| Abstract: | Since 2010, the population of Puerto Rico has declined by 11.8％ and is currently 3.3 million people 1]. This worrisome trend is a result of a plethora of island-wide challenges spanning financial difficulties, natural disasters, and epidemics. Following over a decade of economic hardship and debt, incapacitating hurricanes, Irma and Maria, destroyed large swaths of the island in 2017. While still recovering from that disaster, a magnitude 6.4 earthquake centered about 5 miles off the southwestern coast on January 7, 2020, destroying buildings and roads in southwestern Puerto Rico. This event, and subsequent aftershocks that continue until today, further aggravate an already stressed population. In the mix, viral epidemics have brought further economic, social, and health-related suffering. Puerto Rico was the centre of the 2016–2017 Zika virus infections, representing over 85％ of the US infections in 2016 2]. |
