one of the first countries in the Caribbean to react to the coronavirus, after seeing its first case on March 10. The country barred flights from hot zones, restricted the movement of tourists, enforced quarantines for all new arrivals and canceled school, among other measures. It also put part of an entire town, Bull Bay, on lockdown. On Saturday, the country closed its two international airports to all incoming passengers for at least two weeks.
IS IT WORKING?
Now, while Jamaica has 26 coronavirus cases, neighboring Cuba has 57 and the Dominican Republic has at least 392, according to the Pan American Health Organization, PAHO.
While health professionals say such draconian, isolating measures are the only true safeguard against a novel virus, it’s still too soon to tell if the strategy is truly working.
“As Latin America and the Caribbean is only just beginning to experience cases [and] transmission of COVID-19, it is far too early to evaluate the effect of any distancing measures that particular countries put in place,” said Ashley
Baldwin, a spokeswoman for the Pan American Health Organization.
Even so, “physical distancing measures are an important way of slowing down the spread of the virus and buying time,” she said. “To defeat the virus, countries need aggressive and targeted tactics — testing every suspected case, isolating and caring for every confirmed case, and tracing and quarantining every close contact.”
That’s easier said than done. Like many countries, the region is largely flying blind. Despite promises to begin rapid testing in Puerto Rico, doctors complain that tests are hard to find and it can take days to get results. While the island has detected 51 cases of the coronavirus, Rodríguez Quilinchini, the director of Puerto Rico’s COVID-19 task force, said there were likely an additional 195 to 390 undetected cases.
While governments that acted fast are now being praised, there has been pushback.
Peru, which closed its borders, declared a national quarantine on March 16 and called out the army to enforce the lockdown, has had to arrest more than 16,000 people for violating the order. In
Colombia, street vendors have been protesting — close to rioting — over lockdown rules that began this week.
El Salvador President Nayib Bukele, who shut down the country’s borders and airport on March 14, before the country had seen its first COVID-19 case, has faced stiff political opposition.
“The world IS NOT doing enough to stop the virus. Its advance is ruthless and it has already brought the world’s most powerful countries to their knees,” Bukele wrote Wednesday. “We’re also not doing enough. The worst part is that there are people complaining that we’re being too strict. They don’t understand anything.”
Puerto Rico blunted some of the anger by rolling out a $787 million aid package on Monday that will put cash in the hands of workers and small businesses crippled by the economic shutdown.
Despite the global calls for more and bolder measures, it’s still unclear if total lockdowns are the answer, said Richard Besser, the president and CEO of the Robert Wood Johnson Foundation and the former interim director of the Centers for Disease Control and Prevention.
“Shutting down society, shutting down the economy, has a major impact on people’s lives and affects those on the margins the most,” he said. “We’re asking people to choose between putting food on the table and paying rent, or staying home and protecting their health.”
While many countries have canceled school — an effective way of keeping children from spreading influenza in the past — the verdict is still out as to whether it will be as effective with the coronavirus, he said.
There’s also a timing element. Countries that began quarantines too early may see their citizens develop “compliance fatigue” and grow angry or lax, he explained.
“The takeaway is this: We can learn everything about this virus and ways to control it, but if we don’t give people the ability to take the steps we are recommending, we will fail,” he said.
PRECIOUS TIME
The stringent measures do have one clear benefit, however: They buy time.
Jamaica has been using its measured response to buy ventilators, protective gear and hospital beds, explained Health Minister Christopher Tufton.
“Early in the day we decided it was better to take fairly strong measures — starting with public education, and then graduating into other restrictions in order to at least contain it, even while we prepare our public health system to deal with the inevitable,” he told the Miami Herald.
The truth is many countries have no choice but to keep the coronavirus at bay. Puerto Rico’s decadelong recession has left its healthcare system weak and short staffed, as thousands of doctors have moved to the mainland. If the disease evolves in Puerto Rico as it has in the rest of the world, it could mean 27,000 to 58,000 deaths, according to some estimates.
El Salvador Foreign Minister Alexandra Hill said her government’s tough stance is a matter of survival.
“We have done everything, everything that is in our hands; our cabinet is working 24-7 on all fronts to try and contain this virus,” she said during a video conference Monday sponsored by the Atlantic Council. “We are a vulnerable country. We have a precarious health system, and if this hits us, it’s going to be lethal for our country.”
But lockdowns may be lethal to the economy.
On a recent weekday, Jose Matos, 35, was looking at the empty streets of Puerto Rico’s capital from behind a surgical mask and latex gloves. In order to comply with government regulations, his Rizzeria pizza parlor can only offer carryout and delivery orders.
In the week since the coronavirus measures took effect he’s lost 60 percent of his income and has put workers on part-time schedules so “everyone can work at least a little bit.”
“Our revenue is down but our costs are the same — rent, insurance, electricity, the delivery platforms,” he said. “A lot of businesses won’t be able to survive this.”
Even so, many homebound Puerto Ricans have had time to marvel at images of people packing the beaches of Florida or holding parades in Nicaragua and mass gatherings in places like Brazil and Mexico.
While Puerto Rico’s response is far from perfect, “at least we have measures in place,” Matos said of his island. “I look around at other countries and they aren’t doing anything at all.”