In light of the flexibilization of COVID-19 mitigation measures in Puerto Rico, the NGO and scientific collective Ciencia Puerto Rico (CienciaPR, www.cienciapr.org) is calling on the public not to lower their guard and be prepared to respond to a possible surge in cases. This comes following a recent increase in the positivity rate in the country and ongoing surges in Europe and Asia caused by the Omicron subvariant BA.2.

"In Puerto Rico, the COVID-19 epidemic has been under relative control and this has led to the flexibilization of many mitigation measures. But we should not forget that the pandemic is not over," said Dr. Mónica Feliú Mójer, scientist, director of communications for CienciaPR and director of Aquí Nos Cuidamos, a community-based project by CienciaPR focused on COVID-19 prevention and mental health. 

"We are seeing upticks in other regions of the world. The case positivity in Puerto Rico has gone up recently. We know that the effectiveness of vaccines is waning, that not enough people are boosted, and that Omicron is more contagious and evades part of the immune response. All of this, plus the relaxations and pandemic fatigue could lead to another surge. Just as we prepare for hurricane season, we need to be ready to mitigate the next COVID-19 wave so it doesn't get out of control," she emphasized. 

Even though the new CDC and Puerto Rico government guidelines dictate that most people can stop masking in most scenarios and that vaccination and testing requirements have also been relaxed, CienciaPR urges the population to keep using the mask in enclosed spaces and establishments to continue promoting the practice. 

Edmy Ayala Rosado, coordinator of Aquí Nos Cuidamos and manager of community projects for CienciaPR, said that "although in many places the mask is not mandatory, people continue to use it. We invite people to continue to do so. I think we are appreciating that the mask really is freedom; it lets us get on with our lives while helping us prevent disease and deaths."

Masking and other preventions are still key

"The SARS-CoV-2 virus is transmitted primarily through respiratory droplets, so there is a high risk of airborne transmission in a closed or poorly ventilated environment. As a result, facemask use remains a primary measure to prevent exposure to the virus. A mask or respirator is the main physical barrier that reduces the likelihood of viral particles entering the body. Research has shown that an N95 respirator has a filtration capacity of 98.4% and a surgical mask has a filtration capacity of 71.5%. These results demonstrate the effectiveness of masks and respirators in protecting us against exposure to viral particles," explained epidemiologist Dr. Roberta Lugo Robles. 

"Using a good mask in combination with hygiene measures and vaccination continue to be public health practices that will keep people protected," she added.

CienciaPR also urges people to continue to avoid crowds, have their vaccination up to date with the booster, stay home and get an antigen or molecular test if they have symptoms consistent with COVID-19, suspect they have been exposed to the virus or were in a high-risk scenario for infection. They called on the government to be proactive and further emphasize they must closely monitor COVID-19 data and not wait for the situation to worsen before acting.

"Monitoring data carefully should allow us to live with fewer restrictions. The past 90 days have seen conditions conducive to removing restrictions. Now, to avoid waves with unfortunate consequences, it is important to act as soon as we detect an uptick, not wait to see increases in hospitalizations. Then it is too late because the virus has already spread too far. If we act diligently, as soon as the data give us the signal, we can avoid deaths, hospitalizations and extend living without restrictions," said Dr. Rafael Irizarry, a biostatistician at the Harvard School of Public Health who leads COVID-19 data monitoring efforts.

Important to sustain education efforts

CienciaPR encourages individuals, community groups, businesses, and public and private entities to use its free educational toolkit, Aquí Nos Cuidamos. Aquí Nos Cuidamos contains four public service campaigns on preventive measures, vaccination against COVID-19, and mental and emotional health. The project was co-created with community leaders and the scientific community, among others, and contains videos in Spanish and sign language, audios, infographics, and educational guides that are easy to use and distribute.

"In our toolkit, they have a supportive and hopeful COVID-19 education companion, because we know people are tired," added Ayala Rosado, who is also a journalist. 

The educational project Aquí Nos Cuidamos, has more than 200 multimedia contents and guides that answer frequently asked questions about COVID-19 and vaccination, tools to promote vaccination, combat misinformation and promote mental health. They have recently added timely topics such as a guide on "What to consider when deciding when to use a mask", how to answer questions such as "Why are you still using a mask?", and "How to reuse your KN95 or N95 masks", among others. All contents are available for free download at aquinoscuidamos.org.