- Ronald Avila-Claudio
- BBC News World
In a territory hit by a deep economic crisis, which causes a huge migration of health personnel and a shortage of hospital resources, the pandemic could have been a major disaster.
Puerto Rico, however, draws the world’s attention for its current handling of the pandemic. With 74.7% of the population immunized, the Caribbean island exceeds the figures of any otherO territory U.S.
The percentage is above the global reported by the United States as a country, which for this December 8 registered 60.1%, according to the Centers for Disease Control and Prevention (CDC).
If measured outside the North American nation, Puerto Rico would be competing with the Latin American countries with the best vaccination figures, such as Chile (84.44%) and Uruguay (76.35%).
If the inoculation efforts had not been effective, an expert assures that Puerto Rico would be among the states with the highest rates of victims from the coronavirus in the United States.
Puerto Rico could have added 10,000 deaths in the worst-case scenario, Daniel Colón-Ramos, a professor at the Yale University School of Medicine, told BBC Mundo.
“The consequences could have been really tragic,” he added.
But the island accumulate 3.274 people died from covid-19. The death rate per 100,000 residents is 1.03%, while across the United States it is 2.37%, the CDC indicates.
To avoid a public health crisis, the island faced multiple challenges, such as vaccinating rural communities, with high levels of poverty and minimal access to transportation.
Many of these citizens are still recovering from two major hurricanes and one earthquake in the past four years. They also suffer the economic recession caused by an immense public debt.
The government also had to win the trust of Puerto Ricans. The first period of the pandemic was marked by several scandals, among which a millionaire purchase of tests to detect covid-19 stands out, which were not endorsed by the federal government.
In addition, when vaccination began, in December 2020, the race became urgent, as the island was facing its deadliest month, in which it accumulated 445 deaths.
But Puerto Rico implemented its vaccination plan well. Next, in BBC Mundo we highlight six keys that explain the figures.
1. The role of scientists
Of the first actions that the governor took Pedro Pierluisi After winning the elections, in November 2020 he appointed an independent scientific coalition, not affiliated with the island’s political parties, to advise him on the pandemic.
Some of these scientists also became spokespersons for campaigns and discussion panels.
The main task of the experts was to improve the data system of the local Health Department, with the intention that the government make informed public policy decisions.
Colón-Ramos is precisely the president of this group. The professor accepts that the interests of the government are not always aligned with his recommendations, but they achieve consensus.
2. Make vaccination mandatory
Another key to success was that Puerto Rico implemented stricter measures than those proposed by the federal government and the other states to make vaccination mandatory.
On the island, for example, to go to classrooms, teachers are required to be vaccinated, as well as students who are of age to receive the drug.
To enter mass activities, restaurants and even gyms, proof of vaccination is requested at the entrance.
The executive orders also make the use of masks in closed places mandatory, as well as social distancing.
Rafael Irizarry, a biostatistician at Harvard University, explained that the executive orders changed according to the data.
According to the expert, who is also part of the scientific coalition, when the mandates were imposed in the territory, the percentage of inoculation exceeded that of the states of New England (northeast of the country), which are the ones with the highest figures in the continental United States.
Of this group of states, the one that comes closest to Puerto Rico is Vermont, with 74% of vaccinations. But its population amounts to 623,989 people, compared to the 3.2 million who live in Puerto Rico.
3. Prioritize vaccination of people at risk
With the intention of saving lives and not overloading the health system, the government of Puerto Rico gave priority to certain risk groups during vaccination.
“What resulted in the saving of lives is that the most vulnerable communities were prioritized, including people in prisons, homeless people, the elderly and the health sector,” explained Professor Colón-Ramos.
Another group that also had priority to be immunized was that of teachers and workers in the education sector.
This decision helped the return to the classrooms in August of this year, after long months of distance education.
4. Use NGO logistics
During the first half of 2021, several communities with high levels of poverty complained to the government for an unequal distribution of the vaccine.
In this context, the most important role was played by various non-profit organizations, which have been promoting vaccination in the territory for years and made their personnel and logistical plans available to the government.
They held mass vaccination events in the villages, visited the elderly and the sick from house to house, and led educational efforts. The operation resulted in the immunization of tens of thousands of people.
“If it had not been for entities like us, they are people who really would not have obtained the vaccine,” Carla González Levalle, a nurse who works at the NGO Puerto Rico Saludable, told BBC Mundo.
His team, made up of just four health professionals, helped vaccinate some 10,000 Puerto Ricans, he says.
So did NGOs such as the College of Surgeons, College of Nursing and universities. The National Guard (state military body) and municipal authorities were also involved in this effort.
The vaccine was also available in community pharmacies and large chains, which helped make it more accessible.
5. Do not politicize vaccination
Some say that politics in Puerto Rico is “the national sport.” In the slightest after-dinner discussion, over a beer or in a waiting room, issues such as the political status of the island or corruption flourish.
In this highly politicized territory, experts agree that it was important for the proper management of the pandemic that four of the five parties with representation in the local government supported the executive orders for vaccination.
By contrast, in the rest of the United States, Republican-ruled territories, such as Florida, have sued the Democratic government of President Joe Biden for establishing inoculation requirements.
In addition to the support of political parties, it was also important that most of the island’s religious leaders were “aligned” with vaccination, added Professor Colón-Ramos.
6. Puerto Rico has a pro-vaccination culture
For the experts, something that undoubtedly contributed to the United States’ territory reaching a high level of vaccination was that the population agreed to be vaccinated, despite the exceptions included in the executive orders.
Both private and public workers had the option of submitting a weekly virus test if they did not qualify for immunization.
“We have always been people to get vaccinated, people get vaccinated, they vaccinate children, it is a very minimal population that does not,” nurse Carla González Levalle told BBC Mundo.
In the continental territory, the anti-vaccine movement is much broader and is behind the fact that there is not a higher percentage of inoculation.
Statistician Rafael Irrizary added that before the decrees, there was a good response to vaccination from the public.
“The jurisdiction [Puerto Rico] it was like the tenth or ninth before the mandates and once they put the mandates, it jumps to number one, “he said.
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Eddie is an Australian news reporter with over 9 years in the industry and has published on Forbes and tech crunch.