The COVID-19 pandemic in Puerto Rico was an ongoing viral pandemic of coronavirus disease 2019 (COVID-19), a novel infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is part of the ongoing COVID-19 pandemic.

Puerto Rico started addressing the risks of an outbreak in early 2020. The island took "some of the most dramatic steps of any U.S. jurisdiction to control the virus," and "several U.S. cities and states followed Puerto Rico's lead, imposing curfews and shutting businesses" of their own.Puerto Rico seeks to suspend all incoming flights to battle COVID-19 spread. Jim Wyss. Miami Herald. March 18, 2020. Accessed 17 April 2020. On February 29, Puerto Rico then governor Wanda Vázquez Garced established a task force to look into how the virus could affect Puerto Rico and to lay out plans on how to best mitigate any outbreaks. Given the long delays encountered by the Puerto Rico government in obtaining reasonable turnaround from the CDC test labs in Atlanta for samples submitted for testing, the local government took the position that every suspicious case was to be treated as a COVID-19 case until test results were received, and ordered patients to be kept in isolation for 14 days. On March 12, one day before the first COVID-19 case was confirmed, the governor declared a state of emergency and activated the Puerto Rico National Guard to help monitor travelers arriving to the Island through its airports and cruise ship docks. In Section 6 of the bulletin, the citizens of Puerto Rico were put on a curfew allowing them to travel out of their homes from 5AM to 9PM only for essential business such as to buy medicine or seek medical assistance, purchase groceries, or to care for a sick person.

The first cases of COVID-19 in Puerto Rico were reported on March 13. They consisted of two Italian tourists and a 71-year-old cancer patient. The governor expressing concern that the curfew established on the 12th was not being followed, took stronger actions, and asked all non-essential businesses be close from March 15 through March 30. The first death recorded was that of the 68-year-old Italian woman tourist; a few days later her husband was reported to have recovered from the virus. Testing is being conducted by veteran's hospitals, private labs, and the Puerto Rico Department of Health.

, 2,298,983 residents of Puerto Rico have received at least one dose of the COVID-19 vaccine, equivalent to 88.7% of the population.

Background

Recent events When the first case of COVID-19 was confirmed in Puerto Rico on March 13, Puerto Rico was still recovering from several major natural disasters, including Hurricane Maria and the 2019–20 Puerto Rico earthquakes. Increasing the risk of infections from the virus was also the strong ties between Puerto Rico and the Puerto Rican population in New York City, a city which had its first confirmed COVID-19 case on March 1, making the spread of COVID-19 due to people arriving from New York a concern for Puerto Ricans. It was out of this concern that on April 8 Puerto Rico governor Vázquez Garced asked the FAA to halt flights to Puerto Rico from U.S. "hot spots" including New York, New Jersey, Florida, Pennsylvania, Connecticut and Illinois.

Healthcare infrastructure Like the rest of the world, including United States, Puerto Rico was unprepared for the 2020 COVID-19 pandemic.World not prepared for the next big pandemic: report. Leslie Young. Global News. 18 September 2019. Accessed 16 April 2020. When compared to that of the United States, Puerto Rico's population was at higher risk of COVID-19 due to various additional factors such as an older population, higher levels of poverty, and greater dependence on public resources for access to health care. Despite these factors and shortcomings, by April 16 Puerto Rico had kept the number of COVID-19 deaths rate to less than 17% that of deaths in the United States when the two are compared on an equal per-million-inhabitants basis. A table published on April 16 by Statista, a tracker of COVID-19 cases worldwide, showed the number of deaths in Puerto Rico at 15.96 per million inhabitants while that in the United States is shown at 94.54 per million inhabitants.Coronavirus (COVID-19) deaths worldwide per one million population as of April 16, 2020, by country. Statista. 16 April 2020. Accessed 16 April 2020.

It is generally known that the virus is more lethal to older peopleWhy Coronaviruses Hit Older Adults Hardest: As with flu, immune changes and other health conditions are to blame. Sarah Elizabeth Adler. AARP. 14 March 2020. Accessed 16 April 2020. and Puerto Rico has a high proportion of elderly people. In July 2019, almost 21% of Puerto Rico's population was over the age of 65.

Additionally, elderly residents of Puerto Rico are seven times more likely to live in poverty. Puerto Rico has about 8,194 hospital beds for its (as of July 1, 2019) estimated population of 3,193,694 residents.

Since 2006, when Washington stopped some special taxes incentives, Puerto Rico entered an economic crisis, lowering its fiscal budgets. Puerto Rican average Medicaid enrollee receive $2,200/year against $6,700 in US States. Washington periodic fiscal cliff also represent a threat to territories health care systems.

Persistent underfunding, uncertainty and the natural disasters of recent years placed Puerto Rico's health care system in weaker position to face the pandemic. Hospital infrastructure have aged. From 2006 to 2016, the number of doctors fell from 14,000 to 9,000, while there is also a shortage of nurses. There are not enough resources to prepare for disasters- the model has been to provide relief after disasters hit.

Timeline

January 2020 Late January: Luis Muñoz Marín International Airport becomes one of twenty U.S. airports identified by U.S. Federal officials where travelers were to undergo additional screening. The screenings were to focus on passengers from Wuhan and included a form to be filled out by the traveler stating their travel, contacts in Wuhan, and the presence of any possible symptoms. Travelers will have their temperatures taken.

February 2020 February 29: Governor Wanda Vázquez Garced establishes a coronavirus task force to track potential cases.

March 2020 March 4: A Panamanian doctor and four companions arrive in San Juan, Puerto Rico after traveling to New York, Miami, and Panama. They attend the National Day of Salsa festival in San Juan on March 7 despite having a fever and feeling ill. On March 12, Vázquez requests all people who were in the VIP section of the Salsa venue to isolate if they had flu-like symptoms because they may have been exposed to the virus.

March 8: A 68-year-old, Italian woman on the cruise ship sailing from Fort Lauderdale, Florida is put in isolation in a Puerto Rico hospital after showing symptoms of pneumonia. A test is sent to the Centers for Disease Control and Prevention (CDC). Vázquez orders that all cruises arriving in Puerto Rico certify that no passengers meet the criteria for COVID-19.

March 10: The Puerto Rico Department of Health reports that five cases are under investigation. According to the Secretary of Health, Rafael Rodríguez Mercado, the CDC received tests on March 10. The five are an Italian couple on a cruise, a cruise ship passenger who was transported to Puerto Rico by the Coast Guard, a Puerto Rican man who had not travelled out of Puerto Rico and a missionary priest from Colegio María Auxiliadora, a Catholic school in Carolina, Puerto Rico.

March 11: There were 19 potential coronavirus cases after it was reported that a group of 16 students and 3 sponsors from Robinson School were required to isolate after arriving from a trip to Mexico City, Mexico to attend a Model United Nations competition. The country of Mexico had reported 7 cases of COVID-19 during their stay, starting on March 4. They arrived in Puerto Rico on March 9 and were allowed to attend school the next day, March 10. None of the individuals who traveled to Mexico City were infected upon returning, despite have traveled through Tocumen International Airport in Panama City, Panama.

March 12: As a preventive measure, Vázquez declares a state of emergency and activates the Puerto Rico National Guard. Puerto Rico has no confirmed cases of COVID-19. The Government of Puerto Rico bars tourists from travelling to Vieques and Culebra, island municipalities popular with tourists. Only residents and those delivering supplies are allowed to travel to the islands. Vázquez declares a curfew ordering people to remain in their home through March 30. People are only allowed out for emergencies. There are limited circumstances that people can come out to purchase essential items or obtain essential services from 5:00 am to 9:00 pm.Boletín Administrativo Núm. OE-2020-023: ORDEN EJECUTIVA DE LA GOBERNADORA DE PUERTO RICO, HON. WANDA VÁZQUEZ GARCED, PARA VIABILIZAR LOS CIERRES NECESARIOS GUBERNAMENTALES Y PRIVADOS PARA COMBATIR LOS EFECTOS DEL CORONAVIRUS (COVID-19) Y CONTROLAR EL RIESGO DE CONTAGIO EN NUESTRA ISLA. GOBIERNO DE PUERTO RICO. LA FORTALEZA. SAN JUAN, PUERTO RICO. 15 March 2020. Archived on 2020-04-17 at the WayBack Machine. Accessed 17 April 2020.

Mid-march: Several universities including University of Puerto Rico, Universidad del Sagrado Corazón, Pontifical Catholic University of Puerto Rico, Ana G. Méndez University, Interamerican University of Puerto Rico, and National University College cancel in-person classes and move to remote instruction.

March 13: Puerto Rico has 17 suspected cases of COVID-19 and has sent tests to the CDC on March 9. Vázquez criticizes the CDC on March 13 for not having results in over four days. However, later in the evening of March 13, Vázquez announces, at a press conference, that three cases have been confirmed: the 68-year-old Italian woman from the cruise ship Costa Luminosa and her 70-year-old husband (both tourists) are hospitalized in isolation at the Ashford Presbyterian Community Hospital in Condado, as well as a 71-year-old Puerto Rican cancer patient in treatment at Auxilio Mutuo Hospital whose relatives had traveled off the island. During the evening of March 13, Vázquez closed all public schools for 14 days and bars cruise ships and ferries from the Dominican Republic from docking at Puerto Rico ports.

March 13: Plans to take people's temperature as they enter Puerto Rico at 7 different points of entry are pending the receipt of 50 no-touch infrared thermometers.

March 15: A fourth case of COVID-19 is confirmed and is an 87-year-old military veteran and California resident who was transferred to the Mayagüez Medical Center by United States Coast Guard helicopter after presenting symptoms on a cruise passing through the Mona Passage. Vázquez orders all businesses, with the exception of grocers, supermarkets, gas stations, banking institutions, pharmacies, and medical companies to close.

March 15: Puerto Rico Police commissioner Henry Escalera Rivera postpones all personnel training. Current cadets at the Police Academy will report to locations close to their residences to conduct administrative tasks at the barracks. Until further notice, several documents and certifications will not be issued: background and criminal checks and copies of police reports. The Criminal Record Office will not be offering in-person services and will instead send records through email, free of charge.

March 15: A 65-year-old woman at an undisclosed location becomes the fifth confirmed case. Puerto Rico has 17 other suspected cases.