Puerto Rico's Zika crisis: At least 1 in 4 residents may become infected by the virus

With more than a thousand new cases of Zika reported in Puerto Rico for the first week of September, the numbers of those infected may rise even higher as the U.S. territory enters its fall rainy season.

Between Aug. 26 and Sept. 2, there were 1,024 new positive cases of Zika reported in Puerto Rico, according Candice Burns Hoffmann, a press officer with the National Center for Emerging and Zoonotic Infectious Diseases.

"These reflect just diagnosed cases," she said. "Because many people with Zika don't have symptoms, the number of people who have contacted Zika is likely much higher."

Outbreaks of mosquito-borne viruses like Zika tend to peak in the late summer and fall in Puerto Rico due to "hotter months with higher rainfall," Hoffmann said, adding that health officials fear that Zika will continue to spread and increase in the coming months.

With more than 16,000 cases already confirmed, Puerto Rico has had the highest number of reported cases of the other U.S. territories that have been affected by Zika.

The Zika carrier, the Aedes aegypti mosquitoes, like warmer weather and are also able to replicate the virus more efficiently at higher temperatures, she said. Increased rainfall can also be problematic because Aedes aegypti is known as a "container-breeding mosquito" because it likes to lay eggs in and around standing water.

"[There are] two wet times of the year, September through November, and a smaller rainy season in May," AccuWeather Meteorologist Jim Andrews said, adding that Puerto Rico sees an average of 73 inches of rainfall each year.

In this June 12, 2008, file photo, people walk and play on a beach in San Juan, Puerto Rico. People have become increasingly reluctant to travel to an island where the Zika virus has infected thousands of people and was linked to the first microcephaly case acquired on U.S. soil. (AP Photo/Brennan Linsley, File)

The average rainfall in May is around 8 inches, while September, October and November all have an average between 8 and 9 inches, he said. In addition to increased rainfall, temperatures between July and into October average around 82 F (28 C) , which further increase the breeding of the mosquito populations.

Despite recent tropical storm activity in the region, which can also increase breeding grounds for disease-carrying mosquitoes, Andrews said Puerto Rico rainfall has been slightly below normal during August and so far in September.

Slightly below-average precipitation has done little to slow what is becoming a major concern for health officials as the outbreak of Zika in Puerto Rico continues to spread.

"It's unknown at this time if Zika transmissions in Puerto Rico have reached its peak," Hoffmann said, adding that different parts of the island are also experiencing different rates of transmission, and not every location in Puerto Rico may peak at the same time.

"In addition to the 16,000 plus reported cases of Zika, there have been more than 1,000 pregnant women who have tested positive for Zika virus," she added. "This could result in hundreds of babies being born with microcephaly in the coming months."

The Aedes aegypti mosquito is also indigenous to Puerto Rico. These mosquitoes live in tropical, subtropical and in some temperate climates, making it even more difficult for health officials to control.

"It is very difficult to control or eliminate Aedes aegypti because they have adaptations to the environment that make them highly resilient," Hoffmann said. "It is likely that Aedes aegypti is continually responding or adapting to environmental change."

In this May 23, 2016, file photo, an Aedes aegypti mosquito sits inside a glass tube at the Fiocruz institute where they have been screening for mosquitos naturally infected with the Zika virus in Rio de Janeiro, Brazil. (AP Photo/Felipe Dana, File)

For example, it was recently found that Aedis aegypti is able to undergo immature development in broken or open septic tanks in Puerto Rico, resulting in the production of hundreds or thousands of mosquitoes every day.

In addition to combating natural adaptations, Hoffmann said they have also seen that there is a wide variety of resistance to some insecticides in Puerto Rico.

With more than 16,000 reported cases, less than 1 percent of the population of Puerto Rico has currently tested positive for Zika. However, the number could rise to 20 to 25 percent if the trend continues as it has.

In August, Puerto Rico's lead epidemiologist for the Centers for Disease Control and Prevention's Tyler Sharp told NPR that Zika is even more complicated than previous outbreaks of Dengue and Chikungunya, which were unable to be stopped by public health officials, because it is also transmitted through sexual activity.

"Since local transmission of Zika virus was first reported in Puerto Rico in December 2015, it has become widespread on the island," Hoffmann said. "Estimates suggest that if trends continue, at least one in four people, including women who become pregnant, may become infected with the Zika virus."

By Michael Kuhne,
Puerto Rico's Zika crisis: At least 1 in 4 residents may become infected by the virus

As Puerto Rico Works to Develop New Fiscal Plan, Murray Warns Against Efforts to Weaken Basic Worker Protections; Urges Greater Access to Women’s Reproductive Health Care in Light of Zika

Efforts to restructure Puerto Rico’s debt and implement “PROMESA” take critical step with appointment of new oversight board

In new letter, Murray called on board to ensure basic worker protections, including a minimum wage increase and compliance with new overtime rule

Murray also urged Puerto Rican officials to increase access to health care and resources for women and children impacted by Zika

Murray: “As American citizens, the 3.4 million residents of Puerto Rico deserve the equivalent benefits and protections afforded to residents of the mainland”

(Washington, D.C.) – On Friday, September 9, 2016, Senator Patty Murray (D-WA), the top Democrat on the Senate Health, Education, Labor, and Pensions (HELP) Committee, sent a letter calling on the new Puerto Rico Financial Oversight and Management Board, the group tasked with reviewing a new fiscal plan for the island as part of Puerto Rico Oversight, Management, and Economic Stability Act (“PROMESA”), to address several immediate and systemic issues facing the nearly 3.4 million Puerto Rican citizens who have been suffering under one of the worst financial crises in memory.

On August 31, 2016, the Obama Administration named the seven members of the new oversight board, which Congress established in PROMESA to help Puerto Rico control its spending and restructure its debt load.

“At a time when the residents of Puerto Rico are experiencing so much economic insecurity, it is critically important to proceed with their best interests in mind,” wrote Senator Murray to the recently appointed oversight board. “I urge you to address Puerto Rico’s debts holistically and work to develop a comprehensive strategy that will address certain systemic…problems. The future of Puerto Rico will depend on not only addressing the problems of the past but ensuring that it becomes a place where people can make a living, see a future for themselves, and thrive.”  

In the letter, Senator Murray expressed her serious concerns regarding provisions in PROMESA that threaten a minimum wage increase, expanded overtime protections, and adequate pension funding for Puerto Rican workers. Senator Murray also urged Puerto Rican officials to increase access to health care and resources for women and children impacted by Zika. The letter outlines specific concerns with:

• Provisions affecting minimum wage increases, specifically for Puerto Ricans at 25 years old and younger;
• Possible two-year implementation deferment of the updated rule on overtime;
• Pension cuts facing government workers who have already paid their fair share into the retirement system; and
• Significant lack of access to effective long-acting reversible contraceptives, high cost, incomplete insurance coverage, and lack of trained providers to deal with the ongoing Zika virus epidemic.

As Puerto Rico Works to Develop New Fiscal Plan, Murray Warns Against Efforts to Weaken Basic Worker Protections; Urges Greater Access to Women’s Reproductive Health Care in Light of Zika

Puerto Rico Doctors Warn of Scarce Resources to Fight Zika

Doctors in Puerto Rico are warning that the U.S. territory does not have the resources to handle the fallout of a Zika epidemic as officials report an uptick in the number of fetuses with malformations that were carried by women infected with the virus.

The cases are among the first of what health officials believe could reach a couple hundred next year, sparking concerns about the lack of funds and specialists needed to care for children with severe birth defects on an island mired in a deep economic crisis.

"We are talking about babies that will have problems with hearing disorders, developmental disorders," said Dr. Nabal Bracero, who runs a fertility clinic. "And now, because of the complexity of Puerto Rico's financial situation, our health system is not ready for that."

So far, 13 dead fetuses belonging to Zika-infected mothers have been identified. Several of them presented signs of brain damage, and one was sent to the U.S. Centers for Disease Control and Prevention in Atlanta to be analyzed, according to Health Secretary Ana Rius.

It is unclear whether the 13 cases involved miscarriages or abortions. Jillian Oliveras, a spokeswoman for Puerto Rico's Health Department, said no further information would be released because of privacy laws.

Puerto Rico reported the first Zika-related microcephaly case acquired on U.S. soil in May, and a recent study estimates that up to 10,300 pregnant women on the island could be infected with Zika and that between 100 to 270 babies could be born with microcephaly.

"We are moving into what I call the perfect storm, which will be spring of 2017," Bracero said. "We will have a peak of cases with the least amount of resources."

Puerto Rico faces a nearly $70 billion public debt load it is seeking to restructure, and a federal control board is expected to soon take over the island's finances as a result of a recent U.S. rescue package. Government officials have warned there is barely enough money to keep providing essential services such as education, health and public safety.

The island's Health Department is currently identifying how many medical specialists there are and where they are located as it prepares for a surge in cases, said Dr. Miguel Valencia Prado, director of the department's Division of Children with Special Medical Needs.

The cost to treat a microcephaly case throughout a person's lifetime could range roughly from $3.8 million to $10 million, depending on the severity of the case, he said, adding that he was concerned given Puerto Rico's financial situation plus other limits as a result of being a U.S. territory.

"We cannot expand many services given a cap on Medicaid," he said, referring to a U.S. law that limits the amount of federal funding Puerto Rico receives. "We have to figure out how to make this work."

His concern comes as the CDC director warned Friday that the U.S. government has essentially run out of money to fight Zika amid funding delays, and that microcephaly cases will increase as a result. Previously, Republicans who delayed acting on a $1.9 billion request to fight Zika said none of the money should go to affiliates of Planned Parenthood in Puerto Rico.

Puerto Rico has a total of 17,871 Zika cases, including 1,517 pregnant women. A total of 144 people have been hospitalized, including 45 diagnosed with a temporary paralysis condition known as Guillain-Barre. Two people who had Zika coupled with other medical conditions have died, and a third person between 35 and 45 years old died in July after becoming infected with Zika and developing Guillain-Barre.

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Danica Coto on Twitter: www.twitter.com/danicacoto

By DANICA COTO
Puerto Rico Doctors Warn of Scarce Resources to Fight Zika

Back Again: This Time Obama Administration Wants a Taxpayer Bailout for Puerto Rico

Less than two months after Congress passed a package aimed to provide financial relief for Puerto Rico, the Obama administration is already at it again—this time seeking an outright taxpayer bailout for the U.S. territory through additional Medicaid funds and access to the earned income tax credit.

Why does Puerto Rico need help? After decades of failed economic policies and rising debt, Puerto Rico began defaulting on some of its debt payments in 2015. Faced with substantial government spending (including massive pension costs), a declining economy, and rising interest rates, Puerto Rico was on track to default on multiple other debt payments.

Under Congress’ attempted relief, most debtors still won’t receive full payment. After all, it wouldn’t be relief for Puerto Rico if it actually had to pay all its bills. Instead, the island will have access to bankruptcy-like proceedings that will allow it to write off a large portion of its debt.

This is precisely what the administration wanted. The island now has access to so-called “Super Chapter 9” bankruptcy that will allow Puerto Rico to write down not only its municipal debts (in the same way that states can choose to do), but also its constitutionally protected territorial debt.

In addition, Puerto Rico has been afforded an unprecedented stay on litigation that will allow the island’s government to operate free of legal challenges for months.

But apparently allowing the island to renege on its constitutional obligations and stripping creditors of their right to access the courts wasn’t enough. Now the administration is back at it again, seeking an outright taxpayer bailout for the island.

In a letter to the recently appointed Congressional Task Force on Economic Growth in Puerto Rico, the administration called for granting Puerto Rico the same access as states to Medicaid funds and the earned income tax credit.

But Puerto Rico is not a state and its residents are not subject to federal income taxes. So why should U.S. citizens who do pay federal income taxes have to fork over an extra $36.2 billion over the next 10 years to provide benefits to people who do not pay those taxes?

Puerto Rico and other U.S. territories already receive a disproportionate share of federal welfare spending, and they get these benefits without their residents paying federal income taxes.

Providing additional Medicaid funds to Puerto Rico is not really any different than a pure cash bailout. Money is fungible, and what Puerto Rico doesn’t have to spend from its own resources to provide Medicaid, it can use on whatever else it wants.

The same is true for the earned income tax credit, except that the bailout would go directly to Puerto Rican residents as opposed to its government. But Puerto Ricans aren’t subject to federal income taxes, so why should they receive federal income tax credits?

The administration argues that the earned income tax credit is “one of the most powerful policy tools” to stimulate and encourage work. Stimulating work is an important objective in Puerto Rico where only 38 percent of the island’s working-age population has a job in the formal economy.

But the tax credit would have little impact in Puerto Rico and would be ripe for fraud and abuse.

For starters, the federal minimum wage in Puerto Rico is as large an impediment to job creation as a $20 per hour minimum wage would be on the mainland. Employers who can’t afford to pay workers the minimum wage will still not be able to pay the minimum wage with an earned income tax credit. Instead, the benefits will primarily flow to Puerto Rico’s more fortunate residents—those with a formal job.

Moreover, taxpayers can expect to foot the bill for unlawful earned income tax credit payments. Even when implemented by the IRS, which has access to taxpayers’ federal income tax returns, this tax credit has an excessively highimproper payment rate of about 25 percent.

Just imagine how high the improper payment rate would be in Puerto Rico where residents don’t file federal taxes. Puerto Rico’s Treasury, which would presumably administer the tax credit, would have no incentive to prevent improper payments. After all, mainland taxpayers would be funding the subsidy.

Puerto Rico has the authority to enact and fund its own version of an earned income tax credit. Instead, the territory’s politicians have prioritized maintaining a bloated public sector with much higher pay than the island’s private sector workers.

Congress has already intervened more than it should have in Puerto Rico’s financial crisis. Federal taxpayers shouldn’t be forced to foot the bill for Puerto Rico’s poor economic and fiscal policies.

If Congress does cave in to the bailout demands, states and localities will be encouraged to engage in the same reckless policies so that they too can receive a federal bailout.

Rachel Greszler / Salim Furth 
Back Again: This Time Obama Administration Wants a Taxpayer Bailout for Puerto Rico

White House Selects Members of Puerto Rico Control Board

WASHINGTON — 

The White House on Wednesday announced the members of a new oversight board to help manage Puerto Rico's debt-stricken economy, with President Barack Obama expressing confidence that the panel could turn around a dire financial situation.

Legislation passed in June set up the seven-member control board and required the White House to choose from a list recommended by Republican and Democratic congressional leaders by September. Similar to a board that oversaw the District of Columbia in the late 1990s, the panel will oversee negotiations with creditors and the courts over reducing some of Puerto Rico's roughly $70 billion debt. It will also oversee the U.S. territory's development of a fiscal plan to bring the island out of its financial woes.

In a statement, Obama said those appointed to the board have a broad range of experiences and the depth of knowledge needed to tackle the challenge of righting Puerto Rico's embattled economy. Four of the members of the board are of Puerto Rican descent.

"The task ahead for Puerto Rico is not an easy one, but I am confident Puerto Rico is up to the challenge of stabilizing the fiscal situation, restoring growth and building a better future for all Puerto Ricans,'' Obama said.

According to the White House, members of the board are Carlos Garcia, founder and CEO of private equity firm Bay Boston and a former CEO of Puerto Rico's Government Development Bank; Ana Matosantos, a former director of the California Department of Finance; Jose Ramon Gonzalez, president and CEO of the Federal Home Loan Bank of New York; Andrew Biggs, a scholar at the American Enterprise Institute; University of Pennsylvania law professor David Skeel; former bankruptcy judge Arthur Gonzalez; and Puerto Rico insurance executive Jose B. Carrion.

The governor of Puerto Rico will be an eighth, nonvoting member of the board. The board must elect a chair, hire staff and open an office within 30 days.

White House Selects Members of Puerto Rico Control Board

WHITE HOUSE ANNOUNCES MEMBERS OF PUERTO RICO OVERSIGHT BOARD

We finally know who will essentially govern Puerto Rico for the foreseeable future, after the White House released the names of President Barack Obama’s appointees to the Oversight Board established by PROMESA. Here are their names from a Dow Jones Business News report:

THE LEGISLATION REQUIRES THE OVERSIGHT BOARD, SELECTED BY MR. OBAMA FROM LISTS OF CANDIDATES SUBMITTED BY CONGRESSIONAL LEADERS, TO APPROVE FISCAL PLANS SUBMITTED BY PUERTO RICO’S GOVERNOR. FOUR SELECTIONS ARE CANDIDATES SUBMITTED BY REPUBLICANS, WHILE THREE ARE FROM DEMOCRATS.

THE DEMOCRATIC-SPONSORED APPOINTEES INCLUDE ARTHUR GONZALEZ, THE FORMER CHIEF JUDGE OF THE U.S. BANKRUPTCY COURT IN MANHATTAN, WHO PRESIDED OVER SOME OF THE MOST FAMOUS CORPORATE BANKRUPTCY CASES, INCLUDING ENRON CORP., WORLDCOM INC. AND CHRYSLER LLC. THE OTHER APPOINTEES ARE ANA MATOSANTOS, CALIFORNIA’S FINANCE DIRECTOR FROM 2009 TO 2013, AND JOSÉ RAMÓN GONZÁLEZ, CHIEF EXECUTIVE OF THE FEDERAL HOME LOAN BANK OF NEW YORK.

THE REPUBLICAN-SPONSORED APPOINTEES INCLUDE CARLOS GARCIA, A PRIVATE-EQUITY EXECUTIVE WHO PREVIOUSLY SERVED AS PRESIDENT OF THE PUERTO RICO GOVERNMENT DEVELOPMENT BANK; JOSE CARRION III, AN INSURANCE EXECUTIVE BASED IN SAN JUAN, PUERTO RICO; ANDREW BIGGS, A FELLOW AT THE AMERICAN ENTERPRISE INSTITUTE IN WASHINGTON; AND DAVID SKEEL, A LAW PROFESSOR AT THE UNIVERSITY OF PENNSYLVANIA.

With these appointments, the pieces are in place for Puerto Rico’s new, unelected Oversight Board to take office and begin operations, beginning with approving a fiscal plan to be submitted soon by Governor Alejandro García Padilla.

by William-Jose Velez
WHITE HOUSE ANNOUNCES MEMBERS OF PUERTO RICO OVERSIGHT BOARD