Task Force Created to Lobby for Return of Critical U.S. Manufacturing to Puerto Rico

The Coronavirus problem illustrates it is a no brainer opportunity for Puerto Rico to replace China as the main source of key pharmaceuticals, to reduce the overdependence on China, bringing more jobs to Puerto Rico, speeding delivery of pharmaceuticals to all Americans.

Task Force Created to Lobby for Return of Critical U.S. Manufacturing to Puerto Rico

Task Force Created to Lobby for Return of Critical U.S. Manufacturing to Puerto Rico

By on March 24, 2020
A Baxter International Inc. manufacturing facility for intravenous bags. (Courtesy)

Puerto Rico Manufacturers Association Heads Effort Amid National Security Concerns Raised by Covid-19 Disruptions

SAN JUAN – Puerto Rico Manufacturers Association (PRMA) President Carlos M. Rodríguez announced Monday the creation of a task force with the aim of including the island in federal initiatives to bring back manufacturing to U.S. soil due to national security considerations amid the Covid-19 pandemic.

Rodríguez said in a press release that he is heading the task force, which includes a team of experts in the areas of manufacturing, taxes and the economy.

Puerto Rico Manufacturers Association President Carlos M. Rodríguez (Screen capture of www.industrialespr.org)

“This opportunity has a very short window of time, so the work [of the task force has] started immediately,” the PRMA head said in the statement. “We will be communicating achievements regularly.”

The task force includes Carlos Serrano, a tax attorney who works for the firm of Reichard Escalera and is currently chairman of the PRMA tax committee; former Treasury Secretary Teresita Fuentes, a former partner at Ernst & Young and currently working for financial consulting firm Birling Capital; Carlos Bonilla, a tax attorney and past chairman of the PRMA tax committee; and entrepreneur Joaquín Viso, founder of MOVA Pharmaceutical and MC-21.

Among the other task force members are William Lockwood, president of Lockwood Financial Advisors; Félix Negrón, vice president of operations at Medtronic Worldwide; Wendy Perry, vice president of Merck Sales & Marketing and president of the Pharmaceutical Industry Association; and Silvia Santiago, vice president of manufacturing at Destilería Serrallés and PRMA vice president of local industry.

Rodríguez said Puerto Rico’s role as a global supplier is critical in addressing emergencies such as the novel coronavirus pandemic.

“Our manufacturing is resilient and able to adjust to change and add production lines in the short and medium term, not only in the health sector, but in other sectors that can be adapted to meet the needs of products as demonstrated by companies such as Serrallés, which is manufacturing ethyl alcohol for hospitals instead of rum,” he said, noting that island manufacturers, exempted from Gov. Wanda Vázquez’s curfew/lockdown order, continue to maintain the availability of products with measures to protect its workforce from contagion. “We are confident that our textile industry can move quickly to meet the need for masks and hospital gowns.”

With stateside calls for critical pharmaceutical production to be shifted to the United States from overseas locations that have seen a slowdown in manufacturing amid the Covid-19 crisis, the government of Puerto Rico and the island’s drug-making industry are mounting a lobbying effort in Washington, D.C., to promote the island as an ideal U.S. jurisdiction to make needed active ingredients for disease treatments and vaccines under a national security requirement.

The local actions were prompted by a New York Post editorial published on March 7 that noted that the novel coronavirus crisis has “already exposed the nation’s serious over-reliance on China for pharmaceutical production.” The editorial says that about 90 percent of the active ingredients used by U.S. drugmakers come from China, noting that “America’s pharmaceutical supplies are at risk” with the shutdown of factories in the Asian nation that was the epicenter of the Covid-19 outbreak.

Stating that the Food and Drug Administration (FDA) “fears a shortage of widely used generic drugs,” the editorial calls for critical drug production to be done domestically and endorses Puerto Rico – “that is “now struggling with a debt crisis plus hurricane and earthquake damage” – as an ideal site for this.

Storied role

In a column published on March 16 in Forbes magazine, “Puerto Rico Can Help the U.S. End its Dependence on Chinese Pharmaceutical Ingredients,” policy editor Avik Roy states that in the wake of the coronavirus outbreak, “public health officials and policy experts have raised concerns that the U.S. is too dependent on China for critical active pharmaceutical ingredients—the compounds essential to manufacturing common medicines like penicillin, Advil, and Tylenol.” 

After giving a brief history of the rise and fall of Section 936 and its role in making the island a global pharmaceutical hub and explaining why drug manufacturers in Puerto Rico moved to China, Roy called on Washington, D.C., to provide incentives so that such manufacturing be moved back to the island, improving its battered economy and finances.

Roy proposes addressing these problems by partially restoring the Section 936 tax break in exchange for other Puerto Rican fiscal reforms. Such policies would include exempting generic drug manufacturers from corporate taxes in Puerto Rico and creating a “most-favored nation” Puerto Rican tax rate for pharmaceutical intellectual property.

In exchange for the partial restoration of these tax breaks, Roy explains, Congress should phase out the exemption from taxation of Puerto Rican debt for newly issued bonds.

“Congress, in its recent deliberations on an economic relief package, has thrown a lot of policy mud on the wall to see what sticks,” he wrote in the column. “Reforming Puerto Rican tax policy may be one of those things that actually works.”

In a March 19 letter addressed to President Trump, Senate Majority Leader Mitch McConnell and House Speaker Nancy Pelosi, Rodríguez cites these articles and states that PRMA “wholeheartedly subscribes to this view and wishes to recommend specific actions that could revert the conditions that made manufacturing in offshore jurisdictions, like China and India, attractive.”

Rodríguez says that the federal Tax Cuts and Jobs Act (TCJA) “adequately targeted one of the factors that forced production offshore, the U.S. corporate tax rate of 35 percent, and drastically reduced it to 21 percent.” He said the law’s implementation of the global intangible low taxed income (GILTI) reduced the tax differential between the U.S. mainland and offshore tax rates.

“This is a major step towards the goal of bringing manufacturing back to the U.S., but more can be done to produce a faster shift,” the letter states. “As we pointed out in the TCJA approval process, Puerto Rico, which is neither a state, nor an offshore jurisdiction, but hosts millions of American citizens and is within the shores of the U.S. territory, was left unattended by the TCJA’s tax provisions. U.S. tax policy could have laid the framework to re-attract biopharmaceutical, pharmaceutical, medical device and other related manufacturing activities to U.S. shores. We now continue advocating for policy focused on materially reducing the impact of GILTI on the profits generated in Puerto Rico by biopharmaceutical, pharmaceutical, medical device and other related manufacturing activities. Further, the policy should clearly validate foreign tax creditability of taxes imposed by Puerto Rico. This policy (i) should revert the 1993 policy that favored jurisdictions like China and India; and (ii) be outside the scope of the ‘corporate welfare’ rhetoric as it does not ‘give’ anything to these businesses that they were unable to obtain on their own.”

Rodríguez says in the letter that the effort to bring back U.S. manufacturing from foreign locations has “unified all political sectors in Puerto Rico,” citing support from former Gov. Aníbal Acevedo Vilá, Resident Commissioner Jenniffer González, and the Financial Oversight & Management Board.

In a letter to Trump and the congressional leadership on March 18, the fiscal board expressed its view on potential policy changes that would require increased production of pharmaceuticals and medical products for national security reasons. Chairman José Carrión said the board believes Puerto Rico can again become a leading manufacturing location. He pointed out that the island’s infrastructure, human capital and regulatory processes are already well-positioned.

“The Covid-19 pandemic is an issue that has united you as representatives of U.S. political sectors,” Rodríguez’s letter states. “The policy determinations we request herein are the missing pieces that can solve this problem.”

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Puerto Rico Governor Announces additional $787 million Relief Package Amid Covid-19 Outbreak

If there are 3.1 million people living in Puerto Rico, that equates to about $305 per person.  $787 million plus $160 previously allocated = $947 million/3.1 million people = $305 per person.  This will add close to $1 Billion more to Puerto Rico’s debt.  No mention in the article about the debt situation.   A nation, territory, company, or individual in debt or bankruptcy is not a sign of strength, nor wise management.

Puerto Rico Governor Announces $787 million Relief Package Amid Covid-19 Outbreak

Puerto Rico Governor Announces $787 million Relief Package Amid Covid-19 Outbreak

By on March 23, 2020

SAN JUAN — Calling it the most comprehensive financial relief package offered yet by any state, Puerto Rico Gov. Wanda Vázquez Garced announced Monday economic incentives to mitigate the effects of the coronavirus pandemic on workers and companies on the island.

“Guaranteeing social stability depends largely on how we articulate an economic plan that allows us to respond to this crisis, protecting our families and the productive sectors of Puerto Rico,” Vázquez said.

Among the measures, the governor said 134,200 workers from public agencies and corporations would continue to get paid.

“We have urged mayors to do the same so that we can protect the income of 51,500 employees who work in our municipalities,” Vázquez said.

Regarding private-sector employees the 170,000 self-employed, which includes 19,000 farm workers and 44,000 in construction, manufacturing and agriculture industry, the governor said that “our government is committed to workers and businesspeople. We will do everything we have to do to prevent this emergency from having further effects on the…productive sector. ”

“Let there be no doubt that I will use all my constitutional powers to guarantee that the most vulnerable have their social security and are not left unprotected,” she added.

The financial aid and incentives package was achieved after discussion between representatives of the private sector, her economic team and the Financial Oversight and Management Board for Puerto Rico.

In a first, the governor was accompanied during the press conference by the board’s chairman, José Carrión, and executive director, Natalie Jaresko.

Vázquez announced that the island’s 11.5% sales tax won’t be charged for three months and that public employees will continue to get paid. Self-employed people, she said, would be sent a check for $500, while nurses will receive up to $4,000.

A 90-day moratorium on mortgages, auto loans, personal loans, business loans, and credit cards has been established, including for credit union customers, all of whom must be request the deferment from their financial institution because it is not automatic.

In addition to financial aid for health workers and the police, the governor announced a personal and commercial loan moratorium, including mortgage and credit card payments. Water and electricity services will not be cut either.

“Given the unprecedented reality Puerto Rico currently faces in light of COVID-19, the Financial Oversight and Management Board for Puerto Rico today authorized the Government of Puerto Rico to use $787 million to fight the COVID-19 emergency. This is in addition to the $160 million from the Emergency Reserve fund already authorized,” the board said.

The board said in measures are:

  • $237 million in one-time bonuses for public and private nurses, technicians, emergency medical services personnel, correction officers, and other Public Safety Department (DPS) staff in the front lines of the fight against COVID-19
  • $50 million for investments in hospitals and public safety, to restock medical supplies and invest in equipment for a period of at least two months
  • $160 million in one-time direct payments to self-employed individuals and small businesses whose incomes have been affected by the disruption of their work and income
  • $240 million for the Department of Education to support and enable online learning while schools are closed, to buy tablets for every student and teacher, and provide teachers and students with software and training
  • $100 million for municipalities, providing support for lost revenues over the next two months as a result of the emergency measures implemented to fight COVID-19

In addition, the board and the government agreed to “immediately begin to accelerate an increase in unemployment benefits, which was previously scheduled to start on July 1, 2020,” the board said in a release.

“The Oversight Board’s singular focus right now is on supporting the Government of Puerto Rico in helping to protect the people from the COVID-19 virus, and to minimize and contain the pandemic here,” Carrión said. “In moments like this, it is most important to look for significant and reasonable fiscal policy solution for those fighting this virus and for the health and safety of Puerto Rico overall.”

The board added that it presented Monday a motion in U.S. District Court for the District of Puerto Rico to adjourn consideration of the proposed commonwealth Plan of Adjustment’s disclosure hearing until further notice.

“We support the initiatives presented by the Governor and the Fiscal Control Board, because now more than ever we need to revitalize our economy with funds for small businesses, that our students continue their education, provide with tools to our workers who are in the first line of response to # COVID-19 like our nurses,” Resident Commissioner Jenniffer González Colón said in a statement from Washington, D.C., in reaction to the governor’s message.

The aid announced, the congresswoman said, demonstrates that “we can “bridge the differences” and “seek alternatives for the common good” of Puerto Rico.

“This initiative joins the efforts of President Trump and Congress to seek relief for our economy. I continue fighting for Puerto Rico to continue to be included in the federal stimulus package,” she added.

A break down of some of the economic relief measures announced:

Cash:

  • $500 for self-employed workers
  • $1,500 for small and midsize business that had to halt operations due to executive order OE-2020-23
  • Up to $4,000 for public and private sector nurses
  • Up to $2,500 for health technicians
  • Up to $3,500 for police, firefighters and correction officers
  • The Labor Department will offer unemployment benefits to freelance workers and workers who are on leave due to the curfew.

90-Day Moratorium 

  • Suspension of payments for personal and commercial loans as well as mortgages and credit cards (this applies to banks and cooperatives). It is not automatic. People need to inform their respective financial institution.
  • No cuts to electric or water services
  • No highway toll collection

Taxes 

  • Income tax payment is postponed until July 15
  • 3 months of no sales tax at the ports or distribution chain
  • 10% withholding for self-employed workers suspended for 3 months
  • No penalties will be imposed for non-compliance with the bimonthly IVU withholding for two months; nor will penalties be imposed for non-compliance with the payment of the first installments of the estimated tax return

Purchases 

  • $250 million for tablets, software and training for teachers, students and school directors in the public-school system
  • $30 million for the purchase of materials in public hospitals (Two disbursements of $15 million)
  • $20 million for protective gear and materials (masks, sanitizers) for police officers
  • $50 million for municipalities (Two disbursements of $25 million)

Total: $787 million

The governor’s announcement comes a week after the executive order that nonessential businesses and the government close temporarily and send employees home as a measure to try to stop the spread of COVID-19.

So far, the government has reported two deaths and 31 cases due to the disease.

A translation of the governor’s speech follows, as sent by her office:

Good afternoon Puerto Rico,

In addition to working on protecting the health and well-being of our people, the care of which is being coordinated by a group of medical experts that we have appointed, at this time of crisis, one of the main concerns of our government is how do we preserve our social stability:

How do we ensure, that when this crisis ends, we have protected the physical, mental, and economic health of our families, our communities, and all our citizens.

We must act quickly to protect our people by asking everyone to stay at home, reinforcing social distancing as a measure of prevention of this outbreak, thus controlling contagion and spread of the virus.

We will continue to provide essential services, like access to supermarkets, pharmacies, gas stations, banks, medical services, which are also being made available through telemedicine, among the other services that are included in our Executive Order.

Now, guaranteeing social stability depends, in large part, on how we devise an economic plan that allows us to respond effectively to this crisis, protecting our families and the productive sectors of Puerto Rico.

First, and foremost, we will continue to pay the wages of public sector employees who are part of the central government.

We are talking about 134,200 workers from agencies and public corporations, that will continue to receive their check during the period of this emergency.

We have urged mayors to do the same so that we can protect the income of the 51,500 employees who work in our municipalities.

Additionally, we will not forget that in the midst of this crisis, workers in the private sector, our largest labor group, is the most fragile. We are talking about 170,000 self-employed workers, which includes 19,000 agricultural workers, and 44,000 from the construction industry.

We know that this public health crisis is affecting business owners, particularly small and medium-sized entrepreneurs, as well as the construction, manufacturing and agriculture industries. It also adversely affects many independent professional workers, mainly linked to the service delivery industry.

Our government is committed to all the workers and employers on the island; therefore, we will do everything necessary to prevent this emergency from having further effects on the private sector. Let there be no doubt that I will use all my constitutional powers to guarantee that the most vulnerable have their social security and are not left unprotected.

For this reason, we have worked on the first series of short-term economic and fiscal initiatives, which will be immediately available:

FIRST, we have instructed the Department of the Treasury to:

•        extend the period of income tax payments until July 15

•        suspend the collection of the Sales-and-Use Tax (SUT) at the docks and the resale chain for the next 3 months

•        suspend for a period of 3 months the 10% withholding at the origin of payments for professional services.

•        not to impose penalties for non-compliance with the fortnightly SUT for two months; nor impose penalties for non-compliance with the payment of the first installments of the estimated tax

•        To help our working class, we will provide an incentive of $500 in cash to all the self-employed workers – an estimated 170,000 people in Puerto Rico.

o   It is a measure to help mitigate any emergency situation anyone may be facing.

o   This benefit for self-employed workers has an economic impact of $100 million and has already been discussed and approved by the Fiscal Oversight and Management Board.

o   This subsidy will begin to be sent starting this week.

•        Likewise, we will continue to monitor the result of the federal stimulus package to look for additional measures.

SECOND, through the Department of Economic Development, we will provide $1,500 as an incentive for all small and medium-sized companies that have ceased operations in the midst of this crisis.

This assistance has an impact of $60 million, and we will follow the same protocol that we established with the aid offered to businesses in the southwest region of the island to mitigate the impact of earthquakes.

For this assistance, we will focus on employers in small and medium businesses, with 50 employees or less, who do not qualify for federal aid.

THIRD, a bonus of up to $4,000 is established for all nurses in the public and private systems and up to 2,500 for health technicians who assist in these tasks. For a total of $187 million.

A contribution of up to $4,000 is designated for medical emergency response personnel and a contribution of up to $3,500 for police, firefighters and correctional officers, among others. For a total of an additional $50 million.

$240 million will be awarded for the purchase of tablets, software, and training for approximately 325,000 teachers, students, and directors of the Department of Education, to promote distance education.

$30 million will be available allocated in $15 million over the next 2 months to assist with the purchase of equipment in public hospitals in an effort to reimburse all purchases related to the response of the emergency Coronavirus COVID-19.

$20 million dollars will be made available for the purchase of necessary equipment for the security of the Puerto Rico Department of Public Safety, meaning the Puerto Rico Police Department, this will include gloves, masks, and hand sanitizers, among other essential equipment.

$50 million has been identified and will be distributed for a period of 2 months for those losses that may have affected the municipalities due to this emergency. The government will establish the necessary requirements to access this funding. This represents a total of $787 million, this will go directly to the hands of the people of Puerto Rico to mitigate the impact of Coronavirus COVID-19.

FOURTH we have reached an agreement with the Fiscal Oversight Board to authorize the increase of unemployment benefits beginning July 2020.

I have also directed there to be no suspension of essential water and electricity services. And to suspend the collection of transportation tolls during this emergency.

FIFTH, the Puerto Rico Department of Labor and Human Resources will coordinate with the Federal Government to offer unemployment assistance for those that are self-employed.  This is important since these benefits, usually, do not cover this sector.

The same will be done for those workers who are ordered to take unpaid leave and do not qualify for unemployment payments or sick leave. The unemployment benefits will be extended to part-time workers who have worked in, at least, two- quarters of the basic period.

SIXTH, as an economic measure, we will promote telework or work arrangements from home throughout the Government by means of the use of technology, whenever possible and while the Executive Order is in force.

For these purposes, it is ordered to all secretaries and agency heads present in the next 48 hours a plan of all those areas that can operate by means of remote work, including the services provided by independent contractors, professional service providers, companies, private suppliers, and non-profit organizations.

It is important to emphasize that using the alternative of teleworking or remote work cannot be interpreted as an exception to compliance with social distancing and curfew, ordered by the Executive Order.

SEVENTH, I take this opportunity to report that, in conversation with the Presidents of the banks, a period of 90 days of moratoriums has been established in the payment of mortgages, cars, personal loans, commercial loans, and credit cards.

This benefit will also be available to members of cooperatives. The only requirement is to call your financial institution and request the moratorium because it is not an automatic process. This is important relief because it represents a direct relief to the workers’ wallets.  It is important to understand that moratoriums do not affect the credit of individuals or companies.

This would be one of the most comprehensive and ambitious relief packages that have been announced to deal with this crisis. These are much more comprehensive measures than those offered throughout the Nation.

For example, California announced a $500 million package and Washington State a $200 million package. We announced a first package of almost a billion dollars for our people on the island, achieved in conjunction with the Fiscal Oversight Board.

We thank the Fiscal Oversight Board, its Chairman José Carrión, and its Executive Director, Natalie Jaresko, for working together on behalf of the people of Puerto Ricans.

Fellow Puerto Ricans: these steps we are taking will help mitigate the economic impact of the current crisis. As this is an ongoing emergency, there are other measures we are currently evaluating and that we will be announced accordingly, in particular those in line with the economy and touristic activity.

Through this difficult moment we face as a nation, we must be united, our enemy is Coronavirus COVID – 19 and together, we will defeat this virus as a nation.

It is our hope that we will move forward during this emergency. Together in solidarity, we will conquer this public health crisis.

We must have present that the health and the protection of  the life of all our citizens is our priority.

Therefore, our priority is the health and welfare of our people, we must continue to protect ourselves and stay home.

THIS BATTLE WILL BE CONQUERED WITH ALL PUERTO RICANS UNITED.

God bless you and all your family.

—Yanira Hernández and María Soledad and Cybernews contributed to this report.

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Airline Passengers Arriving in Puerto Rico will Be Placed Under 14-Day Quarantine

Airline Passengers Arriving in Puerto Rico will Be Placed Under 14-Day Quarantine

Airline Passengers Arriving in Puerto Rico will Be Placed Under 14-Day Quarantine

By on March 23, 2020
View from inside Luis Muñoz Marín International Airport (Juan J. Rodríguez/CB)

Starting Wednesday, Commercial Flights Can Only Land in Muñoz Marín Airport

SAN JUAN — Puerto Rico Gov. Wanda Vázquez Garced announced Monday that the Federal Aviation Administration (FAA) has authorized her request to deal with the pandemic that all commercial flights land in Luis Muñoz Marín International Airport (LMM) starting Tuesday at 11:59 p.m.

“We are very grateful that the FAA [Federal Aviation Administration] has accepted our request. This is something historical, since we are the first jurisdiction to receive tools from the federal air regulator to control air traffic amid the COVID-19 threat,” Vázquez said in a statement issued by her office.

The governor stressed on Twitter that “our call is that every traveler who has coordinated a trip to Puerto Rico, knows that no matter the activity or the reason that brings them to our island, once they enter Puerto Rican soil, they will be on lockdown 24/7 for 14 days. You will not be able to carry out any activity that requires you to leave your hotel and / or home. Our recommendation is that you do not travel to Puerto Rico during the emergency.”

The FAA approved redirecting airlines such as JetBlue, American Airlines, Delta, United, etc. (FAA Part 121 operations) to only be allowed to land at Luis Muñoz Marín International Airport (LMM).

These “will no longer be able to land at Ponce and Aguadilla international airports,” the governor’s office said. “This will allow a more centralized screening with more technology.”

All chartered aircraft and general aviation (small private planes) can only land in Aguadilla, Isla Grande and Muñoz Marín airports.

“Before, they could land at seven airports: Culebra, Vieques, Ceiba, Aguadilla, Ponce, LMM, and Isla Grande,” the press release reads, adding that those same kinds flights may land

Cargo flights are not subject to the restrictions.

In the Vázquez administration’s press release, the executive director of the Ports Authority, Joel Pizá emphasized that “it is the first time that a territory or state is granted this type of extraordinary request. We thank the administrator of the FAA, Stephen Marshall Dickson, and the Federal Department of Transportation for responding to our request quickly, given our situation as an island, and a fundamental part of our efforts to control the entry of possible cases of COVID-19 in Puerto Rico. These measures take effect immediately.”

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Second Person Dies of COVID-19 in Puerto Rico

Second Person Dies of COVID-19 in Puerto Rico

Second Person Dies of COVID-19 in Puerto Rico

By on March 23, 2020

SAN JUAN — Puerto Rico’s Health Department reported Monday the death of a second person from the novel coronavirus disease, or COVID-19, a 73-year-old man, residing from New York, who was on vacation on the island.

In a press release that does not specify how long the victim had been on the island, the department reported that the man, who was traveling with his wife, began to develop symptoms in Puerto Rico and was treated in an isolation room of a metro area hospital, where he was tested for COVID-19. However, the release adds, “after various complications” related to his condition, “the patient died.”

New York Times reporter Frances Robles tweeted Sunday that the man’s daughter had contacted her, saying she was having trouble learning about his condition. The tweet was at 5:30 p.m., but at 11:30 p.m., she was informed of his passing.

Eight new cases

The Health Department also said that confirmed COVID-19 infections continue to rise on the island. Six Health Department tests came back positive, as did two from the Veterans Hospital. These bring the total number of known cases to 31.

The Health Department cases are of two men, a 43-year-old from the metro area and an 88-year-old from the Mayagüez region. The rest are two women, ages 30 and 31, from the metro area, a 76-year-old from the Caguas region and a 58-year-old from the Ponce region.

The two Veterans Hospital cases are of two men, one who is 49 years old and the other 26 years old. These are in addition to 11 other positive results, of which only one is a 55-year-old female, to date at the federal hospital, for a total of 13.

In a phone interview with Radio Isla, the head of the Puerto Rico Office of the Advocate for Veterans, Agustín Montañez, said the cases were detected because the institution screens patients as part of its protocol.

With these developments, Puerto Rico residents are urged to redouble efforts to maintain social, or physical, distancing and avoid leaving their homes, in addition to taking preventive measures.

“This is an extremely serious matter in which we must assume individual responsibility for the collective good. Stay at home, wash your hands constantly, clean surfaces and maintain social distance, especially if you are sick, isolate yourself for 14 days,” Dr. Concepción Quiñones de Longo, interim secretary of Health, stressed.

For his part, Dr. Segundo Rodríguez Quilichini, director of the COVID-19 Medical Task Force, expressed his condolences on behalf of the administration “for this second person who died because of the coronavirus and who arrived on the island in March from the United States. This situation reminds us of the seriousness of this matter and why we are asking the citizens to stay at home. Save your life and that of others. Civic duty, handwashing and maintaining your mental health are key pieces to face this challenge in the best possible way,” he said.

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We can’t let down our guard against the Coronavirus in Puerto Rico

https://www.elnuevodia.com/english/english/nota/wecantletdownourguardagainstthevirus-2554861

We can’t let down our guard against the virus

With the first coronavirus death on our island, Puerto Rico enters a new phase of alert and awareness of the danger of this pandemic

Sunday, March 22, 2020 – 10:46 AM

Efforts must be intensified to identify the potential focus of contagion associated with the circumstances in which the woman who died, an Italian tourist, arrived in Puerto Rico. The woman came on a cruise ship on March 8, days before the government took prevention measures that came with the declaration of the state of emergency. According to estimates, 96 percent of the more than 1,400 people, including passengers and crew members, walked the streets and shops of Old San Juan, among other places that day. Another passenger with the virus who was hospitalized in the Cayman Islands and also died, there are reports on contagion on the way back to Europe.

The tourist was one of 21 positive cases in Puerto Rico, out of 235 tests reported up to yesterday. The government acknowledged there may be many more people infected and undiagnosed, even if they are asymptomatic. At least two people with the virus have been reported to participate in mass events.

We insist on the importance of rapid case detection and contact tracing by health authorities. Meanwhile, citizens must strengthen their preventive actions with responsibility and prudence.

The main recommendation for the world and our island is to stay home, especially if you have symptoms of the coronavirus. This has proven to be effective in preventing the spread, which scope on the island is still uncertain.

Puerto Rico was among the first U.S. jurisdictions to decree the partial shutdown of public and commercial operations and to announce a curfew. If the measure has altered daily life at the moment, complying with it with citizens responsibility is what can guarantee that we can soon get out of the emergency. Underestimating the contagion spread of the new strain of the coronavirus has cost countries like Italy the highest number of deaths worldwide. This Saturday, the tragic number of deaths in that country reached more than 700 in a single day.

On the other hand, it is important to follow only official sources’ information to avoid falling into collective hysteria over unfounded rumors of the emergency. Desperation blocks effective response capacity.

Unfortunately, on Saturday thousands of citizens rushed to supermarkets, after the recording of a person who claimed to have information that the government would decree a total shutdown of operations and shops went viral on social media. Both the government and the food sales and distribution sector have stressed that Puerto Rico is not expected to run out of food supplies due to the coronavirus emergency. They have all called to remain calm.

The hours set by the government provide enough time for people to buy what they need without crowding the shops. Unnecessary crowding in stores and parking lots makes it difficult for those who need to stock up on groceries to get there. Also, false rumors can lead to unnecessary hoarding that deprives others of the right to purchase food.

Every citizen, particularly those with leadership positions, can stop the virus of disinformation and the coronavirus. We must refuse to reproduce unfounded and unconfirmed versions that create panic amid the crisis with the same responsibility we take measures to prevent the infection.

Puerto Rico cannot surrender to either the coronavirus or the virus of disinformation and panic. In times of emergency, it is a civic duty to stop the spread of both, the virus and disinformation.

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Puerto Rico: Government on alert due to possible coronavirus case

https://www.elnuevodia.com/english/english/nota/puertoricogovernmentonalertduetopossiblecoronaviruscase-2551586

Puerto Rico: Government on alert due to possible coronavirus case

The Wanda Vázquez Garced administration activated the protocol and isolated an Italian tourist who arrived on a cruise on Sunday

Monday, March 9, 2020 – 12:46 PM

Wanda Vázquez. (GFR Media)

Governor Wanda Vázquez Garced confirmed yesterday the first tests to detect the new strain of the coronavirus COVID-19 on the island upon the arrival of an Italian tourist on a cruise with symptoms linked to the virus.

The governor immediately ordered to take the most restrictive measures with cruise ships that plan to dock in San Juan Bay to avoid repeating the situation.

However, at a press conference, she reiterated that this is a suspected case and not a confirmed one. The samples from a 68-year-old woman and her husband -both on the cruise- will be sent to the Centers for Disease Control and Prevention (CDC) in Atlanta today.

Vázquez Garced said they are handling the situation as a “suspected case” and recalled that the clinical picture of this woman on the boat did not suggest coronavirus. “We are taking an additional measure and sending those tests to the CDC,” said Vázquez Garced.

She said that the tourist comes from northern Italy and arrived on the island yesterday on the Costa Luminosa cruise ship, which left Fort Lauderdale, Florida on February 24. The woman was taken to Ashford Presbyterian Hospital in San Juan in the morning after two days on the ship undergoing antibiotic treatment.

The governor said that as the cruise was approaching Puerto Rico, this woman reportedly had a case of pneumonia.

Once at the hospital, the doctors decided to place her and her husband in isolation and contacted the Health Department to have them tested for COVID-19. Sources said that during the afternoon, the doctors insisted on taking samples from the woman.

The patient will remain in isolation, as will her husband – who has no symptoms – at the Ashford Presbyterian Hospital, said Health Secretary Rafael Rodríguez Mercado. They were both taken samples to identify COVID-19, the results expected to be ready in a period of 24 to 28 hours, the secretary said.

Both Vázquez Garced and Rodríguez Mercado praised the work of the hospital staff. “It is a case similar to pneumonia. But since our responsibility is to take care of the people, we are going to take the samples to rule out a case of coronavirus,” Vázquez Garced said.

Passengers got off the ship

The Tourism Company executive director Carla Campos said the Costa cruise line arrived in San Juan with some 2,500 passengers on board for the first time yesterday. Since the cruise ship did not identify the woman’s condition as coronavirus, they took no extraordinary measures to prevent passengers from getting off the ship neither was it placed in quarantine, Campos said.

The official estimated that 40 percent of the passengers got off the ship, although she later said this was not an exact percentage.

Port Authorities Executive Director Joel Pizá said that the woman tests positive for COVID-19, she presented symptoms on the ship and the cruise line failed to notify the Coast Guard and the CDC, as required by federal authorities, the company is exposed to a fine of more than $92,000.

Vázquez Garced said her government is in communication with the CDC and the Coast Guard to inform if the woman tests positive for COVID-19 so that they can take action with the other passengers. Until last night, it was not confirmed if other passengers or crew members were showing symptoms.

“The Ports Authority contacted the Coast Guard and CDC, and they will have information on all passengers and the line’s guidelines so that future destinations can make informed decisions,” Pizá said.

The cruise ship was to dock today on the neighboring island of St. John and then would sail to Spain.

According to the Ports Authority´s executive director, the woman was able to board the cruise ship in Florida because she did not present symptoms and Donald Trump’s administration guidelines, at the moment, only impose restrictions on passengers from China and Iran, not Italy.

Starting today, all cruise ships must report to the Ports Authority, the Health Department and the Tourism Company on passengers or crew members with symptoms of respiratory infections to enter the San Juan Bay, the governor said. These are additional requirements since they must also inform federal authorities. Likewise, the pilot boats that guide large vessels to the docks will have to verify that cruisers meet this requirement.

This report will allow the government to decide what measures to take to prevent the spread of the infection on the island.

“A boat that does not certify that it has filed the reports to the CDC and the Coast Guard does not enter San Juan Bay,” Piza said.

This is the first case on the island that meets the criteria for the Health Department to authorize the test for coronavirus. Previously, there were cases of respiratory symptoms similar to the coronavirus, but it was determined they did not meet the clinical criteria to justify testing for COVID-19.

The World Health Organization (WHO) confirmed 106,893 cases of COVID-19 in 103 countries and territories until 8:30 p.m. today and, 3,639 deaths reported worldwide.

Last week, Health Secretary Rafael Rodríguez Mercado confirmed that the agency had not received the material to perform the tests on the island, but that samples would be sent to the Centers for Disease Control and Prevention (CDC) in Atlanta.

The Health Department protocol decided with the advice of federal authorities, establishes that the test to detect the virus has to be processed by the CDC in Atlanta. At the local level, it depends on the approval of the state epidemiologist, Carmen Deseda.

An individual´s travel history, as well as fever or respiratory disease symptoms, are among the factors considered to evaluate patients, Another factor is whether the patient presents a respiratory condition without an identified alternative diagnosis.

Denial

Hours earlier, Assistant Secretary of Health Concepción Quiñones de Longo had indicated that the Health Department had not approved even one screening test for patients with possible coronavirus symptoms, a scenario that raised serious questions in the island’s medical community.

She said she understood doctors’ “concern” but that they were following recommendations from the Center for Disease Control and Prevention (CDC). “Since there are still not millions of tests available for the entire population, we are being very strict in clinical and medical history criteria to select who should be tested,” she said in an interview with El Nuevo Día.

“I understand concerns showed by these doctors in the sense that identifying the first case of coronavirus in Puerto Rico is very important, but we have to work with the resources we have available right now, and the resources we have available do not allow us to test everyone if they do not meet the criteria established by the CDC,” she added.

The Health Department protocol, developed with the advice of federal authorities, establishes that the test has to be processed by the CDC in Atlanta. At the local level, tests depend on the approval of the state epidemiologist.

“If the case does not meet the criteria, we wouldn’t be in a position to test that person because there are not millions of tests available for everyone who has even the slightest suspicion, so we are being very strict in meeting specific requirements,” she said.

There have been possible cases reported in the last week which had not been confirmed, even those patients had not been tested. “They have not met the current criteria. This could change. As the incidence of this condition changes, the CDC will probably issue different instructions, but no samples have been collected yet and we haven’t collected samples to send to Atlanta yet,” she insisted.

When asked when the tests might be available on the island, Quiñones de Longo said that they would be available next week. And when asked how many tests would be available, she answered that previous experiences indicate the CDC will determine the number of tests. “They have their criteria of incidence or prevalence of a condition to determine which test materials or resources to send,” she said.

Former Health Secretary Ernesto Vázquez Quintana had questioned the agency’s decisions. Former State Epidemiologist Ángeles Rodríguez had also questioned the agency in an interview with El Nuevo Día. While other expert voices, such as infectious disease expert Javier Morales, hadwarned about the importance of considering medical opinion when approving or ruling out a test.

“I can tell you they are not considering medical opinions, by imposing their views – the Health Department and Dr. Carmen Deseda who is the one who has to decide whether a case has to be tested for the coronavirus – they put doctors in a difficult position,” said Vázquez Quintana.

He said the agency cannot intervene with the right of doctors to practice their profession. “When one asks how to handle this epidemic they say, precisely, that the first case is very important, but if we don’t test people how are we going to find the first case?” he added.

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As 14th Case of Coronavirus is Recorded in Puerto Rico, Hospitals’ Spokesperson Says Testing is Essential

As 14th Case Recorded in Puerto Rico Hospitals’ Spokesperson Says Testing is Essential

As 14th Case Recorded in Puerto Rico Hospitals’ Spokesperson Says Testing is Essential

By on March 20, 2020

PRHA President Believes System Can Handle 500 to 600 Hospitalizations at a Time

SAN JUAN — Puerto Rico registered its 14th case of novel coronavirus disease (Covid-19) Friday, and although hospitals are prepared to manage the outbreak, the system to test for infection needs to improve, Hospitals Association President (PRHA) Jaime Pla stressed Friday.

Puerto Rico’s Veterans Hospital reported six new Covid-19 cases to the island’s Health Department on Friday afternoon. The island now has 14 confirmed cases.

“Given the emergence of new positive cases on the Island of COVID-19, it is imperative to follow strict compliance with all the isolation measures that we have adopted to protect the life and health” of everyone,” Gov. Wanda Vázquez said in a statement.

Six men and one woman make up the most recent group of positive cases. Two of the men are 65 years old, followed by others who are 57, 33 and 37. While the woman is 55 years old.

The Veterans Hospital said all cases had symptoms and only two of them have no travel history. The rest developed symptoms after having traveled to destinations such as New York, Florida and Colorado.

All the patients are stable. Five of them are under home isolation orders and only one is in a hospital isolation unit.

The hospital said the number of cases under investigation in Puerto Rico reached 180, of which 114 returned negative results, 14 were positive and the results for 52 tests have yet to arrive.

Meanwhile, the president of the Primary Care Centers Association (PCCA), Gloria del C. Amador, said its members—known as 330 centers after the federal regulation that enables them—have been preparing for a while, especially by acquiring needed supplies and making efforts to test for the respiratory disease.

“Right now, the most significant problem that hospitals have is the situation of how to do [Covid-19] laboratory tests for patients who arrive or are sent to us because this process is still a bit tortuous,” Pla said.

“The hospitals have already done all the possible exercises, seen all the possible scenarios and we are ready to continue taking care of patients and obviously taking the necessary precautions when patients come who may be suspected of having the virus,” the PRHA said.

Pla said that if the number of hospitalizations stays “below 500 or 600 at a time,” the hospital system would be able to manage it. He emphasized that those numbers are “only an estimate not an official projection.” The key, Pla argued, is to have a “flattened curve”—a drawn-out period, versus a spike in hospitalizations—so the healthcare system’s capability is not overwhelmed. Pla’s estimate is based on the about 9,800 hospital beds on the island.

For her part, Amador said that although the number of patients has dropped dramatically, primary care centers are receiving people who are not regular patients, but their doctors’ offices are closed. The PCCA president explained that they have set up screening stations at the entrance of their facilities in case they see a suspicious case, the patient can be treated separately from other patients.

Regarding the problems with testing, Amador said the PCCA is discussing with private laboratories the possibility of providing Covid-19 testing, which could happen as early as next week.

The other service Amador pointed to was telemedicine, whereby doctors assess whether the patients need to seek medical help over a phone call, including providing a prescription refill. Amador explained that the Health Insurance Administration (ASES by its Spanish Acronym) allowed these types of consultations to be billable.

Amador said that ASES allowing centers to bill for the phone service “is an additional benefit of not having to worry about the economic damage that health institutions may experience in the case of providers,” The PCCA president added, “we have had to reduce the workforce, close facilities, the volume of patients we are going to see went down.”

But more than the economic hit, Amador’s grievance lies with how the government is not including the 330 centers in its planning, she said. The PCCA president argued that, just like with Hurricane Maria in 2017, the primary care centers help the general system by allowing patients to take care of primary-care needs or non-coronavirus-related medical problems, helping curb the overcrowding of emergency rooms.

“It is very important for us to send the message that the Health Department and the health coalitions should treat 330 centers as that first line of response, of support for the healthcare system in Puerto Rico.”

Amador also stressed that 330 centers need to be included in authorities’ assessments when determining the number of supplies needed, especially protective gear, such as the N-95 facial masks.

There are 97 primary care centers managed by 22 organizations in Puerto Rico.

—Cybernews contributed to this report.

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