The U.S. Virgin Islands is halting tourism for a month, hoping against hope to keep out new cases of the coronavirus. Puerto Rico’s Senate is closed after several high-ranking officials came down with Covid-19. Hawaii is facing a surge in new infections. Guam is enduring its most restrictive lockdown since the pandemic began.
For months, United States islands in the Caribbean and the Pacific avoided much of the agony unleashed by the coronavirus across parts of the mainland, due in part to their early mitigation efforts and relative ease in sealing off borders.
But now the state of Hawaii and these territories are emerging as some of the most alarming virus hot spots in the United States, revealing how the coronavirus can spike and then rapidly spread in places with relaxed restrictions, sluggish contact tracing and widespread pressure to end the economic pain that comes with lockdowns.
“People are infecting each other in crowded apartments while hotels sit empty,” Dr. Jonathan Dworkin, an infectious-diseases doctor who lives on Hawaii’s Big Island, wrote in a scathing assessment of Hawaii’s pandemic responses in The Honolulu Star-Advertiser.
Dr. Dworkin lit into the reluctance by health officials in Hawaii to ramp up testing in the early weeks of the pandemic and said it was the privately funded testing efforts that may have staved off an even more acute crisis. He also questioned why contact tracing operations remain inadequately staffed.
Hawaii, as well as other some islands that are U.S. territories, still have relatively fewer cases and Covid-19-related deaths than many parts of the mainland. But Hawaii now ranks among the states where new cases have grown fastest over the last 14 days.
Meanwhile, confusion is emerging over some pandemic measures there, especially in Honolulu, where gyms remain open but hiking trails and parks are closed; restaurants in the city are also open but residents cannot receive visitors into their home from outside their household.
Gov. David Ige defended the state’s contact tracing efforts, saying in a news briefing this month that Hawaii’s operations were “better than average and amongst the best in the country.”
At the same time, sharp increases in cases are raising concerns on other American islands. The situation in Guam seems especially problematic, with cases emerging in several schools, at the territorial port authority and on its police force.
The U.S. Virgin Islands, which registered almost no cases in the early days of the pandemic, is now approaching 1,000 total cases, pushing its per capita infection numbers higher than those of several states.
Dr. Esther Ellis, the territorial epidemiologist for the U.S. Virgin Islands, said officials were reacting quickly and thoroughly to outbreaks in the territory, which includes the islands of St. Croix, St. John and St. Thomas.
The islands are requiring temperature checks with thermal scanners for all visitors upon deplaning, she said, and is also conducting aggressive testing. “We’re the only place giving test results back in 24 hours,” she said.
Still, authorities there are shutting nonessential businesses and imposing stay-at-home orders. The territory saw its cases surge to 224 per 100,000 residents over the past seven days, the highest per capita increase of any state or territory.
There are exceptions to the crisis unfolding on U.S. islands. American Samoa, an archipelago in the Pacific, remains the only territory or state without a single confirmed case of Covid-19, reflecting early moves to halt nearly all incoming flights, rapidly increase testing and seize on social distancing measures adopted in response to a measles outbreak in late 2019.
But the situation in the U.S. Virgin Islands shows how quickly things can change. The territory, which avoided the large outbreaks that were hitting parts of the mainland early in the pandemic, had reopened for leisure visitors on June 1 after an early lockdown — then had to hit the brakes.
Gov. Albert Bryan Jr. announced this month that hotels and Airbnb operators would be prohibited from accepting new guests for 30 days. Mr. Bryan also ordered bars, nightclubs and cabarets to shut down until Aug. 31.
The Coronavirus Outbreak ›
Frequently Asked Questions
Updated August 24, 2020
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What are the symptoms of coronavirus?
- In the beginning, the coronavirus seemed like it was primarily a respiratory illness — many patients had fever and chills, were weak and tired, and coughed a lot, though some people don’t show many symptoms at all. Those who seemed sickest had pneumonia or acute respiratory distress syndrome and received supplemental oxygen. By now, doctors have identified many more symptoms and syndromes. In April, the C.D.C. added to the list of early signs sore throat, fever, chills and muscle aches. Gastrointestinal upset, such as diarrhea and nausea, has also been observed. Another telltale sign of infection may be a sudden, profound diminution of one’s sense of smell and taste. Teenagers and young adults in some cases have developed painful red and purple lesions on their fingers and toes — nicknamed “Covid toe” — but few other serious symptoms.
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Why does standing six feet away from others help?
- The coronavirus spreads primarily through droplets from your mouth and nose, especially when you cough or sneeze. The C.D.C., one of the organizations using that measure, bases its recommendation of six feet on the idea that most large droplets that people expel when they cough or sneeze will fall to the ground within six feet. But six feet has never been a magic number that guarantees complete protection. Sneezes, for instance, can launch droplets a lot farther than six feet, according to a recent study. It's a rule of thumb: You should be safest standing six feet apart outside, especially when it's windy. But keep a mask on at all times, even when you think you’re far enough apart.
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I have antibodies. Am I now immune?
- As of right now, that seems likely, for at least several months. There have been frightening accounts of people suffering what seems to be a second bout of Covid-19. But experts say these patients may have a drawn-out course of infection, with the virus taking a slow toll weeks to months after initial exposure. People infected with the coronavirus typically produce immune molecules called antibodies, which are protective proteins made in response to an infection. These antibodies may last in the body only two to three months, which may seem worrisome, but that’s perfectly normal after an acute infection subsides, said Dr. Michael Mina, an immunologist at Harvard University. It may be possible to get the coronavirus again, but it’s highly unlikely that it would be possible in a short window of time from initial infection or make people sicker the second time.
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I’m a small-business owner. Can I get relief?
- The stimulus bills enacted in March offer help for the millions of American small businesses. Those eligible for aid are businesses and nonprofit organizations with fewer than 500 workers, including sole proprietorships, independent contractors and freelancers. Some larger companies in some industries are also eligible. The help being offered, which is being managed by the Small Business Administration, includes the Paycheck Protection Program and the Economic Injury Disaster Loan program. But lots of folks have not yet seen payouts. Even those who have received help are confused: The rules are draconian, and some are stuck sitting on money they don’t know how to use. Many small-business owners are getting less than they expected or not hearing anything at all.
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What are my rights if I am worried about going back to work?
- Employers have to provide a safe workplace with policies that protect everyone equally. And if one of your co-workers tests positive for the coronavirus, the C.D.C. has said that employers should tell their employees -- without giving you the sick employee’s name -- that they may have been exposed to the virus.
The territory, which has 103,000 residents, was already trying to bounce back after being hit in 2017 with Hurricanes Irma and Maria, two rare Category 5 storms. Tourism, which accounts for a third of the economy in the U.S. Virgin Islands, remains its largest source of employment.
Puerto Rico, the most populous U.S. territory with about 3.2 million residents, showcases how the pandemic is accentuating pre-existing economic and political problems. Puerto Rico imposed the nation’s first lockdown in March, before California became the first state to do so — indeed, before the word “lockdown” started becoming part of the nation’s vocabulary.
The stringent measures helped keep the virus under control and the island’s underequipped hospitals from becoming overwhelmed. Scientists collaborated to expand the island’s testing capacity amid shortages of chemicals and other materials, and promoted pooled testing long before most states.
The lockdown led to an unemployment crisis that forced hundreds of workers to line up for assistance before dawn, and sometimes overnight. Already, Puerto Ricans have endured 14 years of economic sluggishness, several devastating recent hurricanes and, in January, a flurry of earthquakes and aftershocks.
With cases trending upward, Gov. Wanda Vázquez held a televised address last week to announce a stay-at-home order that would apply for the next three Sundays, the latest in a series of escalating restrictions meant to keep people from socializing with friends or family. Violators of the island’s mask order will be subject to a $100 fine, while a nightly curfew remains in effect.
On Thursday, a day after Ms. Vázquez imposed the latest restrictions, Puerto Rico’s Senate closed after cases were identified among high-ranking elected officials, including several legislators, the speaker of the House of Representatives and two top aides to Pedro R. Pierluisi, the nominee for governor from the pro-statehood New Progressive Party. Representative Jenniffer González-Colón, Puerto Rico’s nonvoting member of Congress, also tested positive.
“One of the most critical areas remains contact tracing, and the testing that is done,” said Lorenzo González, Puerto Rico’s health secretary. He added that a shortage of testing materials was making it harder for authorities on the island to get the virus under control.
Guam, which trails only the U.S. Virgin Islands among American states and territories where cases climbed fastest in the past week, is dealing not just with a surge in Covid-19 but with simmering criticism of a lockdown, ordered on Friday by Gov. Lou Leon Guerrero, that includes fines of $1,000 for violators.
Protesters gathered on Monday to voice opposition to the measures in Tumon, the heart of Guam’s tourism industry, and to urge a recall of Ms. Leon Guerrero. The governor warned that such protests could spread the coronavirus and harm the economy even more if restrictions now in place have to be prolonged.
Alejandra Rosa and Mitch Smith contributed reporting.
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