The Trump administration slow response seems to be the modus operandi when it comes to assisting the US citizens that live in the island

The blatant disregard for Puerto Rican lives by this White House is what second-class American citizenship looks like.

Like a patient with a pre-existing condition that is vulnerable to spreading disease, Puerto Rico awaits the inevitable arrival of the coronavirus pandemic with one hand tied behind its back. As the disease spreads across the United States, the guidance from the federal government says Americans can turn to their state governments for testing. But in this America, not all Americans are equal.

In a reprise of the last two crises Puerto Rico has lived through in less than three years, the island’s residents will once again have to wait for assistance. The Centers for Disease Control and Prevention (CDC) status for public health laboratory coronavirus testing in Puerto Rico reads: “in progress,” which translates to no tests in sight. While all 50 states are currently testing patients, albeit with strict criteria due to the limited quantity of tests available, Puerto Rico cannot. It doesn’t seem to matter that Puerto Rico is a hub in the global tourism economy that can be an easy entry or exit point for the virus in connection with the mainland. It welcomed close to 4 million visitors in 2019. In the first month of this year, 200,000 cruise ship passengers passed through its port and 21,000 passengers make its way through its international airport every day.

Over the weekend, a cruise ship passenger from Italy was placed in isolation at a local San Juan hospital after displaying symptoms of pneumonia. Because there is no local testing available, her samples were sent to the CDC in Atlanta. Four other suspected cases await test results. At a press conference, Puerto Rico’s Governor Wanda Vazquez and her team assured the public that tests will be available on the island by next week. Puerto Rico has to wait.

To say the island is unprepared for another disaster is an understatement. Its $74 billion debt obligation is managed by an unelected Fiscal Oversight Management Board (FOMB) that has mandated tax increases and reductions in services to raise revenues. With unemployment that is double that of the country as a whole and the poverty rate at 43%, many of the island’s struggling residents have chosen to migrate to states like Florida in search of a better life.

Since 2004, Puerto Rico has lost over half a million people that have taken talent, labor and tax revenues with them. The brain drain has hit health care particularly hard, overwhelming hospitals that were already financially strained under austerity measures. Puerto Ricans often wait for months for an appointment with a specialist. The problem worsened after Hurricane Maria, and it took the death of a child in the town of Vieques for FEMA to approve funds to rebuild its only hospital. Vieques had been waiting for three years.

When the coronavirus finally tests Puerto Rico’s frail healthcare system, the group to be hit hardest will be the elderly. According to the Census, in 2017 elderly Americans on the island made up 26% of the population, the age group deemed most at risk for severe symptoms. Close to 40% of this population lives in poverty and close to the same number of these older adults work full or part-time in an economy that is hanging on by a thread. As community spread increases, people will be asked to stay home to slow down transmission. Asking Puerto Rico’s labor force to not work is one more blow that the island cannot take. People will have to decide between pay checks or self-quarantines given that paid sick leave is a luxury for many Americans.

Puerto Ricans waited in the dark for disaster relief after Hurricane Maria devastated the island. Help was slow to come and when it came it was chaotic and inadequate compared to relief efforts in other states. More than 3,000 lives were lost as a result of the disaster and slow recovery—a fact that was disputed by the White House. Long-term aid to rebuild the infrastructure and stimulate the economy was stalled for two years by the Trump Administration, citing concerns of corruption on the island. And while the recent earthquakes prompted a partial lift of the hold, severe restrictions remain.

No one will argue that Puerto Rico doesn’t need a radical transformation in governance. Years of mismanagement have taken their toll and weakened the island’s resilience and its ability to argue for unimpeded aid. However, the blatant disregard for Puerto Rican lives by this White House is what second-class American citizenship looks like. The five million Puerto Ricans across the United States with voting power can demand different for loved ones on the island that are sick of waiting, and now will wait while sick.

