For six weeks this summer, it appeared that an idyllic Turks and Caicos was beating back the coronavirus. As cases continued to rise elsewhere in the Caribbean, the sun-splashed island chain just 575 miles southeast of Miami was holding its number of infections steady at 12. Then came June 25.
The island's premier, Sharlene Cartwright Robinson, standing at the podium in a Facebook Live news conference, announced that 12 new cases had been registered, doubling the number of positive COVID-19 cases overnight. Four days later, she appeared again, this time confirming more cases and "an exponential rise."
By June 29, the total number of people infected in the Turks and Caicos Islands with COVID-19 had jumped to 41.
One person, Health Minister Edwin Astwood would later confirm, was "a superspreader," who had infected at least 12 individuals, who in turn, collectively infected at least 11 more. With residents not cooperating with contact tracing efforts, there were still other positive cases, Astwood said, with no known contact with individuals already identified with the disease.
The case of the Turks and Caicos, which found its situation highlighted by the Pan American Health Organization during one of its weekly updates on the spread of the virus in the Americas, shows how even in small island communities suppressing the spread of the new coronavirus has been difficult.
Nearly six months after confirming its first positive case, the British overseas territory is struggling to contain COVID-19 as its confirmed cases have multiplied.
On Wednesday, the territory of about 40,000 residents reported 614 COVID-19 infections and its first confirmed case on the island of South Caicos, one of only a handful of inhabited islands in the chain that was still COVID free.
"Everybody in South Caicos is so worried," said Emily Saunders, 76, a local community leader, former health minister and wife of former Chief Minister Norman Saunders. "People kept saying, 'It's not in South Caicos,' and we kept on saying, 'You never know. You never know because they hadn't been doing any testing.' Persons were not listening. Persons were not adhering to the protocol. We had trouble getting people to wear their masks."
Since the news hit late Tuesday night that the virus had arrived on the island, Saunders said: "Everybody now is wearing their masks because they are so worried.
"And to tell you the truth, I can't say if we are prepared. I can't say 'Yes' and I can't say, 'No,'" she added. "My concern is if someone becomes very ill and if they have breathing problems. I don't know if they have ventilators to put them on. It's really a scary thing."
Astwood, the health minister, said so far the number of hospitalizations has been low and only five COVID-19-related deaths have been recorded in the territory. Anyone becoming seriously ill, he said, would be taken to the island of Providenciales, where the government recently authorized two private labs to help with testing but barred them from carrying out tests on symptomatic individuals.
As for the spread to South Caicos and other family islands, Astwood said, "it was just a matter of time."
"Once I looked at the behavior of people, I said, 'Well, we can try and stop this, we can put all of the measures in place, but we cannot be guarding every person 24-7,'" he said. "If you don't see people taking the necessary precautions and be responsible for themselves and their family, you know that eventually these cases will reach the other islands."
Across the Caribbean, public health experts are seeing a continuing surge of the virus. While the alarming rise has coincided with the reopening of countries' borders to international tourists, a number of Caribbean leaders and health ministers have decried the behavior of residents. Locals, they have noted, are not only flouting social distancing and mandatory mask-wearing rules, but they are holding mass gatherings including parties, leading to the spread.
With their economies heavily dependent on tourism, Caribbean governments have struggled with how to keep economies open while managing the pandemic. Some have been more successful than others, while having to modify policies on the fly.
In the Bahamas, where the response has been criticized as knee-jerk, and at times even chaotic, the government went from fully reopening its borders on July 1 to shutting it down weeks later as cases and hospitalizations saw an alarming spike.
In Jamaica, where the opposition's message of government mismanagement of the pandemic failed to resonate with voters after they returned Prime Minister Andrew Holness to power last week, the response has been to keep the economy open while shutting down parts of the country to try to contain the spread.
In the Turks and Caicos, a smaller tourism-dependent economy than that of either Jamaica or the Bahamas, the government has resisted efforts to close the country back down even though all of the major hotels and resorts are closed.
"You have to balance lives and livelihoods," Astwood said. "Our persons don't have food in their houses; their utilities are off. We don't have enough money to pay everybody what they were making every month. It's hard to go and tell people you're going to lock people down. ... You have to strike a balance. Now if things get real out of hand and that is the only choice, we will move to it."
C. Washington Misick, a former chief minister and current leader of the opposition in the Turks and Caicos, said he doesn't think a full shutdown of the country's borders is the solution. But the current government, he said, has not handled the pandemic well.
"It has been proven that the cases are not coming from the outside; the cases are community-based, so there is no point in shutting down the borders," said Misick, leader of the Progressive National Party. "In fact I don't even think there is much value at this stage of having the nighttime curfew of 8 o'clock in the evening because what it does is it hurts businesses, the hospitality sector."
While he didn't have figures offhand, Misick, a former finance minister, said the economic impact of COVID-19 has been severe in the territory.
"Fortunately for us, we have significant cash reserves and the government has been able to meet its obligations. They haven't burned through all of the cash yet," he said of Robinson's ruling People's Democratic Movement government. "The economic impact on the population, particularly those who are unemployed and vulnerable, has been serious; people are losing their apartments, people aren't having enough to eat. I don't think the government has done a fantastic job in providing for people."
Nor has it done a good job, Misick said, in testing, contact tracing or providing quarantine, which is particularly pertinent now that the disease is spreading beyond the high-end communities of Providenciales and to lesser developed family islands where people live in multi-generational households, are older and may not have enough rooms or bathrooms to self-isolate.
"I think the government has not been exactly forthcoming, and a bit too relaxed about this. They haven't put the resources behind it that should have gone behind it. The response to this virus is resource driven," he said.
If there is one point that he and Astwood agree on, it's the casualness with which people in the local communities are taking the deadly disease.
While health officials are still investigating what triggered the initial "exponential growth of the virus," Astwood believes the culprit is a training session at a hotel, which he said was illegal at the time due to restrictions on large gatherings.
"It just got out of hand from there," he said. "Each one of those persons infected two persons and each of the new cases infected two more and so on; that's what we saw happened here."
Others note that around the same time as the training, locals, emerging from weeks of 24-hour lockdowns and curfews, were staging parties as the island began welcoming back returning residents and students prior to the full reopening of its borders on July 22
Soon, the virus wasn't just spreading in Providenciales, the main tourism center where visitors enjoy conch and bone fishing amid pastel pink buildings and turquoise beaches, it was being confirmed in the nearby family islands of Parrot Cay and North Caicos. On Aug. 24, it finally reached the capital of Grand Turk.
"There was a wedding and some people (from Providenciales) went to the wedding," Astwood said. "They spread it to one person and that person went to work and we had one case at the Wellness Center, where we kept our elderly patients and then one of the workers tested positive there."
On Wednesday, with 12 confirmed cases in Grand Turk, COVID-19 finally arrived in South Caicos, leaving just Salt Cay, Middle Caicos, Pine Cay and Ambergris Cay without the deadly disease, and the government trying to figure out how to suppress it.
Astwood said while closing the country to international tourists doesn't appear to be an option currently, further shutting islands off to inter-island travel is. He also said the government plans to enforce a law it passed several weeks ago, allowing residents to be fined for not wearing masks or for actively spreading the disease.
"We want people to comply with the regulations: the mask wearing, the 6 feet, the hand sanitizer," he said. "If we get full compliance, it will stop the virus. The main challenge we have is influencing human behavior, for people to act responsibly."
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