The US Virgin Islands is halting tourism for a month, hoping against hope to keep out new cases of the coronavirus. Puerto Rico's Senate is closed after several high-ranking officials came down with Covid-19. Hawaii is facing a surge in new infections. Guam is enduring its most restrictive lockdown since the pandemic began.
For months, US islands in the Caribbean and the Pacific avoided much of the agony unleashed by the coronavirus across parts of the mainland, due in part to their early mitigation efforts and relative ease in sealing off borders.
But now the state of Hawaii and these territories are emerging as some of the most alarming virus hot spots in the US, revealing how the coronavirus can spike and then rapidly spread in places with relaxed restrictions, sluggish contact tracing and widespread pressure to end the economic pain that comes with lockdowns.
"People are infecting each other in crowded apartments while hotels sit empty," Dr Jonathan Dworkin, an infectious-diseases doctor who lives on Hawaii's Big Island, wrote in a scathing assessment of Hawaii's pandemic responses in The Honolulu Star-Advertiser.
Dr Dworkin lit into the reluctance by health officials in Hawaii to ramp up testing in the early weeks of the pandemic and said it was the privately funded testing efforts that may have staved off an even more acute crisis. He also questioned why contact tracing operations remain inadequately staffed.
Hawaii, as well as other some islands that are US territories, still have relatively fewer cases and Covid-19-related deaths than several parts of the mainland. But Hawaii now ranks among the states where new cases have grown fastest over the last 14 days.
Meanwhile, confusion is emerging over some pandemic measures there, especially in Honolulu, where gyms remain open but hiking trails and parks are closed; restaurants in the city are also open but residents can't receive visitors into their home from outside their household.
Governor David Ige defended the state's contact tracing efforts, saying in a news briefing this month that Hawaii's operations were "better than average and amongst the best in the country."
At the same time, sharp increases in cases are raising concerns on other American islands. The situation in Guam seems especially problematic, with cases emerging in several schools, at the territorial port authority and on its police force.
The US Virgin Islands, which registered nearly no cases in the early days of the pandemic, is now approaching 1,000 total cases, pushing its per capita infection numbers higher than those of several states.
Dr Esther Ellis, the territorial epidemiologist for the US Virgin Islands, said officials were reacting quickly and thoroughly to outbreaks in the territory, which includes the islands of St Croix, St John and St Thomas.
The islands are requiring temperature checks with thermal scanners for all visitors upon deplaning, she said, and is also conducting aggressive testing.
"We're the only place giving test results back in 24 hours," she said.
Still, authorities there are shutting nonessential businesses and imposing stay-at-home orders. The territory saw its cases surge to 224 per 100,000 residents over the past seven days, the highest per capita increase of any state or territory.
There are exceptions to the crisis unfolding on US islands. American Samoa, an archipelago in the Pacific, remains the only territory or state without a single confirmed case of Covid-19, reflecting early moves to halt nearly all incoming flights, rapidly increase testing and seize on social distancing measures adopted in reaction to a measles outbreak in late 2019.
But the situation in the US Virgin Islands shows how quickly things can change. The territory, which avoided the large outbreaks that were hitting parts of the mainland early in the pandemic, had reopened for leisure visitors on June 1 after an early lockdownthen had to hit the brakes.
Governor Albert Bryan Jr announced this month that hotels and Airbnb operators would be prohibited from accepting new guests for 30 days. Mr Bryan also ordered bars, nightclubs and cabarets to shut down until Aug 31.
The territory, which has 103,000 residents, was already trying to bounce back after being hit in 2017 with Hurricanes Irma and Maria, two rare Category 5 storms. Tourism, which accounts for a third of the economy in the US Virgin Islands, remains its largest source of employment.
Puerto Rico, the most populous US territory with about 3.2 million residents, showcases how the pandemic is accentuating pre-existing economic and political problems. Puerto Rico imposed the nation's first lockdown in March, before California became the first state to do soindeed, before the word "lockdown" started becoming part of the nation's vocabulary.
The stringent measures helped keep the virus under control and the island's underequipped hospitals from becoming overwhelmed. Scientists collaborated to expand the island's testing capacity amid shortages of chemicals and other materials, and promoted pooled testing long before most states.
The lockdown led to an unemployment crisis that forced hundreds of workers to line up for assistance before dawn, and sometimes overnight. Already, Puerto Ricans have endured 14 years of economic sluggishness, several devastating recent hurricanes and, in January, a flurry of earthquakes and aftershocks.
With cases trending upward, Governor Wanda Vazquez held a televised address the previous week to announce a stay-at-home order that would apply for the next three Sundays, the latest in a series of escalating restrictions meant to keep people from socialising with friends or family. Violators of the island's mask order will be subject to a US$100 (S$137) fine, while a nightly curfew remains in effect.
On Thursday, a day after Ms Vazquez imposed the latest restrictions, Puerto Rico's Senate closed after cases were identified among high-ranking elected officials, including several legislators, the speaker of the House of Representatives and two top aides to Pedro R. Pierluisi, the nominee for governor from the pro-statehood New Progressive Party. Representative Jenniffer Gonzalez-Colon, Puerto Rico's nonvoting member of Congress, also tested positive.
"One of the most critical areas remains contact tracing, and the testing that is done," said Mr Lorenzo Gonzalez, Puerto Rico's health secretary. He added that a shortage of testing materials was making it harder for authorities on the island to get the virus under control.
Guam, which trails only the US Virgin Islands among American states and territories where cases climbed fastest in the past week, is dealing not just with a surge in Covid-19 but with simmering criticism of a lockdown, ordered Friday by Governor Lou Leon Guerrero, that includes fines of US$1,000 for violators.
Protesters gathered on Monday (Aug 24) to voice opposition to the measures in Tumon, the heart of Guam's tourism industry, and to urge a recall of Mr Leon Guerrero. The governor warned that such protests could spread the coronavirus and harm the economy even more if restrictions now in place have to be prolonged.