The death toll after Hurricane Maria was hard to capture, and estimates varied widely. The uncertainty about numbers for the coronavirus is caused by some of the same issues… but there are additional factors.
Puerto Rico was not able to begin testing as early as the States did. Per capita testing in Puerto Rico has been lower than in any state but Oklahoma. San Juan has a drive-through testing station, but Toa Baja has no tests at all.
Puerto Rico ordered and paid a 50% deposit on a million rapid-response tests — but they didn’t arrive. Now, the government has learned that the FDA didn’t approve the tests, and is trying to cancel the order and get its money back.
A lack of testing kits has led to Puerto Rico’s having to limit testing to people who have traveled to coronavirus hot spots or have had contact with travelers. Officials explain that they have not seen community transmission and are therefore focusing on travelers. However, since only people who could have caught the disease from travelers are being tested, community transmission may not be identified quickly.
Authorities are still waiting for the results of 1,055 screening tests. And once the results of the tests are gathered, Puerto Rico authorities say, it is difficult to track all the contacts the infected person has had.
These factors make it challenging to identify the coronavirus victims.
States have begun to review individual records from early 2020 and change their minds regarding the cause of death. Some people who died of pneumonia in February may actually have died of COVID-19, but the disease was too unfamiliar to recognize at that time.
The World Health Organization also now estimates that as many as 25% of people who test positive for COVID-19 may have no symptoms at all. Asymptomatic carriers of the virus will generally not be tested, but they can still spread the disease.
Puerto Rico will probably have a similar experience. Particularly with limitations on testing, chances are good that the number of cases is being underreported.
Lack of resources
Puerto Rico has some special challenges when it comes to facing the COVID-19 pandemic. Rates of chronic diseases like diabetes and asthma are higher in Puerto Rico than in most States, and the population is older than in the States. Both these factors increase the likelihood of severe cases of he coronavirus.
Puerto Rico’s healthcare system has been underfunded for so long that it is not a strong position to cope with the added needs the coronavirus will bring.
There has also been an exodus of doctors over the years, especially those in medical specialties like pulmonology, and Puerto Rico now has a shortage.
If cases are being underreported, it will be difficult for health officials to respond usefully to the emergency.