Where to get tested for COVID-19 in Puerto Rico?

“But you don’t look that sick. Did you walk here, or did someone drive you?”

“Your cough isn’t a dry cough, like the virus. It’s a wet cough, like a cold.”

On Mar. 19, Carlos Del Valle, a 65 year-old man claimed that a doctor at the Río Piedras Medical Center refused to run the COVID-19 test on him, despite having a referral from his doctor, who told him he could be at risk because he was showing symptoms and had been exposed to people infected with the virus. “I’m an old person, I have diabetes and I feel weak,” the man told the doctor, who did not think those circumstances were enough to authorize the test administered by the Health Department.

Federal government faces COVID-19 crisis blindly, lacking a risk monitoring system that would include pandemics

President Donald Trump’s administration is steering the response to the coronavirus like a pilot who flies blindfolded. The Department of Health and Human Services (HHS) for 12 years has failed to comply with its obligation to operate a centralized digital platform to share information, as close as possible to real time, about threats to public health such as pandemics. Now it lacks that tool to avoid deaths related to COVID-19. The Government Accountability Office (GAO) has filed three reports, two during the Trump term and one during former President Barack Obama’s tenure, noting that HHS has failed in its legal obligation to design the enhanced situational awareness network. Furthermore, the GAO sent a letter on March 28, 2019 to the highest federal health authority in the US, HHS Secretary Alex Azar II, outlining more than 42 critical actions that the agency has not complied with, including the implementation of this tool.

No man’s land: Buying tests and supplies for the COVID-19 emergency in Puerto Rico

The Government of Puerto Rico’s procurement process for materials and equipment to deal with the coronavirus emergency has been plagued with mistakes, delays, inefficiency, questionable purchases and a lack of details. The Center for Investigative Journalism (CPI, in Spanish) interviewed more than three sources who identified Adil Rosa Rivera as responsible for buying supplies and equipment for the emergency, such as ventilators, tests and protective equipment. Up until a few days ago, Rosa Rivera coordinated the procurement process, first through the Health Department and then through the Bureau for Emergency and Disaster Management’s (NMEAD, in Spanish) Emergency Operations Center (COE). From the COE, together with Medical Task Force members Dr. Juan Salgado and Dr. Segundo Rodríguez, they have coordinated what to buy and from whom, three sources confirmed. Rosa Rivera previously worked as the Family Department’s Administration Director for the Caguas region, and until last week was in charge of the Health Department’s Undersecretary of Administration office.

Passengers arrive in Puerto Rico from areas of greatest contagion by coronavirus in the US

The spike in COVID-19 cases in regions with the highest concentration of Puerto Ricans living in the United States, added to the historic volume of traffic of passengers arriving from those places through the Luis Muñoz Marín International Airport could represent an open route for the transmission of the virus. In Puerto Rico, epidemiology, public health, and infectious disease experts interviewed by the Center for Investigative Journalism (CPI, in Spanish) agreed. Upon reviewing data of the areas of greater COVID-19 infection in the United States, it appears that New York, New Jersey, and Florida are among the first 10 places in the spread of the virus. According to 2018 Census data, these three states are where the most Puerto Ricans live. Most of the flights that arrived at the airport between Mar.

“The hospital is not ready”

Juan frets about how doctors and nurses are too exposed to the virus. After all, what are we left with if we lose those who heal us? He is concerned that those arriving in the emergency room with symptoms are not being isolated, that the protocols are not being followed, that the hospital administration is not doing its job right and the crisis is just beginning. This is the third time I talk to Juan. He works at the Ramón Ruiz Arnau University Hospital, better known as the Bayamón Regional Hospital or HURRA.

Data Mismatch Prevents Knowing If There are Enough Ventilators and Isolation Beds for COVID-19 Patients

The ventilators available in Puerto Rico, which are not exclusively for COVID-19 patients, would not be sufficient to care for the 15,800 to 20,250 critically ill patients who could   require their use to save their lives, according to projections by the COVID-19 Task Force about people who may   contract the virus for as long as the epidemic lasts on the island, and data from the World Health Organization (WHO). Between public and private hospitals, there are only 880 ventilators available in Puerto Rico, and as the spread of the novel disease continues, worldwide demand for this equipment is also on the rise. The COVID-19 Task Force projected that between 316,000 to 405,000 people could become ill with COVID-19. Puerto Rico has a population of 3.7 million. This data, presented last Tuesday, comes   from tests done   locally   and based on the experience in other countries such as China and Italy .

Thousands could die from COVID-19 in Puerto Rico

Government and public health experts at the highest levels have known this for days, but nobody wants to say it openly: thousands could die from COVID-19 in Puerto Rico. So far, the projections that the Center for Investigative Journalism (CPI, in Spanish) has learned from experts are overwhelming. The most conservative suggests that some 16,000 deaths could be registered during the pandemic on the island; the worst case scenario approaches 58,000 victims.

The CPI asked health demographer Raúl Figueroa to calculate the number of possible deaths, based on the contagion estimates that the Government of Puerto Rico has disclosed, as well as the fatality rates published by countries that lead the way in the pandemic, and the local case-fatality rate that the few tests done to date show. The first test was done on March 8. According to Figueroa’s calculations, if Puerto Rico approaches the global average mortality rate — which to date is 4.4% — 27,000 people would die in about 12 to 18 months.

Falsehood Behind the State Epidemiologist in Charge of the Response to the Coronavirus

State Epidemiologist Carmen Deseda, responsible to advise and inform citizens on how to fight the coronavirus pandemic in Puerto Rico, has no formal academic training as an epidemiologist, but instead took a course that accredits her as an Epidemiology Officer, the Center for Investigative Journalism (CPI, in Spanish) found. According to her curriculum vitae, Deseda has a bachelor’s degree in Biology from the University of Puerto Rico and an MD in Medicine from the Universidad Central del Caribe in Puerto Rico. In 1980, she participated in a field epidemiology training at the Epidemiology Intelligence Service Unit at the Atlanta headquarters of the Centers for Disease Control and Prevention (CDC). She has no master’s degree or PhD in epidemiology. Her field training in epidemiology was offered by the CDC, which is not an academic institution, and is offered to coach doctors who will practice as “State Epidemiologists.”

Deseda was appointed State Epidemiologist in 1994 by ex-Governor Pedro Rosselló-González.