In Shadow of Puerto Rico's Nightmare, Virgin Islands and Others Facing Intense Struggle
By Julia Conley
While much media attention has rightly been focused on the devastation in Puerto Rico this week as calls have grown louder for President Donald Trump to deploy more resources to help the recovery from Hurricane Maria, the White House's inaction has caused attention to be pulled away from the U.S. Virgin Islands and other parts of the Caribbean that were also ravaged by the storm.
Forty-eight thousand people in the U.S. Virgin Islands are without power following both Maria and Hurricane Irma, which made landfall two weeks earlier. More than 600 residents are still in shelters across St. John, St. Thomas, Water Island and St. Croix, which was spared much of the damage of Irma but overtaken by floodwaters after Maria.
Gov. Kenneth Mapp has been asking the public for help via Twitter and in a radio interview on WBUR:
"We need help," Mapp said just after Maria hit last week, as the islands were assessing the second wave of destruction. "With our FEMA partners and our cruise ship partners, we're bringing in a lot of food, water, tarpaulins, personal hygiene packs, cots and blankets. That's really the immediacy of the need. We're asking folks who can to go to USVI Recovery and they can donate there."
The economy of the U.S. Virgin Islands "evaporated pretty much overnight," according to Clinton Gaskins, a restaurant owner interviewed by the New York Times. Tourism revenue makes up about a third of the island's gross national product, and the marine industry was also hit hard. As the Times reported, following Maria:
Harbors are littered with ferries that capsized or were washed ashore, leaving fewer vessels to carry supplies back and forth. Masts from sunken sailboats jut out of the water. Charter boats, a big economic driver, lie on beaches, their hulls ripped open.
The small island country of Barbuda was reported to be "nearly uninhabitable" in the wake of Irma. The 1,600 residents have still not been able to return home after the hurricane "almost completely destroyed" the island. Neighboring Antigua has been hosting many in shelters. Earlier this week, the Red Cross delivered bottled water, kitchen utensils, and toiletries to 300 Barbudan families who were most in-need; the aid came after a week-long assessment process, suggesting that relief efforts are moving slowly due to the immense destruction.
Almost every structure on the island was damaged and officials say the hospital, which is receiving priority, still won't be open for weeks. The Antigua Observer reported on Tuesday that Barbudans themselves are beginning the recovery process, with 150 residents joining the island's solid waste cleanup crew to help remove debris from rooftops. The do-it-yourself effort is leading to concerns about exposing the population to diseases like cholera, dengue fever and Zika.
"The fact of the matter is that the surface area of Barbuda, including the settlement of water, has created an environment that has to be carefully managed," said a spokesperson for the Barbudan government.
Reposted with permission from our media associate Common Dreams.
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By Melissa Hawkins
After sustained declines in the number of COVID-19 cases over recent months, restrictions are starting to ease across the United States. Numbers of new cases are falling or stable at low numbers in some states, but they are surging in many others. Overall, the U.S. is experiencing a sharp increase in the number of new cases a day, and by late June, had surpassed the peak rate of spread in early April.
Seven day rolling average of number of people confirmed to have COVID-19, per day (not including today). This chart gets updated once per day with data by Johns Hopkins. Johns Hopkins university doesn't provide reliable data for March 12 and March 13. Johns Hopkins CSSE Get the data
To Have a Second Wave, the First Wave Needs to End.<p>A wave of an infection describes a large rise and fall in the number of cases. There isn't a precise epidemiological definition of when a wave begins or ends.</p><p>But with talk of a <a href="https://www.theguardian.com/world/2020/jun/27/new-covid-19-clusters-across-world-spark-fear-of-second-wave" target="_blank">second wave in the news</a>, as an <a href="https://www.american.edu/cas/faculty/mhawkins.cfm" target="_blank">epidemiologist and public health researcher</a>, I think there are two necessary factors that must be met before we can colloquially declare a second wave.</p><p>First, the virus would have to be controlled and transmission brought down to a very low level. That would be the end of the first wave. Then, the virus would need to reappear and result in a large increase in cases and hospitalizations.</p><p>Many countries in <a href="https://doi.org/10.1038/s41562-020-0908-8" target="_blank">Europe and Asia have successfully ended the first wave</a>. <a href="https://www.theguardian.com/world/2020/jun/08/new-zealand-abandons-covid-19-restrictions-after-nation-declared-no-cases" target="_blank">New Zealand</a> and <a href="https://www.newyorker.com/magazine/2020/06/08/how-iceland-beat-the-coronavirus" target="_blank">Iceland</a> have also made it through their first waves and are now essentially coronavirus-free, with very low levels of community transmission and only a handful of active cases currently.</p>
Different States, Different Trends<p>Looking at U.S. numbers as a whole hides what is really going on. Different states are in <a href="https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html" target="_blank">vastly different situations right now</a> and when you look at states individually, four major categories emerge.</p><ol><li>Places where the first wave is ending: States in the Northeast and a few scattered elsewhere experienced large initial spikes but were able to mostly contain the virus and substantially brought down new infections. <a href="https://www.nytimes.com/interactive/2020/us/new-york-coronavirus-cases.html" target="_blank">New York</a> is a good example of this.</li><li>Places still in the first wave: Several states in the South and West – see <a href="https://www.nytimes.com/interactive/2020/us/texas-coronavirus-cases.html" target="_blank">Texas</a> and <a href="https://www.nytimes.com/interactive/2020/us/california-coronavirus-cases.html" target="_blank">California</a> – had some cases early on, but are now seeing massive surges with no sign of slowing down.</li><li>Places in between: Many states were hit early in the first wave, managed to slow it down, but are either at a plateau – like <a href="https://www.nytimes.com/interactive/2020/us/north-dakota-coronavirus-cases.html" target="_blank">North Dakota</a> – or are now seeing steep increases – like <a href="https://www.nytimes.com/interactive/2020/us/oklahoma-coronavirus-cases.html" target="_blank">Oklahoma</a>.</li><li>Places experiencing local second waves: Looking only at a state level, <a href="https://www.nytimes.com/interactive/2020/us/hawaii-coronavirus-cases.html" target="_blank">Hawaii</a>, <a href="https://www.nytimes.com/interactive/2020/us/montana-coronavirus-cases.html" target="_blank">Montana</a> and <a href="https://www.nytimes.com/interactive/2020/us/alaska-coronavirus-cases.html" target="_blank">Alaska</a> could be said to be experiencing second waves. Each state experienced relatively small initial outbreaks and was able to reduce spread to single digits of daily new confirmed cases, but are now all seeing spikes again.</li></ol><p>The trends aren't surprising based on how states have been dealing with reopening. The virus will go wherever there are susceptible people and until the U.S. stops community spread across the entire country, the first wave isn't over.</p>
What Could a Second Wave Look Like?<p>It is possible – though at this point it seems unlikely – that the U.S. could control the virus before a vaccine is developed. If that happens, it would be time to start thinking about a second wave. The question of what it might look like depends in large part on everyone's actions.</p><p>The <a href="https://dx.doi.org/10.1086%2F592454" target="_blank">1918 flu pandemic</a> was characterized by a mild first wave in the winter of 1917-1918 that went away in summer. After restrictions were lifted, people very quickly went back to pre-pandemic life. But a second, deadlier strain came back in fall of 1918 and third in spring of 1919. In total, <a href="https://www.cdc.gov/flu/pandemic-resources/1918-commemoration/1918-pandemic-history.htm" target="_blank">more than 500 million people were infected</a> worldwide and upwards of <a href="https://theconversation.com/compare-the-flu-pandemic-of-1918-and-covid-19-with-caution-the-past-is-not-a-prediction-138895" target="_blank">50 million died</a> over the course of three waves.</p><p>It was the combination of a quick return to normal life and a mutation in the flu's genome that made it more deadly that led to the horrific second and third waves.</p><p>Thankfully, the coronavirus appears to be much more <a href="https://doi.org/10.1016/j.meegid.2020.104351" target="_blank">genetically stable</a> than the influenza virus, and thus less likely to mutate into a more deadly variant. That leaves human behavior as the main risk factor.</p><p>Until a <a href="https://theconversation.com/what-needs-to-go-right-to-get-a-coronavirus-vaccine-in-12-18-months-136816" target="_blank">vaccine or effective treatment is developed</a>, the tried-and-true public health measures of the last months – <a href="https://theconversation.com/this-simple-model-shows-the-importance-of-wearing-masks-and-social-distancing-140423" target="_blank">social distancing,</a> <a href="https://theconversation.com/masks-help-stop-the-spread-of-coronavirus-the-science-is-simple-and-im-one-of-100-experts-urging-governors-to-require-public-mask-wearing-138507" target="_blank">universal mask wearing</a>, frequent hand-washing and avoiding crowded indoor spaces – are the ways to stop the first wave and thwart a second one. And when there are surges like what is happening now in the U.S., further reopening plans need to be put on hold.</p>
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