DODGING THE DESANTIS FLU:

As of November 22, Puerto Rico had fully vaccinated 74 percent of its population -- a higher proportion than any other US state or territory -- and had among the lowest Covid-19 death rates since the start of the pandemic, with 102 in 100,000 people dying from the virus.

By comparison, Florida's vaccination rate is far more typical for the US; it has administered two shots to 60.9 percent of its population, slightly above the national average of 59.2 percent. That's after Florida led the country in total caseloads for months, and after significant loss of life: Florida residents have died of the virus at nearly triple the rate of Puerto Rico residents.

Throughout the US, politics has been a key factor in determining how states have fared during the Covid-19 pandemic. States that embraced the individualistic approach of the Trump administration, sometimes ignoring scientific guidelines and avoiding mandates, have seen worse outcomes than states that took more comprehensive actions to stop the spread of Covid-19.

Florida Republican Gov. Ron De Santis has been threatening government agencies with millions in fines if they mandate vaccines for employees and has boosted the voices of anti-vaxxers. At the same time, Puerto Rico Gov. Pedro R. Pierluisi, a member of the Partido Nuevo Progresista who caucused with Democrats while a commissioner in Congress, has quietly implemented some of the broadest vaccine mandates in the country across the private and public sectors.

And while Floridians have taken to the streets with signs reading "No jab, no job, no way," Puerto Ricans have largely embraced the mandates without protest. Though coronavirus cases have risen across the mainland in recent weeks, Puerto Rico has avoided a spike, with cases and hospitalizations even trending downward. [...]

The federal and Puerto Rican governments failed to adequately respond to the hurricane and the quakes, with the Trump administration deliberately delaying more than $20 billion in relief. The Puerto Rican government mismanaged the funds that were delivered.

NGOs and community leaders picked up the pieces, which built trust with the people they served. In the immediate aftermath, they helped assess the damage, mobilized volunteers, set up emergency support centers, helped clear routes to water sources and medical facilities, and distributed basic supplies including non-perishable food, medicine, water purifiers, hygiene kits, and tents.

"It was the NGOs that put together everything because the government, locally and federally, couldn't deal with the aftermath of Hurricane Maria," said José Rodríguez-Orengo, executive director of the Puerto Rico Public Health Trust (PRPHI), a public health institution that partners with the Puerto Rican government and community groups.

Data gathered after Hurricane Maria was crucial. PRPHI captured data on individuals whose homes had been damaged or destroyed and who were staying in camps in the southwest of the island. It provided that information to the local Department of Health to ensure that victims received the services they needed.

And Voces, a coalition of Puerto Rican community groups and health care providers focused on immunization, provided flu vaccines in the wake of both disasters to people who could not otherwise access a vaccination site. That was important because the lack of clean drinking water and overpopulation at emergency shelters was creating the ideal conditions for the flu to spread and become a serious public health issue.

By the time the coronavirus pandemic hit, such organizations had already established the infrastructure and community relationships necessary for effective Covid-19 prevention and vaccination campaigns under difficult circumstances -- an advantage that Puerto Rico might have had over other states and territories. Voces alone, for example, has administered close to a quarter of a million vaccine shots.

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