The White House COVID Task Force has been conducting state-by-state weekly analyses of the status of the pandemic and has issued reports with specific recommendations to all state governments for more than six months but has left Puerto Rico out.
Apparently, the White House also forgot about the other US territories: Virgin Islands, Guam, Samoa and Mariana Islands. When combined, 3.6 million people live in the four territories.
The Center for Investigative Journalism (CPI, in Spanish) detected the omission during a review of the reports, obtained and published by The Center for Public Integrity. In the case of Puerto Rico, the exclusion was also confirmed by the Puerto Rico Health Secretary under the prior administration, and with new Gov. Pedro Pierluisi. Both said through their spokespersons that they had not received any report or communication from the White House COVID Task Force.
Requests for information sent to the White House, to the Office of the former Vice President of the United States, Mike Pence, who was leading the COVID efforts and the Task Force under the Trump administration, and to the Office of Internal Affairs, which was in charge of sending the COVID reports to the states, to find out why Puerto Rico and the other territories were excluded, were not answered.
The CPI asked Michael Baker of US Department of Health and Human Services (HHS) to confirm if the reports for the territories were never produced and, if so, why not, but he referred the questions to the agency’s Public Affairs Office. As of press time, the agency had not responded to the request for information.
The CPI asked the administration of new President Joe Biden, about the exclusion, and whether there will be changes, and the White House COVID-19 Response Team said: “The COVID-19 pandemic has exposed and exacerbated severe and pervasive health inequities among communities, states, and territories. This Administration is committed to working in partnership with territories in the response. That includes access to supplies, vaccines, relief funds, and the latest data regarding the pandemic. We’ve referenced the Federal Government’s full commitment to territories — including Puerto Rico — in our National Strategy for the COVID-19 Response and Pandemic Preparedness that was released last Thursday.”
The reports of the White House Task Force contain specific and analytical information on each state’s situation regarding new cases and the level of alert according to positivity. They also include the counties (equivalent to municipalities in Puerto Rico) with the highest increase in cases that week and specific recommendations for each state. The document also provides information on deaths, tests, new cases, COVID-19 admissions and information on the storage of medical supplies and availability of personnel in hospitals.
Some of this information, such as the positivity rate by municipality, is not public in Puerto Rico, although it is vital to develop and execute an effective response against the spread of the virus as well as to the reactivation of activities such as the return of children to in-person school.
Some reports contain data on the doses of COVID-19 vaccines distributed per 100,000 inhabitants and the total and percentage of the first dose administered in that state.
When approached by the CPI about the implications of excluding Puerto Rico from the reports, Dr. Cruz María Nazario, epidemiologist and professor at the University of Puerto Rico’s Medical Sciences Campus, said it is discriminatory and significant given that the island’s population is composed mainly of what is considered in the United States as the ethnic minorities with the highest risk of contagion and death from COVID-19: Hispanics and Afro-descendants.
“There’s no justification for not including Puerto Rico in the Task Force’s analyses because the source of information is the same as in the states: the Puerto Rico Department of Health and the Centers for Disease Control (CDC). Therefore, it isn’t because of the lack of data. Nor should it be because of our political status, as Washington D.C. isn’t a state either and is included,” said Dr. Nazario.
Dr. Nazario, a graduate of Johns Hopkins University who is also a researcher, said this is not the first time that Puerto Rico has been excluded in a discriminatory manner from the United States’ national public health efforts. She recalled, for example, the exclusion of the island in the National Health and Nutrition Examination Survey (NHANES).
Another example is that none of the territories and colonies are included in the survey conducted since 1999 to assess the health status and risk factors in the United States, she said. For the CDC it is enough to include Mexican-Americans and a sample of Puerto Ricans from New York in this survey, she added.
Despite the importance of these types of reports to manage the pandemic, the White House’s past administration said that it does not make these reports public because it wanted each state to lead it´s response to the pandemic, according to The Center of Public Integrity, the entity that collects and publishes the reports.
The Community Profile Report, which is prepared by a subgroup of the Task Force called the Data Strategy and Execution Workgroup in the Joint Coordination Cell, does include Puerto Rico. This report, produced by an interagency group of federal agencies such as HHS and the CDC, only contains data, not analysis or recommendations.
Among the data included in the report, which is updated daily, are the number of new cases and deaths in the past seven days, the positivity rate according to COVID-19 tests conducted, the total hospitalizations due to the disease, and the number of patients in intensive care units.
In addition, the document lists the cities with the highest increases in cases, mortality, hospital admissions and intensive care.
The January 13 report shows that among the areas with the biggest growth of infections among counties — which translates to municipalities in the island’s case — with a population of between 250,000 and 1 million people, was the municipality of Ponce, with 286 new cases in the last seven days and 12.9% positivity rate. Compared to the week before, the city had an increase of more than 44% in cases and more than 2.9% in the positivity rate.
In the January 20 report, Ponce also appears as one of the places with a population of 250,000 to 1 million people that showed an increase in cases in the past seven days.
In a previous report dated January 12, San Juan -Puerto Rico’s capital- was on the list of cities with more than 1 million inhabitants with a growth in the number of cases in the last seven days. The week before, the capital city reported a 53% increase in cases.
Last Friday, Puerto Rico reported 29 deaths, the highest number of deaths from COVID-19 reported on a single day since the pandemic officially began at the local level in March 2020. Although the deaths reported that day occurred on different dates, as is typical of the Puerto Rico Department of Health reports, the new Health Secretary Carlos Mellado said publicly that two happened in December and the rest in January. As of Monday, there were almost 85,114 cases of contagion confirmed with PCR tests on the island, 66,352 suspected cases, 6,482 probable cases, and 1,778 accumulated deaths, according to the Department of Health’s dashboard.
Latinos in the new Task ForceAmong the new members of the Task Force appointed by President Joe Biden are two Latinos and a Caribbean woman from the US Virgin Islands linked to Puerto Rican affairs. She is Dr. Marcela Nunez-Smith, Professor of Internal Medicine and Public Health at Yale University and Associate Dean for Research on Health Equity at the Yale School of Medicine, specializing in health care for underserved populations. The doctor was named as one of the body’s co-chairs.
The chairman of Puerto Rico’s Scientific Coalition to address matters related to COVID-19 on the island, Daniel Colón, said that Nunez-Smith has “close ties with Puerto Rico” and has been studying and interested in the issue of health equality in Puerto Rico and the US Virgin Islands, where she was born and raised. The doctor also has research projects in Puerto Rico, including on COVID-19, Colón, who is a professor of Neuroscience and Cell Biology at Yale School of Medicine, said through his Twitter account.
The other Latino members are Dr. Luciana Borio and Dr. Robert Rodríguez.
Borio, a native of Brazil, is a doctor specializing in infectious diseases who served on President Donald Trump’s National Security Council as a member of his pandemic response team until Trump disbanded it in 2018. She is vice president of technical staff at In-Q-Tel, a nonprofit venture capital firm that develops new technologies for national security agencies.
Meanwhile, Rodríguez, is a professor of Emergency Medicine at the University of California’s School of Medicine. He grew up in Brownsville, Texas, between the US and Mexico border, where he traveled last summer due to the increase in COVID-19 cases in the area and the lack of doctors and resources to address the situation.